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Kelly ME, Gharpure R, Shivji S, Matonya M, Moshi S, Mwafulango A, Mwalongo V, Mghamba J, Simba A, Balajee SA, Gatei W, Mponela M, Saguti G, Whistler T, Moremi N, Mmbaga V. Etiologies of influenza-like illness and severe acute respiratory infections in Tanzania, 2017-2019. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000906. [PMID: 36962965 PMCID: PMC10021583 DOI: 10.1371/journal.pgph.0000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/30/2022] [Indexed: 02/11/2023]
Abstract
In 2016, Tanzania expanded sentinel surveillance for influenza-like illness (ILI) and severe acute respiratory infection (SARI) to include testing for non-influenza respiratory viruses (NIRVs) and additional respiratory pathogens at 9 sentinel sites. During 2017-2019, respiratory specimens from 2730 cases underwent expanded testing: 2475 specimens (90.7%) were tested using a U.S. Centers for Disease Control and Prevention (CDC)-developed assay covering 7 NIRVs (respiratory syncytial virus [RSV], rhinovirus, adenovirus, human metapneumovirus, parainfluenza virus 1, 2, and 3) and influenza A and B viruses. Additionally, 255 specimens (9.3%) were tested using the Fast-Track Diagnostics Respiratory Pathogens 33 (FTD-33) kit which covered the mentioned viruses and additional viral, bacterial, and fungal pathogens. Influenza viruses were identified in 7.5% of all specimens; however, use of the CDC assay and FTD-33 kit increased the number of specimens with a pathogen identified to 61.8% and 91.5%, respectively. Among the 9 common viruses between the CDC assay and FTD-33 kit, the most identified pathogens were RSV (22.9%), rhinovirus (21.8%), and adenovirus (14.0%); multi-pathogen co-detections were common. Odds of hospitalization (SARI vs. ILI) varied by sex, age, geographic zone, year of diagnosis, and pathogen identified; hospitalized illnesses were most common among children under the age of 5 years. The greatest number of specimens were submitted for testing during December-April, coinciding with rainy seasons in Tanzania, and several viral pathogens demonstrated seasonal variation (RSV, human metapneumovirus, influenza A and B, and parainfluenza viruses). This study demonstrates that expanding an existing influenza platform to include additional respiratory pathogens can provide valuable insight into the etiology, incidence, severity, and geographic/temporal patterns of respiratory illness. Continued respiratory surveillance in Tanzania, and globally, can provide valuable data, particularly in the context of emerging respiratory pathogens such as SARS-CoV-2, and guide public health interventions to reduce the burden of respiratory illnesses.
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Affiliation(s)
| | - Radhika Gharpure
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sabrina Shivji
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | | | | | | | | | - Azma Simba
- Ministry of Health, Dar es Salaam, Tanzania
| | - S. Arunmozhi Balajee
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Wangeci Gatei
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Marcelina Mponela
- U.S. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Grace Saguti
- World Health Organization, Dar es Salaam, Tanzania
| | - Toni Whistler
- U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Regassa BT, Gebrewold LA, Mekuria WT, Kassa NA. Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis. J Glob Health 2023; 13:04001. [PMID: 36637855 PMCID: PMC9840062 DOI: 10.7189/jogh.13.04001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Globally, the respiratory syncytial virus (RSV) is the most common etiologic agent of acute respiratory illnesses in children. However, its burden has not been well addressed in developing countries. We aimed to estimate the molecular epidemiology of RSV in children less than 18 years of age with acute respiratory infections in Africa by conducting a systematic review and meta-analysis. Methods We systematically searched PubMed, Scopus, CINAHL, and Global Index Medicus databases to identify studies published from January 1, 2002, to April 27, 2022, following the PRISMA 2020 guideline. We assessed the study quality using the Joanna Brigg's Institute (JBI) critical appraisal checklists. We conducted a qualitative synthesis by describing the characteristics of included studies and performed the quantitative synthesis with random effects model using STATA-14. We checked for heterogeneity with Q statistics, quantified by I2, and determined the prediction interval. We performed subgroup analyses to explain the sources of heterogeneity and assessed publication biases by funnel plots augmented with Egger's test. Results Eighty-eight studies with 105 139 participants were included in the review. The overall pooled prevalence of RSV in children <18 years of age was 23% (95% confidence interval (CI) = 20, 25%). Considerable heterogeneity was present across the included studies. The adjusted prediction interval was found to be 19%-27%. Heterogeneities were explained by subgroups analyses. The highest prevalence of RSV was found among inpatients, 28% (95% CI = 25, 31%) compared with inpatients/outpatients and outpatients, with statistically significant differences (P < 0.01). The RSV estimate was also highest among those with acute lower respiratory tract illnesses (ALRTIs), 28% (95% CI = 25, 31%) compared with acute upper respiratory tract illnesses (AURTIs) and both acute upper/lower respiratory manifestations, with statistically different prevalence (P < 0.01). RSV infection estimates in each sub-region of Africa were statistically different (P < 0.01). There were no statistically significant differences in RSV infections by designs, specimen types, and specimen conditions, despite them contributing to heterogeneity. Conclusions We found a high prevalence of RSV in pediatric populations with acute respiratory tract illnesses in Africa, highlighting that the prevention and control of RSV infections in children deserve more attention. Registration PROSPERO CRD42022327054.
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Affiliation(s)
- Belay Tafa Regassa
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Lami Abebe Gebrewold
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Wagi Tosisa Mekuria
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ethiopia
| | - Nega Assefa Kassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Ethiopia
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Tempia S, Moyes J, Cohen AL, Walaza S, McMorrow ML, Treurnicht FK, Hellferscee O, Wolter N, von Gottberg A, Dawood H, Variava E, Cohen C. The national burden of influenza-like illness and severe respiratory illness overall and associated with nine respiratory viruses in South Africa, 2013-2015. Influenza Other Respir Viruses 2022; 16:438-451. [PMID: 35150059 PMCID: PMC8983907 DOI: 10.1111/irv.12949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Estimates of the disease burden associated with different respiratory viruses are severely limited in low- and middle-income countries, especially in Africa. METHODS We estimated age-specific numbers and rates of medically and non-medically attended influenza-like illness (ILI) and severe respiratory illness (SRI) that were associated with influenza, respiratory syncytial virus (RSV), rhinovirus, human metapneumovirus, adenovirus, enterovirus and parainfluenza virus types 1-3 after adjusting for the attributable fraction (AF) of virus detection to illness in South Africa during 2013-2015. The base rates were estimated from five surveillance sites and extrapolated nationally. RESULTS The mean annual rates per 100,000 population were 51,383 and 4196 for ILI and SRI, respectively. Of these, 26% (for ILI) and 46% (for SRI) were medically attended. Among outpatients with ILI, rhinovirus had the highest AF-adjusted rate (7221), followed by influenza (6443) and adenovirus (1364); whereas, among inpatients with SRI, rhinovirus had the highest AF-adjusted rate (400), followed by RSV (247) and influenza (130). Rhinovirus (9424) and RSV (2026) had the highest AF-adjusted rates among children aged <5 years with ILI or SRI, respectively, whereas rhinovirus (757) and influenza (306) had the highest AF-adjusted rates among individuals aged ≥65 years with ILI or SRI, respectively. CONCLUSIONS There was a substantial burden of ILI and SRI in South Africa during 2013-2015. Rhinovirus and influenza had a prominent disease burden among patients with ILI. RSV and influenza were the most prominent causes of SRI in children and the elderly, respectively.
