Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic

被引：0

作者：

Lucinde, Ruth Khadembu ^{[1
]}

Gathuri, Henry ^{[1
]}

Isaaka, Lynda ^{[1
]}

Ogero, Morris ^{[1
]}

Mumelo, Livingstone ^{[1
]}

Kimego, Dennis ^{[1
]}

Mbevi, George ^{[1
]}

Wanyama, Conrad ^{[1
]}

Otieno, Edwin Onyango ^{[1
]}

Mwakio, Stella ^{[1
]}

Saisi, Metrine ^{[1
]}

Isinde, Elizabeth ^{[1
]}

Oginga, Irene Njeri ^{[2
]}

Wachira, Alvin ^{[3
]}

Manuthu, Evans ^{[4
]}

Kariuki, Hazel ^{[5
]}

Nyikuli, Jared ^{[6
]}

Wekesa, Cyprian ^{[6
]}

Otedo, Amos ^{[7
]}

Bosire, Hannah ^{[7
]}

Okoth, Steve Biko ^{[8
]}

Ongalo, Winston ^{[8
]}

Mukabi, David ^{[9
]}

Lusamba, Wilber ^{[9
]}

Muthui, Beatrice ^{[10
]}

Adembesa, Isaac ^{[11
]}

Mithi, Caroline ^{[11
]}

Sood, Mohammed ^{[12
]}

Ahmed, Nadia ^{[13
]}

Gituma, Bernard ^{[14
]}

Giabe, Matiko ^{[15
]}

Omondi, Charles ^{[16
]}

Aman, Rashid ^{[17
]}

Amoth, Patrick ^{[17
]}

Kasera, Kadondi ^{[17
]}

Were, Fred ^{[18
]}

Nganga, Wangari ^{[19
]}

Berkley, James A. ^{[1
,20
]}

Tsofa, Benjamin ^{[1
]}

Mwangangi, Jospeh ^{[1
]}

Bejon, Philip ^{[1
]}

Barasa, Edwine ^{[1
]}

English, Mike ^{[1
,20
]}

Scott, John Athony Gerard ^{[1
,21
]}

Akech, Samuel ^{[1
]}

Kagucia, Eunice Wangeci ^{[1
]}

Agweyu, Ambrose ^{[1
,20
]}

Etyang, Anthony Oliwa ^{[1
]}

机构：

[1] Wellcome Trust Res Programme KWTRP, KEMRI, Kilifi, Kenya

[2] KIAMBU DIST HOSP, Kiambu, Kenya

[3] Machakos Level Five Hosp, Machakos, Kenya

[4] Kitale Cty Referral Hosp, Kitale, Kenya

[5] Naivasha Level Five Hosp, Naivasha, Kenya

[6] Bungoma Cty Referral Hosp, Bungoma, Kenya

[7] Kisumu Cty Hosp, Kisumu, Kenya

[8] Kakamega Prov Gen Hosp, Kakamega, Kenya

[9] Busia Cty Referral Hosp, Busia, Kenya

[10] Mama Lucy Kibaki Hosp, Nairobi, Kenya

[11] Kenyatta Univ, Teaching Referral & Res Hosp, Nairobi, Kenya

[12] Coast Gen Teaching & Referral Hosp, Mombasa, Kenya

[13] Kilifi Cty Hosp, Kilifi, Kenya

[14] Mbagathi Cty Hosp, Nairobi, Kenya

[15] Kisii Teaching & Referral Hosp, Kisii, Kenya

[16] Jaram Oginga Odinga Teaching & Referral Hosp, Kisumu, Kenya

[17] Kenya Minist Hlth, Nairobi, Kenya

[18] Kenya Paediat Res Consortium, Nairobi, Kenya

[19] Govt Kenya, Presidential Policy & Strategy Unit, The Presidency, Nairobi, Kenya

[20] Univ Oxford, Ctr Trop Med & Global Hlth, Nuffield Dept Med, Oxford, England

[21] London Sch Hyg & Trop Med, London, England

来源：

BMC INFECTIOUS DISEASES | 2024年 / 24卷 / 01期

关键词：

Hospital surveillance; COVID-19; Severe acute respiratory illness; Vaccine effectiveness; NETWORK; CARE;

D O I：

10.1186/s12879-024-10140-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

BackgroundThere are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic.MethodsWe conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) and progression to inpatient mortality among patients admitted with SARI, using a test-negative case control design.ResultsOf the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10-1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24-1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27-0.77).ConclusionWe have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.

引用

页数：11

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