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Burden of influenza among hospitalized febrile children in Ghana

机译:加纳住院发热儿童的流感负担

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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.
机译:摘要背景来自非洲的流感监测数据表明,疾病负担重,死亡率高。但是,仍然缺乏实验室设施有限的地区医院的本地流感数据。目的确定加纳乡村医院住院发热儿童中流感的频率和季节性分布,并描述与其他严重发热感染的鉴别诊断。方法在2014年1月至2015年4月之间,通过RT-PCR筛查加纳地区医院收治的所有温度≥38°C的儿童,以进行甲型和乙型流感的筛查,并将其分为A(H1N1)pdm09和A(H3N2)亚型。对每位患者进行疟疾显微镜检查和血液培养。结果共招募了1063名中位年龄为2岁(IQR:1-4岁)的儿童。在这些人中,有271名(21%)被归为严重急性呼吸道感染(SARI),而47名(4%)被确定为流感阳性,即26(55%)乙型流感,15(32%)A(H1N1)pdm09和A(H3N2)6例(13%)。流感主要发生在3-5岁的儿童中,并且在上半年的主要雨季更常见(OR?=?2.9; 95%CI:1.47-6.19)。分别对2名(4%)和7名(15%)流感阳性儿童进行了侵入性血液感染或疟疾的联合诊断。结论流感对加纳住院的发热儿童的负担有很大影响,这主要取决于年龄,并且与上半年的主要雨季相对应。

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