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Affiliation(s)
- Stefano Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,MassGenics, Duluth, GA, USA.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Adam L Cohen
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Global Immunization Monitoring and Surveillance Team, Expanded Programme on Immunization, Department of Immunization, Vaccines and Biological, World Health Organization, Geneva, Switzerland
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Florette K Treurnicht
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,Division of Virology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Orienka Hellferscee
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Halima Dawood
- Department of Medicine, Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa.,Department of Medicine, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Ebrahim Variava
- Department of Medicine, Klerksdorp-Tshepong Hospital Complex, Klerksdorp, South Africa.,Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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The first epidemiological and virological influenza surveillance in the Republic of Guinea revealed the predominance of influenza A/H3N2 and B Victoria viruses. Epidemiol Infect 2021; 149:e223. [PMID: 34579803 PMCID: PMC8569828 DOI: 10.1017/s0950268821001965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Little is known about respiratory viruses infection in Guinea. Influenza surveillance has not been implemented in Guinea mainly because of the paucity of laboratory infrastructure and capacity. This paper presents the first influenza surveillance data in Guinea.Swabs were obtained from August 2018 through December 2019 at influenza sentinel sites and transported to the Institut National de Santé Publique for testing. Ribonucleic acid was extracted and tested for the presence of influenza A and B by real-time reverse transcription-polymerase chain reaction (RT-PCR). Positive samples were further characterised to determine the subtypes and lineages of influenza viruses.A total of 862 swabs were collected and tested. Twenty-three per cent of samples tested positive for influenza A and B viruses. Characterisation of positive specimens identified influenza A/H1N1pmd09 (2.5%), influenza A/H3N2 (57.3%), influenza B/Victoria lineage (36.7%) and 7 (3.5%) influenza B with undetermined lineage. Influenza B virus activity clustered in August through November while influenza A/H3N2 displayed two clusters of activities that appeared in May through August and November through December.For the first time in Guinea, the epidemiology, diversity and period of circulation of influenza viruses were studied. The results indicate the predominance and the periods of activities of influenza B Victoria lineage and influenza A/H3N2 which are important information for preventive strategies. It is warranted to extend the influenza surveillance to other parts of Guinea to better understand the epidemiology of the viruses and monitor the emergence of influenza strains with pandemic potential.
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Elhakim MM, Kandil SK, Abd Elaziz KM, Anwar WA. Epidemiology of Severe Acute Respiratory Infection (SARI) Cases at a sentinel site in Egypt, 2013-15. J Public Health (Oxf) 2021; 42:525-533. [PMID: 31090911 PMCID: PMC7107553 DOI: 10.1093/pubmed/fdz053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 04/13/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Sentinel surveillance for severe acute respiratory infection (SARI) in Egypt began in 2006 and occurs at eight sites. Avian influenza is endemic, and human cases of influenza A (H5N1) have been reported annually since 2006. This study aimed to describe the epidemiology of SARI at a major sentinel site in the country. METHODS Data included in the study were collected from a major SARI sentinel site in Egypt during three consecutive years (2013-15). RESULTS A total of 1254 SARI patients conforming to the WHO case definition were admitted to the sentinel site, representing 5.6% of admitted patients for all causes and 36.6% of acute respiratory infection patients. A total of 99.7% of the patients were tested, and 21.04% tested positive; 48.7% of cases involved influenza A viruses, while 25% involved influenza B. The predominant age group was under 5 years of age, accounting for 443 cases. The seasonality of the influenza data conformed to the Northern Hemisphere pattern. CONCLUSIONS The present study's results show that SARI leads to substantial morbidity in Egypt. There is a great need for high-quality data from the SARI surveillance system in Egypt, especially with endemic respiratory threats such as influenza A (H5N1) in Egypt.
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Affiliation(s)
- Mohamed M Elhakim
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Ain Shams University, 11566, Cairo, Egypt
| | - Sahar K Kandil
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Ain Shams University, 11566, Cairo, Egypt
| | - Khaled M Abd Elaziz
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Ain Shams University, 11566, Cairo, Egypt
| | - Wagida A Anwar
- Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Ain Shams University, 11566, Cairo, Egypt
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Suryadevara M, Domachowske JB. Epidemiology and Seasonality of Childhood Respiratory Syncytial Virus Infections in the Tropics. Viruses 2021; 13:696. [PMID: 33923823 PMCID: PMC8074094 DOI: 10.3390/v13040696] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Infections caused by respiratory syncytial virus (RSV) are a major cause of morbidity and mortality in young children worldwide. Understanding seasonal patterns of region-specific RSV activity is important to guide resource allocation for existing and future treatment and prevention strategies. The decades of excellent RSV surveillance data that are available from the developed countries of the world are incredibly instructive in advancing public health initiatives in those regions. With few exceptions, these developed nations are positioned geographically across temperate regions of the world. RSV surveillance across tropical regions of the world has improved in recent years, but remains spotty, and where available, still lacks the necessary longitudinal data to determine the amount of seasonal variation expected over time. However, existing and emerging data collected across tropical regions of the world do indicate that patterns of infection are often quite different from those so well described in temperate areas. Here, we provide a brief summary regarding what is known about general patterns of RSV disease activity across tropical Asia, Africa and South America, then offer additional country-specific details using examples where multiple reports and/or more robust surveillance data have become available.
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Carbonell-Estrany X, Rodgers-Gray BS, Paes B. Challenges in the prevention or treatment of RSV with emerging new agents in children from low- and middle-income countries. Expert Rev Anti Infect Ther 2020; 19:419-441. [PMID: 32972198 DOI: 10.1080/14787210.2021.1828866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) causes approximately 120,000 deaths annually in children <5 years, with 99% of fatalities occurring in low- and middle-income countries (LMICs). AREAS COVERED There are numerous RSV interventions in development, including long-acting monoclonal antibodies, vaccines (maternal and child) and treatments which are expected to become available soon. We reviewed the key challenges and issues that need to be addressed to maximize the impact of these interventions in LMICs. The epidemiology of RSV in LMICs was reviewed (PubMed search to 30 June 2020 inclusive) and the need for more and better-quality data, encompassing hospital admissions, community contacts, and longer-term respiratory morbidity, emphasized. The requirement for an agreed clinical definition of RSV lower respiratory tract infection was proposed. The pros and cons of the new RSV interventions are reviewed from the perspective of LMICs. EXPERT OPINION We believe that a vaccine (or combination of vaccines, if practicable) is the only viable solution to the burden of RSV in LMICs. A coordinated program, analogous to that with polio, involving governments, non-governmental organizations, the World Health Organization, the manufacturers and the healthcare community is required to realize the full potential of vaccine(s) and end the devastation of RSV in LMICs.
