Author:
Pang Yong Kek,Ismail Ahmad Izuanuddin,Chan Yoke Fun,Cheong Adelina,Chong Yoong Min,Doshi Paras,Lau Joanne Zhi Han,Khor Jean,Wang Lilian Phei Lian,Leong Chee Loon,Musa Aisya Natasya,Ng Kee Sing,Poh Mau Ern,Sam I-Ching,Tan Jiunn Liang,Zim Mohd Arif Mohd,Taurel Anne-Frieda
Abstract
Abstract
Background
Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.
Methods
We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018–August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis.
Results
Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January–February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329–0.970)], p = 0.038) and of dyspnea (0.544 (0.341–0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death).
Conclusions
Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population.
Study registration, NMRR ID: NMRR-17-889-35,174.
Publisher
Springer Science and Business Media LLC
Reference32 articles.
1. World Health Organization. Vaccines against influenza WHO position paper – November 2012. Wkly Epidemiol Rec. 2012;87:461–76.
2. Centers for Disease Control and Prevention. Influenza (Flu). 2018. Available at https://www.cdc.gov/flu/highrisk/index.htm. Accessed 2 Jul 2021.
3. Van Kerkhove MD, Vandemaele KAH, Shinde V, Jaramillo-Gutierrez G, Koukounari A, Donnelly CA, et al. Risk factors for severe outcomes following 2009 influenza a (H1N1) infection: a global pooled analysis. PLoS Med. 2011;8(7):e1001053. https://doi.org/10.1371/journal.pmed.1001053.
4. World Health Organization. Seasonal influenza fact sheet. 2018. Available at https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal). Accessed 03 July 2020.
5. Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018;391(10127):1285–300. https://doi.org/10.1016/S0140-6736(17)33293-2.
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献