tetano
Editor, Senior Moderator
J Infect Dis. (2012) doi: 10.1093/infdis/jis591
Influenza and malaria co-infection among young children in western Kenya, 2009-2011
Mark G. Thompson1,
Robert F. Breiman2,
Mary J. Hamel3,
Meghna Desai3,
Gideon Emukule4,
Sammy Khagayi5,
David K. Shay1,
Kathleen Morales4,
Simon Kariuki,
Godfrey M. Bigogo2,
M. Kariuki Njenga2,
Deron C. Burton2,
Frank Odhiambo5,
Daniel R. Feikin2,
Kayla F. Laserson5 and
Mark A. Katz1,4
+ Author Affiliations
1Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA (MG Thompson PhD, DK Shay MD MPH, MA Katz MD)
2International Emerging Infections Program and Influenza Program, Global Disease Detection Division, Centers for Disease Control and Prevention, Kenya (RF Breiman MD, G Emukule MSc, K Morales MSc, GM Bigogo, MK Njenga BVM PhD, DC Burton MD JD MPH, DR Feikin MD MSPH)
3Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA (MJ Hamel MD, M Desai PhD,)
4Influenza Program, Centers for Disease Control and Prevention-Kenya (G. Emukule, K. Morales, MA Katz)
5Field Research Station, Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention, Kisumu, Kenya (S Khagayi, S Kariuki PhD, GM Bigogo, DC Burton MD JD MPH, F Odhiambo PhD MPH, MJ Hamel MD, KF Laserson ScD)
Corresponding author and address for reprint requests: Mark G. Thompson, Ph.D., Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop A-32, Atlanta, GA 30333, USA; Telephone: (404) 639-0814; Facsimile: (404) 639-0243; Email: isq8@cdc.gov.
Abstract
Background. Although children <5 years old in sub-Saharan Africa are vulnerable to both malaria and influenza, little is known about co-infection.
Methods. This retrospective, cross-sectional study in rural western Kenya examined outpatient visits and hospitalizations associated with febrile acute respiratory illness (ARI) during a two-year period (July 2009 ? June 2011) in children <5 years old.
Results. Across sites, 45% (149/331) of influenza-positive cases were co-infected with malaria, while only 6% (149/2408) of malaria-positive patients were co-infected with influenza. Depending on age, co-infection was present in 4-8% of outpatient visits and 1-3% of inpatient admissions for febrile ARI. Children with influenza were less likely than those without to have malaria (risk ratios [RRs] = 0?57-0?76 across sites and ages), and children with malaria were less likely than those without to have influenza (RRs = 0?36-0?63). Among co-infected children aged 24-59 months hospital length of stay was 2?7 and 2?8 days longer than influenza-only infected children at the two sites, and 1?3 and 3?1 days longer than those with malaria-only (p?s < .01).
Conclusions. Co-infection with malaria and influenza was uncommon but associated with longer hospitalization than single infections among children 24-59 months old.
http://jid.oxfordjournals.org/content/early/2012/09/14/infdis.jis591.abstract
Influenza and malaria co-infection among young children in western Kenya, 2009-2011
Mark G. Thompson1,
Robert F. Breiman2,
Mary J. Hamel3,
Meghna Desai3,
Gideon Emukule4,
Sammy Khagayi5,
David K. Shay1,
Kathleen Morales4,
Simon Kariuki,
Godfrey M. Bigogo2,
M. Kariuki Njenga2,
Deron C. Burton2,
Frank Odhiambo5,
Daniel R. Feikin2,
Kayla F. Laserson5 and
Mark A. Katz1,4
+ Author Affiliations
1Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA (MG Thompson PhD, DK Shay MD MPH, MA Katz MD)
2International Emerging Infections Program and Influenza Program, Global Disease Detection Division, Centers for Disease Control and Prevention, Kenya (RF Breiman MD, G Emukule MSc, K Morales MSc, GM Bigogo, MK Njenga BVM PhD, DC Burton MD JD MPH, DR Feikin MD MSPH)
3Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA (MJ Hamel MD, M Desai PhD,)
4Influenza Program, Centers for Disease Control and Prevention-Kenya (G. Emukule, K. Morales, MA Katz)
5Field Research Station, Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention, Kisumu, Kenya (S Khagayi, S Kariuki PhD, GM Bigogo, DC Burton MD JD MPH, F Odhiambo PhD MPH, MJ Hamel MD, KF Laserson ScD)
Corresponding author and address for reprint requests: Mark G. Thompson, Ph.D., Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop A-32, Atlanta, GA 30333, USA; Telephone: (404) 639-0814; Facsimile: (404) 639-0243; Email: isq8@cdc.gov.
Abstract
Background. Although children <5 years old in sub-Saharan Africa are vulnerable to both malaria and influenza, little is known about co-infection.
Methods. This retrospective, cross-sectional study in rural western Kenya examined outpatient visits and hospitalizations associated with febrile acute respiratory illness (ARI) during a two-year period (July 2009 ? June 2011) in children <5 years old.
Results. Across sites, 45% (149/331) of influenza-positive cases were co-infected with malaria, while only 6% (149/2408) of malaria-positive patients were co-infected with influenza. Depending on age, co-infection was present in 4-8% of outpatient visits and 1-3% of inpatient admissions for febrile ARI. Children with influenza were less likely than those without to have malaria (risk ratios [RRs] = 0?57-0?76 across sites and ages), and children with malaria were less likely than those without to have influenza (RRs = 0?36-0?63). Among co-infected children aged 24-59 months hospital length of stay was 2?7 and 2?8 days longer than influenza-only infected children at the two sites, and 1?3 and 3?1 days longer than those with malaria-only (p?s < .01).
Conclusions. Co-infection with malaria and influenza was uncommon but associated with longer hospitalization than single infections among children 24-59 months old.
http://jid.oxfordjournals.org/content/early/2012/09/14/infdis.jis591.abstract