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Affiliation(s)
- Xavier Carbonell-Estrany
- Neonatology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi Suñer (IDIBAPS), Barcelona, Spain
| | | | - Bosco Paes
- Department of Pediatrics (Neonatal Division), McMaster University, Hamilton, Ontario, Canada
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Lagare A, Rajatonirina S, Testa J, Mamadou S. The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review. Afr Health Sci 2020; 20:1514-1536. [PMID: 34394213 PMCID: PMC8351825 DOI: 10.4314/ahs.v20i4.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Influenza infection is a serious public health problem that causes an estimated 3 to 5 million cases and 250,000 deaths worldwide every year. The epidemiology of influenza is well-documented in high- and middle-income countries, however minimal effort had been made to understand the epidemiology, burden and seasonality of influenza in Africa. This study aims to assess the state of knowledge of seasonal influenza epidemiology in Africa and identify potential data gaps for policy formulation following the 2009 pandemic. Method We reviewed articles from Africa published into four databases namely: MEDLINE (PubMed), Google Scholar, Cochrane Library and Scientific Research Publishing from 2010 to 2019. Results We screened titles and abstracts of 2070 studies of which 311 were selected for full content evaluation and 199 studies were considered. Selected articles varied substantially on the basis of the topics they addressed covering the field of influenza surveillance (n=80); influenza risk factors and co-morbidities (n=15); influenza burden (n=37); influenza vaccination (n=40); influenza and other respiratory pathogens (n=22) and influenza diagnosis (n=5). Conclusion Significant progress has been made since the last pandemic in understanding the influenza epidemiology in Africa. However, efforts still remain for most countries to have sufficient data to allow countries to prioritize strategies for influenza prevention and control.
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Affiliation(s)
- Adamou Lagare
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
| | | | - Jean Testa
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
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Brini I, Bhiri S, Ijaz M, Bouguila J, Nouri-Merchaoui S, Boughammoura L, Sboui H, Hannachi N, Boukadida J. Temporal and climate characteristics of respiratory syncytial virus bronchiolitis in neonates and children in Sousse, Tunisia, during a 13-year surveillance. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23379-23389. [PMID: 30569350 DOI: 10.1007/s11356-018-3922-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
This study established the correlation between respiratory syncytial virus (RSV) bronchiolitis and climate factors in the area of Sousse, Tunisia, during 13 years (2003-2015), from neonates and children <= 5 years old and hospitalized in Farhat Hached University-Hospital of Sousse. The meteorological data of Sousse including temperature, rainfall, and humidity were obtained. RSV detection was carried out with the direct immunofluorescence assay. The impact of climate factors on viral circulation was statistically analyzed. From 2003 to 2015, the total rate of RSV bronchiolitis accounted for 34.5% and peaked in 2007 and 2013. RSV infection was higher in male cases and pediatric environment (p<0.001) and was detected in 47.3% of hospitalizations in intensive care units. The epidemic of this pathogen started in October and peaked in January (41.6%). When the infectivity of RSV was at its maximum, the monthly average rainfall was high (31 mm) and the monthly average temperature and the monthly average humidity were at their minimum (11 °C and 66%, respectively). RSV activity was negatively correlated with temperature (r = - 0.78, p = 0.003) and humidity (r = - 0.62, p = 0.03). Regression analysis showed that the monthly average temperature fits into a linear model (R2 = 61%, p < 0.01). No correlation between RSV activity and rainfall was observed (p = 0.48). The meteorological predictions of RSV outbreaks with specific Tunisian climate parameters will help in determining the optimal timing of appropriate preventive strategies. In the area of Sousse, preventive measures should be enhanced since October especially, when the temperature is around 11 °C and humidity is above 60%.
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Affiliation(s)
- Ines Brini
- Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia.
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia.
| | - Sana Bhiri
- Department of Epidemiology and Medical Statistics, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Muhammad Ijaz
- Department of Pharmacy, COMSATS University Islamabad, Lahore CAMPUS, Lahore, Pakistan
| | - Jihene Bouguila
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | | | - Lamia Boughammoura
- Pediatric ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Hassen Sboui
- Neonatology ward, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Naila Hannachi
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
| | - Jalel Boukadida
- Laboratory of Microbiology, Sousse Medical University, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
- Unit Research for Genomic Characterization of Infectious Agents, UR12SP34, Farhat Hached University-Hospital of Sousse, Sousse, Tunisia
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Lagare A, Ousmane S, Dano ID, Issaka B, Issa I, Mainassara HB, Testa J, Tempia S, Mamadou S. Molecular detection of respiratory pathogens among children aged younger than 5 years hospitalized with febrile acute respiratory infections: A prospective hospital-based observational study in Niamey, Niger. Health Sci Rep 2019; 2:e137. [PMID: 31768420 PMCID: PMC6869554 DOI: 10.1002/hsr2.137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AND AIMS In Niger, acute respiratory infections (ARIs) are the second most common cause of death in children aged younger than 5 years. However, the etiology of ARI is poorly understood in the country. This study aims to describe viral and bacterial infections among children aged younger than 5 years hospitalized with febrile ARI at two hospitals in Niamey, Niger's capital city, and the reported clinical procedures. METHODS We conducted a prospective study among children aged younger than 5 years hospitalized with febrile ARI at two national hospitals in Niamey between January and December 2015. Clinical presentation and procedures during admission were documented using a standardized case investigation form. Nasopharyngeal specimens collected from each patient were tested for a panel of respiratory viruses and bacteria using the Fast Track Diagnostic 21 Plus kit. RESULTS We enrolled and tested 638 children aged younger than 5 years, of whom 411 (64.4%) were aged younger than 1 year, and 15 (2.4%) died during the study period. Overall, 496/638 (77.7%) specimens tested positive for at least one respiratory virus or bacterium; of these, 195 (39.3%) tested positive for respiratory viruses, 126 (25.4%) tested positive for respiratory bacteria, and 175 (35.3%) tested positive for both respiratory viruses and bacteria. The predominant viruses detected were respiratory syncytial virus (RSV) (149/638; 23.3%), human parainfluenza virus (HPIV) types 1 to 4 (78/638; 12.2%), human rhinovirus (HRV) (62/638; 9.4%), human adenovirus (HAV) (60/638; 9.4%), and influenza virus (INF) (52/638; 8.1%). Streptococcus pneumoniae (249/638; 39.0%) was the most frequently detected bacterium, followed by Staphylococcus aureus (112/638; 12.2%) and Haemophilus influenzae type B (16/638; 2.5%). Chest X-rays were performed at the discretion of the attending physician on 301 (47.2%) case patients. Of these patients, 231 (76.7%) had abnormal radiological findings. A total of 135/638 (21.2%) and 572/638 (89.7%) children received antibiotic treatment prior to admission and during admission, respectively. CONCLUSION A high proportion of respiratory viruses was detected among children aged younger than 5 years with febrile ARI, raising concerns about excessive use of antibiotics in Niger.
