Burden of Influenza and Influenza-associated Pneumonia in the First Year of Life in a Prospective Cohort Study in Managua, Nicaragua

被引:19
作者
Gresh, Lionel [1 ]
Kuan, Guillermina [2 ]
Sanchez, Nery [1 ]
Azziz-Baumgartner, Eduardo [3 ]
Ojeda, Sergio [1 ]
Melendez, Marlon [1 ]
Lopez, Roger [4 ]
Martin, Emily T. [5 ]
Widdowson, Marc-Alain [3 ]
Bresee, Joseph [3 ]
Harris, Eva [6 ]
Balmaseda, Angel [4 ]
Gordon, Aubree [5 ]
机构
[1] Sustainable Sci Inst, Managua, Nicaragua
[2] Minist Hlth, Ctr Salud Socrates Flores Vivas, Managua, Nicaragua
[3] Ctr Dis Control & Prevent, Atlanta, GA USA
[4] Minist Hlth, Ctr Nacl Diagnost & Referencia, Lab Nacl Virol, Managua, Nicaragua
[5] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, 1415 Washington Hts, Ann Arbor, MI 48104 USA
[6] Univ Calif Berkeley, Sch Publ Hlth, Div Infect Dis & Vaccinol, Berkeley, CA 94720 USA
基金
美国国家卫生研究院;
关键词
influenza; infant; cohort studies; pneumonia; hospitalization; YOUNG-CHILDREN; RESPIRATORY-INFECTIONS; SEASONAL INFLUENZA; GLOBAL BURDEN; HOSPITALIZATIONS; INFANTS; VACCINATION; VIRUS;
D O I
10.1097/INF.0000000000000944
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Influenza is a major public health problem worldwide; however, relatively little is known about influenza in tropical regions, especially for infants. Additional information is required to inform public health policy making, in particular vaccination guidelines. Methods: Between September 2011 and July 2013, we enrolled newborns into the Nicaraguan Birth Cohort Study. Infants were provided primary medical care and actively followed for reverse-transcription polymerase chain reaction-confirmed influenza virus infection when presenting with influenza-like illness or undifferentiated fever. This report presents data pertaining to the first year of life. Results: Of the 518 children enrolled in the study, 441 participated throughout their first year of life, 71 were withdrawn, and 6 died. Overall, 13% of the participants experienced at least 1 laboratory-confirmed influenza virus infection. The overall incidence of influenza was 15.5 cases per 100 person-years [95% confidence interval (CI): 12.2-19.5]. Infants aged 6-11 months experienced significantly higher rates of laboratory-confirmed influenza than infants aged 0-5 months (incidence rate ratio: 2.1; 95% CI: 1.3-3.4). The overall incidence of pneumonia was 52.6 cases per 100 person-years (95% CI: 46.3-59.6). Three percent of the pneumonia cases were influenza associated, and the incidence of influenza-associated pneumonia and hospitalization was 1.7 (95% CI: 0.9-3.5) and 0.22 (95% CI: 0.03-1.55) cases per 100 person-years, respectively. Conclusions: We found a significant burden of influenza and influenza-associated severe respiratory outcomes in infants. Our results support the need to explore the potential value of vaccinating pregnant women and infants aged >6 months, as recommended by the World Health Organization in 2012.
引用
收藏
页码:152 / 156
页数:5
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