Facility-based Surveillance for Influenza and Respiratory Syncytial Virus in Rural Zambia

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2021 Sep 22

PMID 34548020

Citations 5

Authors

Gideon Loevinsohn

Mutinta Hamahuwa

Pamela Sinywimaanzi

Katherine Z J Fenstermacher

Kathryn Shaw-Saliba

Andrew Pekosz

Mwaka Monze

Richard E Rothman

Edgar Simulundu

Philip E Thuma

Catherine G Sutcliffe

Affiliations

Soon will be listed here.

Abstract

Background: While southern Africa experiences among the highest mortality rates from respiratory infections, the burden of influenza and respiratory syncytial virus (RSV) in rural areas is poorly understood.

Methods: We implemented facility-based surveillance in Macha, Zambia. Outpatients and inpatients presenting with influenza-like illness (ILI) underwent testing for influenza A, influenza B, and RSV and were prospectively followed for 3 to 5 weeks to assess clinical course. Log-binomial models assessed correlates of infection and clinical severity.

Results: Between December 2018 and December 2019, 17% of all outpatients presented with ILI and 16% of inpatients were admitted with an acute respiratory complaint. Influenza viruses and RSV were detected in 17% and 11% of outpatient participants with ILI, and 23% and 16% of inpatient participants with ILI, respectively. Influenza (July-September) and RSV (January-April) prevalence peaks were temporally distinct. RSV (relative risk [RR]: 1.78; 95% confidence interval [CI] 1.51-2.11), but not influenza, infection was associated with severe disease among patients with ILI. Underweight patients with ILI were more likely to be infected with influenza A (prevalence ratio [PR]: 1.72; 95% CI 1.04-2.87) and to have severe influenza A infections (RR: 2.49; 95% CI 1.57-3.93).

Conclusions: Populations in rural Zambia bear a sizeable burden of viral respiratory infections and severe disease. The epidemiology of infections in this rural area differs from that reported from urban areas in Zambia.

Citing Articles

Respiratory viruses in rural Zambia during the second year of the COVID-19 pandemic.

Sutcliffe C, Hamahuwa M, Miller E, Sinywimaanzi P, Hardick J, Morales J IJID Reg. 2023; 8:90-94.

PMID: 37533553 PMC: 10391682. DOI: 10.1016/j.ijregi.2023.07.003.

Molecular epidemiology of respiratory syncytial virus in children with acute respiratory illnesses in Africa: A systematic review and meta-analysis.

Regassa B, Gebrewold L, Mekuria W, Kassa N J Glob Health. 2023; 13:04001.

PMID: 36637855 PMC: 9840062. DOI: 10.7189/jogh.13.04001.

Uptake of public health measures and vaccine acceptance during the COVID-19 pandemic in rural Zambia.

Sutcliffe C, Sinywimaanzi P, Morales J, Sianyanda M, Muleka M, Fenstermacher K Hum Vaccin Immunother. 2022; 18(7):2153538.

PMID: 36482701 PMC: 9762779. DOI: 10.1080/21645515.2022.2153538.

The Unmeasured Burden of Febrile, Respiratory, and Diarrheal Illnesses Identified Through Active Household Surveillance in a Low Malaria Transmission Setting in Southern Zambia.

Mueller A, Matoba J, Schue J, Hamapumbu H, Kobayashi T, Stevenson J Am J Trop Med Hyg. 2022; 106(6):1791-1799.

PMID: 35895429 PMC: 9209922. DOI: 10.4269/ajtmh.21-1253.

Respiratory viruses in rural Zambia before and during the COVID-19 pandemic.

Loevinsohn G, Hamahuwa M, Hardick J, Sinywimaanzi P, Fenstermacher K, Munachoonga P Trop Med Int Health. 2022; 27(7):647-654.

PMID: 35611546 PMC: 9348166. DOI: 10.1111/tmi.13781.

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