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Affiliation(s)
- Adamou Lagare
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Sani Ousmane
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Ibrahim Dan Dano
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Bassira Issaka
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Idi Issa
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | | | - Jean Testa
- Bacteriology‐Virology UnitCentre de Recherche Médicale et Sanitaire (CERMES)NiameyNiger
| | - Stefano Tempia
- Influenza DivisionCenters for Disease Control and PreventionAtlantaGeorgia
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
- MassGenics DuluthDuluthGeorgia
| | - Saidou Mamadou
- Faculté des Sciences de la SantéUniversité Abdou MoumouniNiameyNiger
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Kenmoe S, Bigna JJ, Well EA, Simo FBN, Penlap VB, Vabret A, Njouom R. Prevalence of human respiratory syncytial virus infection in people with acute respiratory tract infections in Africa: A systematic review and meta-analysis. Influenza Other Respir Viruses 2018; 12:793-803. [PMID: 29908103 PMCID: PMC6185896 DOI: 10.1111/irv.12584] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 12/31/2022] Open
Abstract
AIM The epidemiology of human respiratory syncytial virus (HRSV) infection has not yet been systematically investigated in Africa. This systematic review and meta-analysis are to estimate the prevalence of HRSV infections in people with acute respiratory tract infections (ARTI) in Africa. METHOD We searched PubMed, EMBASE, Africa Journal Online, and Global Index Medicus to identify observational studies published from January 1, 2000, to August 1, 2017. We used a random-effects model to estimate the prevalence across studies. Heterogeneity (I2 ) was assessed via the chi-square test on Cochran's Q statistic. Review registration: PROSPERO CRD42017076352. RESULTS A total of 67 studies (154 000 participants) were included. Sixty (90%), seven (10%), and no studies had low, moderate, and high risk of bias, respectively. The prevalence of HRSV infection varied widely (range 0.4%-60.4%). The pooled prevalence was 14.6% (95% CI 13.0-16.4, I2 = 98.8%). The prevalence was higher in children (18.5%; 95% CI 15.8-21.5) compared to adults (4.0%; 95% CI 2.2-6.1) and in people with severe respiratory tract infections (17.9%; 95% CI 15.8-20.1) compared to those with benign forms (9.4%; 95% CI 7.4-11.5); P-values <0.0001. The HRSV prevalence was not associated with sex, subregion in Africa, setting, altitude, latitude, longitude, and seasonality. CONCLUSION This study suggests a high prevalence of HRSV in people with ARTI in Africa, particularly among children and people with severe clinical form. All innovative strategies to curb the burden should first focus on children which present the highest HRSV-related burden.
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Affiliation(s)
- Sebastien Kenmoe
- Department of VirologyNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
| | - Jean Joel Bigna
- Department of Epidemiology and Public HealthNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
- School of Public HealthFaculty of MedicineUniversity of Paris SudLe Kremlin‐BicêtreFrance
| | | | - Fredy Brice N. Simo
- Department of BiochemistryFaculty of SciencesUniversity of Yaoundé 1YaoundéCameroon
| | - Véronique B. Penlap
- Department of BiochemistryFaculty of SciencesUniversity of Yaoundé 1YaoundéCameroon
| | - Astrid Vabret
- Normandie UniversitéCaenFrance
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM)Université de CaenCaenFrance
- Laboratoire de VirologieCentre Hospitalo‐Universitaire de CaenCaenFrance
| | - Richard Njouom
- Department of VirologyNational Influenza CenterCentre Pasteur of CameroonYaoundéCameroon
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12
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Bigna JJ, Kenmoe S, Well EA, Simo FBN, Penlap VB, Vabret A, Njouom R. Contemporaneous data on the prevalence of Human Respiratory Syncytial Virus infection in people with acute respiratory tract infections in Africa (2000-2017). Data Brief 2018; 20:940-947. [PMID: 30225305 PMCID: PMC6138983 DOI: 10.1016/j.dib.2018.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/24/2018] [Accepted: 08/15/2018] [Indexed: 11/28/2022] Open
Abstract
Availability of accurate data on the burden of the Human Respiratory Syncytial Virus (HRSV) can help to implement better strategies to curb this burden in Africa continent among people with acute respiratory tract infections (ARTI). We summarize here available contemporaneous data published from January 1, 2000 to August 31, 2017 on the prevalence of HSRV infection among people with ARTI in the continent.
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Affiliation(s)
- Jean Joel Bigna
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Sebastien Kenmoe
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Estelle Amandine Well
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaoundé, Cameroon
| | - Fredy Brice N. Simo
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
| | - Véronique B. Penlap
- Department of Biochemistry, Faculty of Sciences, University of Yaoundé 1, P.O. Box 337, Yaoundé, Cameroon
| | - Astrid Vabret
- Normandie Université, 14032 Caen, France
- Université de Caen, Groupe de Recherche sur l’Adaptation Microbienne (GRAM), F-14000 Caen, France
- Laboratoire de Virologie, Centre Hospitalo-Universitaire de Caen, F-14033 Caen, France
| | - Richard Njouom
- National Influenza Center, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274, Yaoundé, Cameroon
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13
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Kadjo HA, Adjogoua E, Dia N, Adagba M, Abdoulaye O, Daniel S, Kouakou B, Ngolo DC, Coulibaly D, Ndahwouh TN, Dosso M. DETECTION OF NON-INFLUENZA VIRUSES IN ACUTE RESPIRATORY INFECTIONS IN CHILDREN UNDER FIVE-YEAR-OLD IN COTE D'IVOIRE (JANUARY - DECEMBER 2013). Afr J Infect Dis 2018; 12:78-88. [PMID: 30109291 PMCID: PMC6085743 DOI: 10.21010/ajid.v12i2.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 05/04/2018] [Accepted: 05/07/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Influenza sentinel surveillance in Cote d'Ivoire showed that 70% of Acute Respiratory Infections (ARI) cases remained without etiology. This work aims to describe the epidemiological, clinical, and virological pattern of ARI that tested negative for influenza virus, in children under five years old. MATERIALS AND METHODS one thousand and fifty nine samples of patients presenting influenza Like Illness (ILI) or Severe Acute Respiratory Infections (SARI) symptoms were tested for other respiratory viruses using multiplex RT-PCR assays targeting 10 respiratory viruses. RESULTS The following pathogens were detected as follows, hRV 31,92% (98/307), hRSV 24.4% (75/329), PIV 20.5% (63/307), HCoV 229E 12,05% (37/307), hMPV 6.2% (19/307), HCoVOC43 1.0% (3/307) and EnV 1.0% (3/307). Among the 1,059 specimens analyzed, 917 (86.6%) were ILI samples and 142 (23.4%) were SARI samples. The proportion of children infected with at least one virus was 29.8% (273/917) in ILI cases and 23.9% (34/142) in SARI cases. The most prevalent viruses, responsible for ILI cases were hRV with 35.89% (98/273) and hRSV in SARI cases with 41.2% (14/34) of cases. Among the 1,059 patients, only 22 (2.1%) children presented risk factors related to the severity of influenza virus infection. CONCLUSION This study showed that respiratory viruses play an important role in the etiology of ARI in children. For a better understanding of the epidemiology of ARI and improved case management, it would be interesting in this context to expand the surveillance of influenza to other respiratory viruses.
