Risk factors for influenza-associated severe acute respiratory illness hospitalization in South Africa, 2012–2015

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dc.contributor.author Tempia, Stefano
dc.contributor.author Walaza, Sibongile
dc.contributor.author Moyes, Jocelyn
dc.contributor.author Cohen, Adam L.
dc.contributor.author Von Mollendorf, Claire
dc.contributor.author Treurnicht, Florette K.
dc.contributor.author Venter, Marietjie
dc.contributor.author Pretorius, Marthi A.
dc.contributor.author Hellferscee, Orienka
dc.contributor.author Mtshali, Senzo
dc.contributor.author Seleka, Mpho
dc.contributor.author Tshangela, Akhona
dc.contributor.author Nguweneza, Athermon
dc.contributor.author McAnerney, Johanna M.
dc.contributor.author Wolter, Nicole
dc.contributor.author Von Gottberg, Anne
dc.contributor.author Dawood, Halima
dc.contributor.author Variava, Ebrahim
dc.contributor.author Madhi, Shabir A.
dc.contributor.author Cohen, Cheryl
dc.date.accessioned 2018-08-01T12:42:29Z
dc.date.available 2018-08-01T12:42:29Z
dc.date.issued 2017
dc.description.abstract BACKGROUND : Data on risk factors for influenza-associated hospitalizations in low- and middle-income countries are limited. METHODS : We conducted active syndromic surveillance for hospitalized severe acute respiratory illness (SARI) and outpatient influenza-like illness (ILI) in 2 provinces of South Africa during 2012–2015. We compared the characteristics of influenza-positive patients with SARI to those with ILI to identify factors associated with severe disease requiring hospitalization, using unconditional logistic regression. RESULTS : During the study period, influenza virus was detected in 5.9% (110 of 1861) and 15.8% (577 of 3652) of SARI and ILI cases, respectively. On multivariable analysis factors significantly associated with increased risk of influenza-associated SARI hospitalization were as follows: younger and older age (<6 months [adjusted odds ratio {aOR}, 37.6], 6–11 months [aOR, 31.9], 12–23 months [aOR, 22.1], 24–59 months [aOR, 7.1], and ≥65 years [aOR, 40.7] compared with 5–24 years of age), underlying medical conditions (aOR, 4.5), human immunodeficiency virus infection (aOR, 4.3), and Streptococcus pneumoniae colonization density ≥1000 deoxyribonucleic acid copies/mL (aOR, 4.8). Underlying medical conditions in children aged <5 years included asthma (aOR, 22.7), malnutrition (aOR, 2.4), and prematurity (aOR, 4.8); in persons aged ≥5 years, conditions included asthma (aOR, 3.6), diabetes (aOR, 7.1), chronic lung diseases (aOR, 10.7), chronic heart diseases (aOR, 9.6), and obesity (aOR, 21.3). Mine workers (aOR, 13.8) and pregnant women (aOR, 12.5) were also at increased risk for influenza-associated hospitalization. CONCLUSIONS : The risk groups identified in this study may benefit most from annual influenza immunization, and children <6 months of age may be protected through vaccination of their mothers during pregnancy en_ZA
dc.description.department Medical Virology en_ZA
dc.description.librarian am2018 en_ZA
dc.description.sponsorship The National Institute for Communicable Diseases (National Health Laboratory Service) and the US Centers for Disease Control and Prevention (cooperative agreement number 5U51IP000155). en_ZA
dc.description.uri https://academic.oup.com/ofid en_ZA
dc.identifier.citation Tempia et al 2017, 'Risk factors for influenza-associated severe acute respiratory illness hospitalization in South Africa, 2012–2015', Open Forum Infectious Diseases, vol. 10, no. 4, pp. 1-10. en_ZA
dc.identifier.issn 2328-8957 (online)
dc.identifier.other 10.1093/ofid/ofw262
dc.identifier.uri http://hdl.handle.net/2263/66050
dc.language.iso en en_ZA
dc.publisher Oxford University Press en_ZA
dc.rights © The Author 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence. en_ZA
dc.subject Hospitalization en_ZA
dc.subject Risk factors en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Influenza-associated hospitalization en_ZA
dc.subject Severe acute respiratory illness (SARI) en_ZA
dc.subject Influenza-like illness (ILI) en_ZA
dc.title Risk factors for influenza-associated severe acute respiratory illness hospitalization in South Africa, 2012–2015 en_ZA
dc.type Article en_ZA


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