Abstract
BackgroundInfluenza surveillance data from Africa indicate a substantial disease burden with high mortality. However, local influenza data from district hospitals with limited laboratory facilities are still scarce.ObjectivesTo identify the frequency and seasonal distribution of influenza among hospitalized febrile children in a rural hospital in Ghana and to describe differential diagnoses to other severe febrile infections.MethodsBetween January 2014 and April 2015, all children with a temperature of ≥38°C admitted to a district hospital in Ghana were screened for influenza A and B by RT‐PCR and differentiated to subtypes A(H1N1)pdm09 and A(H3N2). Malaria microscopy and blood cultures were performed for each patient.ResultsA total of 1063 children with a median age of 2 years (IQR: 1‐4 years) were recruited. Of those, 271 (21%) were classified as severe acute respiratory infection (SARI) and 47 (4%) were positive for influenza, namely 26 (55%) influenza B, 15 (32%) A(H1N1)pdm09, and 6 (13%) A(H3N2) cases. Influenza predominantly occurred in children aged 3‐5 years and was more frequently detected in the major rainy season (OR = 2.9; 95% CI: 1.47‐6.19) during the first half of the year. Two (4%) and seven (15%) influenza‐positive children were co‐diagnosed with an invasive bloodstream infection or malaria, respectively.ConclusionInfluenza contributes substantially to the burden of hospitalized febrile children in Ghana being strongly dependent on age and corresponds with the major rainy season during the first half‐year.
Highlights
Influenza has long been regarded as a major public health concern
It has been assumed that 99% of inpatient deaths from severe acute respiratory infections (SARI)[4] and 70% of all deaths attributable to influenza- like illnesses (ILI) among children below 5 years of age occurred in developing countries.[5]
In contrast to SARI cases, influenza patients had a median age of 3 years (IQR: 1-5 ) and were most frequently detected in the 3-5 years age group (n = 18; 6%) with an odds ratio of 2.0 (Table 1)
Summary
Influenza has long been regarded as a major public health concern. the elderly and very young children have been identified as a vulnerable group for influenza infections. Objectives: To identify the frequency and seasonal distribution of influenza among hospitalized febrile children in a rural hospital in Ghana and to describe differential diagnoses to other severe febrile infections. Methods: Between January 2014 and April 2015, all children with a temperature of ≥38°C admitted to a district hospital in Ghana were screened for influenza A and B by RT-PCR and differentiated to subtypes A(H1N1)pdm[09] and A(H3N2). Influenza predominantly occurred in children aged 3-5 years and was more frequently detected in the major rainy season (OR = 2.9; 95% CI: 1.47-6.19) during the first half of the year. Conclusion: Influenza contributes substantially to the burden of hospitalized febrile children in Ghana being strongly dependent on age and corresponds with the major rainy season during the first half-year
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