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Affiliation(s)
- Herve A. Kadjo
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
| | | | | | - Marius Adagba
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
| | | | - Saraka Daniel
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
| | - Bertin Kouakou
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
| | - David C. Ngolo
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
| | | | - Talla Nzussouo Ndahwouh
- Noguchi Memorial Institute for Medical Research (NMIMR) University of Ghana, Legon, Accra, Ghana
| | - Mireille Dosso
- Pasteur Institute of Cote d’Ivoire, Abidjan, Cote d’Ivoire
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14
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Sanou AM, Wandaogo SCM, Poda A, Tamini L, Kyere AE, Sagna T, Ouedraogo MS, Pauly M, Hübschen JM, Muller CP, Tarnagda Z, Snoeck CJ. Epidemiology and molecular characterization of influenza viruses in Burkina Faso, sub-Saharan Africa. Influenza Other Respir Viruses 2018; 12:490-496. [PMID: 29350841 PMCID: PMC6005621 DOI: 10.1111/irv.12539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 01/08/2023] Open
Abstract
Background The importance of influenza viruses in respiratory infections in sub‐Saharan Africa has been historically overlooked, including in Burkina Faso. Objectives This study therefore aimed at evaluating the prevalence and seasonal occurrence of influenza viruses in children under 5 years old, at risk of influenza‐related complications, presenting with influenza‐like illness (ILI) or severe acute respiratory infection (SARI). The study also aimed at identifying the periods with increased influenza transmission for vaccination recommendations in Burkina Faso. Methods From January 2014 to December 2015, ILI and SARI (2015 only) patients were recruited in six healthcare centers in Burkina Faso. Influenza A and B molecular detection and subtyping were performed. Clade clustering of a subset of A(H1N1)pdm09 and A(H3N2) strains was deduced by performing phylogenetic analyses on hemagglutinin gene sequences. Weekly surveillance data from FluNet (2011‐2013; 2016) and this study (2014‐2015) were used to identify periods of increased influenza activity. Results Influenza A and B viruses were detected in 15.1% (112 of 743) of ILI and 6.6% (12 of 181) of SARI patients. Overall, influenza A viruses were largely predominant (81 of 124, 65.3%), with 69.1% of A(H3N2) and 30.9% of A(H1N1)pdm09 strains. Four waves of increased transmission were identified in 2014‐2015, each dominated by different influenza subtypes and clades. Between 2011 and 2016, periods of increased influenza activity varied in their frequency, duration, and timing. Conclusion Influenza A and B viruses were detected in a substantial number of ILI and SARI cases in Burkina Faso. Vaccination in September‐October would likely protect the highest number of patients.
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Affiliation(s)
- Armel M Sanou
- National Influenza Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Sampoko Carine M Wandaogo
- National Influenza Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Armel Poda
- Hôpital du jour, Service des maladies infectieuses, CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso.,Université Polytechnique de Bobo-Dioulasso (UPB), Bobo-Dioulasso, Burkina Faso
| | - Laure Tamini
- Service de Pédiatrie, CHU Pédiatrique Charles De Gaulles, Ouagadougou, Burkina Faso.,Unité de Formation et de Recherche en Sciences de la Santé (UFR/SDS), Université de Ouagadougou, Ouagadougou, Burkina Faso
| | - Anselme E Kyere
- National Influenza Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Tani Sagna
- National Influenza Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Macaire S Ouedraogo
- Hôpital du jour, Service des maladies infectieuses, CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso.,Université Polytechnique de Bobo-Dioulasso (UPB), Bobo-Dioulasso, Burkina Faso
| | - Maude Pauly
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Judith M Hübschen
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Claude P Muller
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Zekiba Tarnagda
- National Influenza Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Chantal J Snoeck
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
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15
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Talla Nzussouo N, Duque J, Adedeji AA, Coulibaly D, Sow S, Tarnagda Z, Maman I, Lagare A, Makaya S, Elkory MB, Kadjo Adje H, Shilo PA, Tamboura B, Cisse A, Badziklou K, Maïnassara HB, Bara AO, Keita AM, Williams T, Moen A, Widdowson MA, McMorrow M. Epidemiology of influenza in West Africa after the 2009 influenza A(H1N1) pandemic, 2010-2012. BMC Infect Dis 2017; 17:745. [PMID: 29202715 PMCID: PMC5716025 DOI: 10.1186/s12879-017-2839-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/16/2017] [Indexed: 01/20/2023] Open
Abstract
Background Over the last decade, capacity for influenza surveillance and research in West Africa has strengthened. Data from these surveillance systems showed influenza A(H1N1)pdm09 circulated in West Africa later than in other regions of the continent. Methods We contacted 11 West African countries to collect information about their influenza surveillance systems (number of sites, type of surveillance, sampling strategy, populations sampled, case definitions used, number of specimens collected and number of specimens positive for influenza viruses) for the time period January 2010 through December 2012. Results Of the 11 countries contacted, 8 responded: Burkina Faso, Cote d’Ivoire, Mali, Mauritania, Niger, Nigeria, Sierra Leone and Togo. Countries used standard World Health Organization (WHO) case definitions for influenza-like illness (ILI) and severe acute respiratory illness (SARI) or slight variations thereof. There were 70 surveillance sites: 26 SARI and 44 ILI. Seven countries conducted SARI surveillance and collected 3114 specimens of which 209 (7%) were positive for influenza viruses. Among influenza-positive SARI patients, 132 (63%) were influenza A [68 influenza A(H1N1)pdm09, 64 influenza A(H3N2)] and 77 (37%) were influenza B. All eight countries conducted ILI surveillance and collected 20,375 specimens, of which 2278 (11%) were positive for influenza viruses. Among influenza-positive ILI patients, 1431 (63%) were influenza A [820 influenza A(H1N1)pdm09, 611 influenza A(H3N2)] and 847 (37%) were influenza B. A majority of SARI and ILI case-patients who tested positive for influenza (72% SARI and 59% ILI) were children aged 0–4 years, as were a majority of those enrolled in surveillance. The seasonality of influenza and the predominant influenza type or subtype varied by country and year. Conclusions Influenza A(H1N1)pdm09 continued to circulate in West Africa along with influenza A(H3N2) and influenza B during 2010–2012. Although ILI surveillance systems produced a robust number of samples during the study period, more could be done to strengthen surveillance among hospitalized SARI case-patients. Surveillance systems captured young children but lacked data on adults and the elderly. More data on risk groups for severe influenza in West Africa are needed to help shape influenza prevention and clinical management policies and guidelines. Electronic supplementary material The online version of this article (10.1186/s12879-017-2839-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ndahwouh Talla Nzussouo
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. .,CTS Global Inc., California, El Segundo, USA. .,Noguchi Memorial Institute for Medical Research, P.O. Box LG 481, Legon, Accra, Ghana.
| | - Jazmin Duque
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Battelle Atlanta, Atlanta, GA, USA
| | - Adebayo Abel Adedeji
- National Influenza Reference Laboratory, Federal Ministry of Health, Abuja, Nigeria
| | - Daouda Coulibaly
- Institut National d'Hygiene Publique (INHP), Abidjan, Côte d'Ivoire
| | - Samba Sow
- Centre National d'Appui à la Lutte Contre la Maladie (CNAM), Centre pour le Développement des Vaccins du Mali (CVD), Bamako, Mali
| | - Zekiba Tarnagda
- Institut de Recherche en Sciences de Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | - Adamou Lagare
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
| | - Sonia Makaya
- Influenza National Reference Laboratory Lakka, Freetown, Sierra Leone
| | | | | | - Paul Alhassan Shilo
- National Influenza Reference Laboratory, Federal Ministry of Health, Abuja, Nigeria
| | - Boubou Tamboura
- Centre National d'Appui à la Lutte Contre la Maladie (CNAM), Centre pour le Développement des Vaccins du Mali (CVD), Bamako, Mali
| | - Assana Cisse
- Institut de Recherche en Sciences de Santé (IRSS), Bobo-Dioulasso, Burkina Faso
| | | | | | - Ahmed Ould Bara
- Institut National Recherche en Sante Publique (INRSP), Nouakchott, Mauritanie
| | - Adama Mamby Keita
- Centre National d'Appui à la Lutte Contre la Maladie (CNAM), Centre pour le Développement des Vaccins du Mali (CVD), Bamako, Mali
| | - Thelma Williams
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ann Moen
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marc-Alain Widdowson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Meredith McMorrow
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.,U.S. Public Health Service, Rockville, MD, USA
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16
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Ndegwa LK, Emukule G, Uyeki TM, Mailu E, Chaves SS, Widdowson MA, Lewa BV, Muiruri FK, Omoth P, Fields B, Mott JA. Evaluation of the point-of-care Becton Dickinson Veritor™ Rapid influenza diagnostic test in Kenya, 2013-2014. BMC Infect Dis 2017; 17:60. [PMID: 28077093 PMCID: PMC5225564 DOI: 10.1186/s12879-016-2131-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/15/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We evaluated the performance of the Becton Dickinson Veritor™ System Flu A + B rapid influenza diagnostic test (RIDT) to detect influenza viruses in respiratory specimens from patients enrolled at five surveillance sites in Kenya, a tropical country where influenza seasonality is variable. METHODS Nasal swab (NS) and nasopharyngeal (NP)/oropharyngeal (OP) swabs were collected from patients with influenza like illness and/or severe acute respiratory infection. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the RIDT using NS specimens were evaluated against nasal swabs tested by real time reverse transcription polymerase chain reaction (rRT-PCR). The performance parameter results were expressed as 95% confidence intervals (CI) calculated using binomial exact methods, with P < 0.05 considered significant. Two-sample Z tests were used to test for differences in sample proportions. Analysis was performed using SAS software version 9.3. RESULTS From July 2013 to July 2014, 3,569 patients were recruited, of which 78.7% were aged <5 years. Overall, 14.4% of NS specimens were influenza-positive by RIDT. RIDT overall sensitivity was 77.1% (95% CI 72.8-81.0%) and specificity was 94.9% (95% CI 94.0-95.7%) compared to rRT-PCR using NS specimens. RIDT sensitivity for influenza A virus compared to rRT-PCR using NS specimens was 71.8% (95% CI 66.7-76.4%) and was significantly higher than for influenza B which was 43.8% (95% CI 33.8-54.2%). PPV ranged from 30%-80% depending on background prevalence of influenza. CONCLUSION Although the variable seasonality of influenza in tropical Africa presents unique challenges, RIDTs may have a role in making influenza surveillance sustainable in more remote areas of Africa, where laboratory capacity is limited.
