dc.contributor.author |
Cohen, Cheryl
|
|
dc.contributor.author |
Walaza, Sibongile
|
|
dc.contributor.author |
Moyes, Jocelyn
|
|
dc.contributor.author |
Groome, Michelle
|
|
dc.contributor.author |
Tempia, Stefano
|
|
dc.contributor.author |
Pretorius, Marthi Andréa
|
|
dc.contributor.author |
Hellferscee, Orienka
|
|
dc.contributor.author |
Dawood, Halima
|
|
dc.contributor.author |
Haffejee, Summaya
|
|
dc.contributor.author |
Variava, Ebrahim
|
|
dc.contributor.author |
Kahn, Kathleen
|
|
dc.contributor.author |
Tshangela, Akhona
|
|
dc.contributor.author |
Von Gottberg, Anne
|
|
dc.contributor.author |
Wolter, Nicole
|
|
dc.contributor.author |
Cohen, Adam L.
|
|
dc.contributor.author |
Kgokong, Babatyi
|
|
dc.contributor.author |
Venter, Marietjie
|
|
dc.contributor.author |
Madhi, Shabir A.
|
|
dc.date.accessioned |
2015-06-23T09:15:17Z |
|
dc.date.available |
2015-06-23T09:15:17Z |
|
dc.date.issued |
2015-02-23 |
|
dc.description.abstract |
OBJECTIVE
There are few published studies describing severe acute respiratory illness (SARI) epidemiology
amongst older children and adults from high HIV-prevalence settings. We aimed to
describe SARI epidemiology amongst individuals aged 5 years in South Africa.
METHODS
We conducted prospective surveillance for individuals with SARI from 2009–2012. Using
polymerase chain reaction, respiratory samples were tested for ten viruses, and blood for
pneumococcal DNA. Cumulative annual SARI incidence was estimated at one site with
population denominators. FINDINGS
We enrolled 7193 individuals, 9% (621/7067) tested positive for influenza and 9%(600/6519)
for pneumococcus. HIV-prevalence was 74% (4663/6334). Among HIV-infected individuals
with available data, 41% of 2629 were receiving antiretroviral therapy (ART). The annual
SARI hospitalisation incidence ranged from 325-617/100,000 population. HIV-infected individuals
experienced a 13–19 times greater SARI incidence than HIV-uninfected individuals
(p<0.001). On multivariable analysis, compared to HIV-uninfected individuals, HIV-infected
individuals were more likely to be receiving tuberculosis treatment (odds ratio (OR):1.7;
95%CI:1.1–2.7), have pneumococcal infection (OR 2.4; 95%CI:1.7–3.3) be hospitalised
for >7 days rather than <2 days (OR1.7; 95%CI:1.2–2.2) and had a higher case-fatality
ratio (8% vs 5%;OR1.7; 95%CI:1.2–2.3), but were less likely to be infected with influenza
(OR 0.6; 95%CI:0.5–0.8). On multivariable analysis, independent risk indicators associated
with death included HIV infection (OR 1.8;95%CI:1.3–2.4), increasing age-group, receiving
mechanical ventilation (OR 6.5; 95%CI:1.3–32.0) and supplemental-oxygen therapy
(OR 2.6; 95%CI:2.1–3.2).
CONCLUSION
The burden of hospitalized SARI amongst individuals aged 5 years is high in South Africa.
HIV-infected individuals are the most important risk group for SARI hospitalization and mortality
in this setting. |
en_ZA |
dc.description.librarian |
am2015 |
en_ZA |
dc.description.sponsorship |
The NICD/
NHLS and was supported in part by funds from the
United States Centers for Disease Control and
Prevention (CDC), Atlanta, Georgia Preparedness
and Response to Avian and Pandemic Influenza in
South Africa (Cooperative Agreement Number: U51/
IP000155-04). |
en_ZA |
dc.description.uri |
http://www.plosone.org |
en_ZA |
dc.identifier.citation |
Cohen C, Walaza S, Moyes J, Groome M, Tempia S, Pretorius M, et al. (2015) Epidemiology of Severe Acute Respiratory Illness (SARI) among Adults and Children Aged 5 Years in a High HIV-Prevalence Setting, 2009–2012. PLoS ONE 10(2): e0117716. DOI: 10.1371/journal.pone.0117716 |
en_ZA |
dc.identifier.issn |
1932-6203 |
|
dc.identifier.other |
10.1371/journal.pone.0117716 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/45669 |
|
dc.language.iso |
en |
en_ZA |
dc.publisher |
Public Library of Science |
en_ZA |
dc.rights |
This is an open access article, free of all
copyright, and may be freely reproduced, distributed,
transmitted, modified, built upon, or otherwise used
by anyone for any lawful purpose. The work is made
available under the Creative Commons CC0 public
domain dedication. |
en_ZA |
dc.subject |
SARI epidemiology |
en_ZA |
dc.subject |
Adults |
en_ZA |
dc.subject |
Children |
en_ZA |
dc.subject |
Severe acute respiratory illness (SARI) |
en_ZA |
dc.subject |
Human immunodeficiency virus (HIV) |
en_ZA |
dc.title |
Epidemiology of severe acute respiratory illness (SARI) among adults and children aged 5 years in a high HIV-prevalence Setting, 2009–2012 |
en_ZA |
dc.type |
Article |
en_ZA |