Mortality amongst patients with influenza-associated severe acute respiratory illness, South Africa, 2009-2013.
Mortality amongst patients with influenza-associated severe acute respiratory illness, South Africa, 2009-2013.
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DOI：
10.1371/journal.pone.0118884
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Madhi SA
中科院分区：
文献类型：
--
作者：
Cohen C;Moyes J;Tempia S;Groome M;Walaza S;Pretorius M;Dawood H;Chhagan M;Haffejee S;Variava E;Kahn K;von Gottberg A;Wolter N;Cohen AL;Malope-Kgokong B;Venter M;Madhi SA
关于非洲流感相关死亡的负担和风险群体的数据有限。我们的目的是评估住院期间流感相关严重急性呼吸系统疾病(SARI)死亡的发生率和危险因素。2009-2013年间，南非四个省的沙利氏综合症住院患者进行了前瞻性登记。利用聚合酶链式反应，对呼吸道样本进行了10种呼吸道病毒的检测，并对血液进行了肺炎球菌DNA的检测。流感相关SARI死亡的发生率是在一家有固定集水区人口的城市医院估计的。我们招募了1376名流感相关SARI患者，其中3%(1358名有可用结果数据的患者中有41名死亡)。在有艾滋病毒状态的患者中，艾滋病毒感染者的病死率(5%，22/419)高于未感染者(2%，13/620；P=0.006)。CFPS因年龄组不同而不同，在5岁的个体中，随着年龄的增长，CFPS通常会增加(p<；0.001)。在多变量分析中，与死亡相关的因素有45-年龄组(OR4.0，95%可信区间(CI)1.01-16.3)和≥65岁(OR6.5，95%CI1.2-34.3)，而1-4岁年龄组的CFP最低，艾滋病毒感染(OR2.9，95%CI1.1-7.8)，基础疾病(OR2.9，95%CI1.2-7.3)和肺炎球菌混合感染(OR4.1，95%可信区间1.5-11.2)。1岁儿童(20.1，95%可信区间12.1-31.3)和45-年龄的成人(10.4，95%可信区间8.4-12.9)每10万人口中与流感相关的SARI死亡的估计发病率最高。调整年龄因素后，HIV感染者的死亡率是未感染者的20倍(95%可信区间15.0-27.8)。流感在南非城市造成大量死亡，特别是在1岁的婴儿和感染艾滋病毒的个人中。更广泛地获得抗逆转录病毒治疗和流感疫苗接种可能会减轻这一负担。
Data on the burden and risk groups for influenza-associated mortality from Africa are limited. We aimed to estimate the incidence and risk-factors for in-hospital influenza-associated severe acute respiratory illness (SARI) deaths. Hospitalised patients with SARI were enrolled prospectively in four provinces of South Africa from 2009–2013. Using polymerase chain reaction, respiratory samples were tested for ten respiratory viruses and blood for pneumococcal DNA. The incidence of influenza-associated SARI deaths was estimated at one urban hospital with a defined catchment population. We enrolled 1376 patients with influenza-associated SARI and 3% (41 of 1358 with available outcome data) died. In patients with available HIV-status, the case-fatality proportion (CFP) was higher in HIV-infected (5%, 22/419) than HIV-uninfected individuals (2%, 13/620; p = 0.006). CFPs varied by age group, and generally increased with increasing age amongst individuals >5 years (p<0.001). On multivariable analysis, factors associated with death were age-group 45–64 years (odds ratio (OR) 4.0, 95% confidence interval (CI) 1.01–16.3) and ≥65 years (OR 6.5, 95%CI 1.2–34.3) compared to 1–4 year age-group who had the lowest CFP, HIV-infection (OR 2.9, 95%CI 1.1–7.8), underlying medical conditions other than HIV (OR 2.9, 95%CI 1.2–7.3) and pneumococcal co-infection (OR 4.1, 95%CI 1.5–11.2). The estimated incidence of influenza-associated SARI deaths per 100,000 population was highest in children <1 year (20.1, 95%CI 12.1–31.3) and adults aged 45–64 years (10.4, 95%CI 8.4–12.9). Adjusting for age, the rate of death was 20-fold (95%CI 15.0–27.8) higher in HIV-infected individuals than HIV-uninfected individuals. Influenza causes substantial mortality in urban South Africa, particularly in infants aged <1 year and HIV-infected individuals. More widespread access to antiretroviral treatment and influenza vaccination may reduce this burden.
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影响因子：
3.7
作者：
Chowell G;Echevarría-Zuno S;Viboud C;Simonsen L;Miller MA;Fernández-Gárate I;González-Bonilla C;Borja-Aburto VH
通讯作者：
Borja-Aburto VH
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168.9
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Jamieson, Denise J.;Honein, Margaret A.;Olsen, Sonja J.
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6.4
作者：
Lee, Nelson;Chan, Paul K. S.;Hui, David. S. C.
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Hui, David. S. C.
影响因子：
11.8
作者：
Sheth, Anandi N.;Althoff, Keri N.;Brooks, John T.
通讯作者：
Brooks, John T.
影响因子：
3.7
作者：
Feikin DR;Njenga MK;Bigogo G;Aura B;Aol G;Audi A;Jagero G;Muluare PO;Gikunju S;Nderitu L;Balish A;Winchell J;Schneider E;Erdman D;Oberste MS;Katz MA;Breiman RF
通讯作者：
Breiman RF