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Affiliation(s)
- Linus K. Ndegwa
- DGHP, Centers for Disease Control and Prevention, Nairobi, Kenya
- Infection Control African Network (ICAN), Infection prevention network-Kenya (IPNET-K), Mbagathi Road off Mbagathi way, Village Market, PO Box 606, 00621 Nairobi, Kenya
| | - Gideon Emukule
- DGHP, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Timothy M. Uyeki
- Influenza Division, Centers for Disease Control and Prevention-Atlanta, Georgia, USA
| | - Eunice Mailu
- Kenya Medical Research Institute/Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
| | - Sandra S. Chaves
- DGHP, Centers for Disease Control and Prevention, Nairobi, Kenya
| | | | | | | | | | - Barry Fields
- DGHP, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Joshua A. Mott
- Influenza Division, Centers for Disease Control and Prevention-Atlanta, Georgia, USA
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17
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Epidemiology and Surveillance of Influenza Viruses in Uganda between 2008 and 2014. PLoS One 2016; 11:e0164861. [PMID: 27755572 PMCID: PMC5068740 DOI: 10.1371/journal.pone.0164861] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/03/2016] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Influenza surveillance was conducted in Uganda from October 2008 to December 2014 to identify and understand the epidemiology of circulating influenza strains in out-patient clinic attendees with influenza-like illness and inform control strategies. METHODOLOGY Surveillance was conducted at five hospital-based sentinel sites. Nasopharyngeal and/or oropharyngeal samples, epidemiological and clinical data were collected from enrolled patients. Real-time reverse transcription polymerase chain reaction (RT-PCR) was performed to identify and subtype influenza strains. Data were double-entered into an Epi Info 3.5.3 database and exported to STATA 13.0 software for analysis. RESULTS Of the 6,628 patient samples tested, influenza virus infection was detected in 10.4% (n = 687/6,628) of the specimens. Several trends were observed: influenza circulates throughout the year with two peaks; the major one from September to November and a minor one from March to June. The predominant strains of influenza varied over the years: Seasonal Influenza A(H3) virus was predominant from 2008 to 2009 and from 2012 to 2014; Influenza A(H1N1)pdm01 was dominant in 2010; and Influenza B virus was dominant in 2011. The peaks generally coincided with times of higher humidity, lower temperature, and higher rainfall. CONCLUSION Influenza circulated throughout the year in Uganda with two major peaks of outbreaks with similar strains circulating elsewhere in the region. Data on the circulating strains of influenza and its patterns of occurrence provided critical insights to informing the design and timing of influenza vaccines for influenza prevention in tropical regions of sub-Saharan Africa.
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18
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N'gattia AK, Coulibaly D, Nzussouo NT, Kadjo HA, Chérif D, Traoré Y, Kouakou BK, Kouassi PD, Ekra KD, Dagnan NS, Williams T, Tiembré I. Effects of climatological parameters in modeling and forecasting seasonal influenza transmission in Abidjan, Cote d'Ivoire. BMC Public Health 2016; 16:972. [PMID: 27624302 PMCID: PMC5022141 DOI: 10.1186/s12889-016-3503-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 08/12/2016] [Indexed: 12/03/2022] Open
Abstract
Background In temperate regions, influenza epidemics occur in the winter and correlate with certain climatological parameters. In African tropical regions, the effects of climatological parameters on influenza epidemics are not well defined. This study aims to identify and model the effects of climatological parameters on seasonal influenza activity in Abidjan, Cote d’Ivoire. Methods We studied the effects of weekly rainfall, humidity, and temperature on laboratory-confirmed influenza cases in Abidjan from 2007 to 2010. We used the Box-Jenkins method with the autoregressive integrated moving average (ARIMA) process to create models using data from 2007–2010 and to assess the predictive value of best model on data from 2011 to 2012. Results The weekly number of influenza cases showed significant cross-correlation with certain prior weeks for both rainfall, and relative humidity. The best fitting multivariate model (ARIMAX (2,0,0) _RF) included the number of influenza cases during 1-week and 2-weeks prior, and the rainfall during the current week and 5-weeks prior. The performance of this model showed an increase of >3 % for Akaike Information Criterion (AIC) and 2.5 % for Bayesian Information Criterion (BIC) compared to the reference univariate ARIMA (2,0,0). The prediction of the weekly number of influenza cases during 2011–2012 with the best fitting multivariate model (ARIMAX (2,0,0) _RF), showed that the observed values were within the 95 % confidence interval of the predicted values during 97 of 104 weeks. Conclusion Including rainfall increases the performances of fitted and predicted models. The timing of influenza in Abidjan can be partially explained by rainfall influence, in a setting with little change in temperature throughout the year. These findings can help clinicians to anticipate influenza cases during the rainy season by implementing preventive measures. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3503-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A K N'gattia
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire. .,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire.
| | - D Coulibaly
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire
| | - N Talla Nzussouo
- Influenza Division, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - H A Kadjo
- Department of Virology, Respiratory Diseases, Pasteur Institute, 01 BP 490, Abidjan 01, Côte d'Ivoire
| | - D Chérif
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire
| | - Y Traoré
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - B K Kouakou
- Department of Virology, Respiratory Diseases, Pasteur Institute, 01 BP 490, Abidjan 01, Côte d'Ivoire
| | - P D Kouassi
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Department of Public Health and Community Medicine, Alassane Ouattara University, BP V 18, Bouaké, Côte d'Ivoire
| | - K D Ekra
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - N S Dagnan
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
| | - T Williams
- Influenza Division, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329-4027, USA
| | - I Tiembré
- Department of Epidemiology, Institut National d'Hygiène Publique, BP V 14, Abidjan, Côte d'Ivoire.,Training and Research Unit of Medical Sciences, Department of Public Health and Community Medicine, Félix Houphouët-Boigny University, BP V 34, Abidjan, Côte d'Ivoire
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19
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Jones AH, Ampofo W, Akuffo R, Doman B, Duplessis C, Amankwa JA, Sarpong C, Sagoe K, Agbenohevi P, Puplampu N, Armah G, Koram KA, Nyarko EO, Bel-Nono S, Dueger EL. Sentinel surveillance for influenza among severe acute respiratory infection and acute febrile illness inpatients at three hospitals in Ghana. Influenza Other Respir Viruses 2016; 10:367-74. [PMID: 27239956 PMCID: PMC4947945 DOI: 10.1111/irv.12397] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/04/2022] Open
Abstract
Background Influenza epidemiology in Africa is generally not well understood. Using syndrome definitions to screen patients for laboratory confirmation of infection is an established means to effectively conduct influenza surveillance. Methods To compare influenza‐related epidemiologic data, from October 2010 through March 2013, we enrolled hospitalized severe acute respiratory infection (SARI; fever with respiratory symptoms) and acute febrile illness (AFI; fever without respiratory or other localizing symptoms) patients from three referral hospitals in Ghana. Demographic and epidemiologic data were obtained from enrolled patients after which nasopharyngeal and oropharyngeal swabs were collected, and processed by molecular methods for the presence of influenza viruses. Results Of 730 SARI patients, 59 (8%) were influenza positive; of 543 AFI patients, 34 (6%) were positive for influenza. Both SARI and AFI surveillance yielded influenza A(H3N2) (3% versus 1%), A(H1N1)pdm09 (2% versus 1%), and influenza B (3% versus 4%) in similar proportions. Data from both syndromes show year‐round influenza transmission but with increased caseloads associated with the rainy seasons. Conclusions As an appreciable percentage of influenza cases (37%) presented without defined respiratory symptoms, and thus met the AFI but not the SARI definition, it is important to consider broader screening criteria (i.e., AFI) to identify all laboratory‐confirmed influenza. The identified influenza transmission seasonality has important implications for the timing of related public health interventions.
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Affiliation(s)
- Alexander H Jones
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - William Ampofo
- Noguchi Memorial Institute for Medical Research, National Influenza Center, Accra, Ghana
| | - Richard Akuffo
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 Ghana Detachment, Accra, Ghana
| | - Brooke Doman
- Global Disease Detection and Response Program, U.S. Naval Medical Research Unit No. 3 Ghana Detachment, Accra, Ghana
| | | | | | | | - Ken Sagoe
- Tamale Teaching Hospital, Tamale, Ghana
| | | | - Naiki Puplampu
- U.S. Naval Medical Research Unit No. 3 Ghana Detachment, Accra, Ghana
| | - George Armah
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | | | | | - Erica L Dueger
- U.S. Centers for Disease Control & Prevention, Atlanta, GA, USA.,U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
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20
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Otomaru H, Kamigaki T, Tamaki R, Opinion J, Santo A, Daya E, Okamoto M, Saito M, Tallo V, Lupisan S, Suzuki A, Oshitani H. Influenza and other respiratory viruses detected by influenza-like illness surveillance in Leyte Island, the Philippines, 2010-2013. PLoS One 2015; 10:e0123755. [PMID: 25893441 PMCID: PMC4404362 DOI: 10.1371/journal.pone.0123755] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/23/2015] [Indexed: 01/06/2023] Open
Abstract
This study aimed to determine the role of influenza-like illness (ILI) surveillance conducted on Leyte Island, the Philippines, including involvement of other respiratory viruses, from 2010 to 2013. ILI surveillance was conducted from January 2010 to March 2013 with 3 sentinel sites located in Tacloban city, Palo and Tanauan of Leyte Island. ILI was defined as fever ≥38°C or feverish feeling and either cough or running nose in a patient of any age. Influenza virus and other 5 respiratory viruses were searched. A total of 5,550 ILI cases visited the 3 sites and specimens were collected from 2,031 (36.6%) cases. Among the cases sampled, 1,637 (75.6%) were children aged <5 years. 874 (43.0%) cases were positive for at least one of the respiratory viruses tested. Influenza virus and respiratory syncytial virus (RSV) were predominantly detected (both were 25.7%) followed by human rhinovirus (HRV) (17.5%). The age distributions were significantly different between those who were positive for influenza, HRV, and RSV. ILI cases were reported throughout the year and influenza virus was co-detected with those viruses on approximately half of the weeks of study period (RSV in 60.5% and HRV 47.4%). In terms of clinical manifestations, only the rates of headache and sore throat were significantly higher in influenza positive cases than cases positive to other viruses. In conclusion, syndromic ILI surveillance in this area is difficult to detect the start of influenza epidemic without laboratory confirmation which requires huge resources. Age was an important factor that affected positive rates of influenza and other respiratory viruses. Involvement of older age children may be useful to detect influenza more effectively.
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Affiliation(s)
- Hirono Otomaru
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Taro Kamigaki
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
- * E-mail:
| | - Raita Tamaki
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Jamie Opinion
- Tacloban City Health Office, Tacloban City, the Philippines
| | - Arlene Santo
- Tanauan Rural Health Unit, Tanauan, the Philippines
| | - Edgard Daya
- Leyte Provincial Health Office, Palo, the Philippines
| | - Michiko Okamoto
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
| | - Mariko Saito
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
- Tohoku-RITM Research Center for Emerging and Reemerging Infections, Muntinlupa City, the Philippines
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Soccoro Lupisan
- Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Akira Suzuki
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University School of Medicine, Sendai, Japan
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21
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Tarnagda Z, Yougbaré I, Ilboudo AK, Kagoné T, Sanou AM, Cissé A, Médah I, Yelbéogo D, Nzussouo NT. Sentinel surveillance of influenza in Burkina Faso: identification of circulating strains during 2010-2012. Influenza Other Respir Viruses 2014; 8:524-9. [PMID: 25074591 PMCID: PMC4181815 DOI: 10.1111/irv.12259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2014] [Indexed: 12/14/2022] Open
Abstract
Background Although influenza surveillance has recently been improved in some sub-Saharan African countries, no information is yet available from Burkina Faso. Objectives Our study was the first to determine the prevalence of influenza viruses circulating in Burkina Faso through a sentinel surveillance system. Methods We conducted sentinel surveillance with oropharyngeal (OP) swabs collected from outpatients (1 month to 83 years) from six sites in Bobo-Dioulasso and Ouagadougou, among patients meeting the WHO/CDC case definition for influenza-like illness (ILI; fever ≥38°C, and cough and/or sore throat in the absence of other diagnosis) from July 2010 to May 2012. Influenza viruses were detected by real-time RT-PCR using CDC primers, probes, and protocols. Results The first three ILI cases were enrolled each day; of 881 outpatients with ILI enrolled and sampled, 58 (6·6%) tested positive for influenza viruses (29 influenza A and 29 influenza B). Among the influenza A viruses, 55·2% (16/29) were influenza A (H1N1)pdm09 and 44·8% (13/29) were seasonal A (H3N2). No cases of seasonal A/H1N1 were detected. Patients within 0–5 years and 6–14 years were the most affected, comprising 41·4% and 22·4% laboratory-confirmed influenza cases, respectively. Influenza infections occurred during both the dry, dusty Harmattan months from November to March and the rainy season from June to October with peaks in January and August. Conclusions This surveillance was the first confirming the circulation of influenza A (H1N1)pdm09, A/H3N2, and influenza B viruses in humans in Burkina Faso.
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Affiliation(s)
- Zékiba Tarnagda
- Institut de Recherche en Sciences de la Santé, Centre National de Référence pour la Grippe, Bobo-Dioulasso, Burkina Faso; West African Master Field Epidemiology and Laboratory Training Program (WA FELTP), University of Ouagadougou, Ouagadougou, Burkina Faso
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22
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Ekaza E, Kadjo HA, Coulibaly D, Koutouan GGM, Coulibaly-N'golo GMD, Kouakou B, Talla Nzussouo N, Olsen SJ, Ekra DK, Akoua-Koffi CG, Gilbernair EA, Bretin-Dosso MC. Investigation of an outbreak of acute respiratory disease in côte d'ivoire in april 2007. Afr J Infect Dis 2014; 8:31-35. [PMID: 25729534 PMCID: PMC4325357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This study aim was to investigate an outbreak of human cases of unexplained influenza-like illness and fatal acute respiratory infection (ARI), with simultaneous poultry illness and high mortality raising concerns of possible influenza A (H5N1), virus in Cote d'Ivoire in February and March 2007. MATERIALS AND METHODS To investigate the outbreak, we conducted active surveillance in the community and reviewed health registries. Persons meeting the case definition were asked to provide nasopharyngeal specimens. On the basis of clinical and epidemiological information, specimens were tested using conventional RT-PCR for the M gene of the influenza viruses and hemagglutinin H5 of avian influenza A (H5N1), virus; negative samples were tested for other respiratory viruses. Specimens from healthy animals were also collected. RESULTS Between October 2006, and February 2007, 104 suspected cases of Acute Respiratory Disease that included; 31 deaths recorded. We collected and tested 73 nasopharyngeal specimens; of which, 2, were positive for human Coronavirus OC43 and 1 for influenza C virus. No pathogens were identified in animal specimens. CONCLUSIONS The investigation quickly ruled out influenza A (H5N1), virus as the cause and found laboratory-confirmed cases of influenza C virus and human Coronavirus OC 43 for the first time in both Côte d'Ivoire and in a Sub-Saharan African country. However we were not able to show that these viruses caused the outbreak. Monitoring of influenza viruses must be a priority but other respiratory viruses and non-viral causes may be of interest too.
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Affiliation(s)
- Euloge Ekaza
- Pasteur Institute, Côte d'Ivoire 01 BP 490 Abidjan 01 Côte d'Ivoire
| | - Hervé Adjé Kadjo
- Pasteur Institute, Côte d'Ivoire 01 BP 490 Abidjan 01 Côte d'Ivoire
| | - Daouda Coulibaly
- National institute of the public health, 11 BP 202 Abidjan 11 Côte d'Ivoire
| | | | | | - Bertin Kouakou
- Pasteur Institute, Côte d'Ivoire 01 BP 490 Abidjan 01 Côte d'Ivoire
| | | | - Sonja Julia Olsen
- Influenza Division, U.S. Centers for Disease Control and Prevention (CDC)
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23
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Balinandi S, Bakamutumaho B, Kayiwa JT, Ongus J, Oundo J, Awor AC, Lutwama JJ. The viral aetiology of influenza-like illnesses in Kampala and Entebbe, Uganda, 2008. Afr J Lab Med 2013; 2:65. [PMID: 29043164 PMCID: PMC5637772 DOI: 10.4102/ajlm.v2i1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 04/09/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As the threat of zoonoses and the emergence of pandemic-prone respiratory viruses increases, there is a need to establish baseline information on the incidence of endemic pathogens in countries worldwide. OBJECTIVES To investigate the presence of viruses associated with influenza-like illnesses (ILI) in Uganda. METHODS A cross-sectional study was conducted in which nasopharyngeal swab specimens were collected from patients diagnosed with ILI in Kampala and Entebbe between 14 August 2008 - 15 December 2008. A multiplex polymerase chain reaction assay for detecting 12 respiratory viruses was used. RESULTS A total of 369 patients (52.3% females) was enrolled; the median age was 6 years (range 1-70). One or more respiratory viruses were detected in 172 (46.6%) cases and their prevalence were influenza A virus (19.2%), adenovirus (8.7%), human rhinovirus A (7.9%), coronavirus OC43 (4.3%), parainfluenza virus 1 (2.7%), parainfluenza virus 3 (2.7%), influenza B virus (2.2%), respiratory syncytial virus B (2.2%), human metapneumovirus (1.4%), respiratory syncytial virus A (1.1%), parainfluenza virus 2 (0.5%) and coronavirus 229E (0.5%). There were 24 (14.0%) mixed infections. CONCLUSIONS This study identified some of the respiratory viruses associated with ILI in Uganda. The circulation of some of the viruses was previously unknown in the study population. These results are useful in order to guide future surveillance and case management strategies involving respiratory illnesses in Uganda.
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Affiliation(s)
- Stephen Balinandi
- Field Epidemiology and Laboratory Training Program, Kenya.,Uganda Virus Research Institute, Uganda
| | | | | | - Juliette Ongus
- Department of Medical Laboratory Sciences, Jomo Kenyatta University of Agriculture and Technology, Kenya
| | - Joseph Oundo
- Field Epidemiology and Laboratory Training Program, Kenya
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24
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Nakouné E, Tricou V, Manirakiza A, Komoyo F, Selekon B, Gody JC, Victoir K, Buchy P, Kazanji M. First introduction of pandemic influenza A/H1N1 and detection of respiratory viruses in pediatric patients in Central African Republic. Virol J 2013; 10:49. [PMID: 23391188 PMCID: PMC3598402 DOI: 10.1186/1743-422x-10-49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 02/06/2013] [Indexed: 01/03/2023] Open
Abstract
Background Acute viral respiratory illnesses in children in sub-Saharan Africa have received relatively little attention, although they are much more frequent causes of morbidity and mortality than in developed countries. Active surveillance is essential to identify the causative agents and to improve clinical management, especially in the context of possible circulation of pandemic viruses. Findings A prospective study was conducted in the Central African Republic (CAR) between January and December 2010 among infants and children aged 0–15 years attending sentinel sites for influenza-like illness or acute respiratory illness. Nasopharyngeal swabs were collected, and one-step real-time and multiplex reverse transcription-polymerase chain reaction were used to detect respiratory viruses. Respiratory viruses were detected in 49 of the 329 (14.9%) nasopharyngeal samples: 29 (8.8%) contained influenza viruses (5 (1.5%) had pandemic influenza A/H1N1 virus and 24 (7.3%) had influenza B viruses), 11 (3.3%) contained parainfluenza viruses types 1 and 3 and 9 (2.7%) contained human respiratory syncytial virus. Most cases were detected during the rainy season in the CAR. Analysis of the amplicon sequences confirmed the identity of each detected virus. Conclusions The influenza surveillance system in the CAR has provided valuable data on the seasonality of influenza and the circulation of other respiratory viruses. Our network could therefore play a valuable role in the prevention and control of influenza epidemics in the CAR.
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Affiliation(s)
- Emmanuel Nakouné
- Virology department, Institut Pasteur de Bangui, Bangui, Central African Republic
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