Burden of Influenza and Influenza-associated Pneumonia in the First Year of Life in a Prospective Cohort Study in Managua, Nicaragua.
Burden of Influenza and Influenza-associated Pneumonia in the First Year of Life in a Prospective Cohort Study in Managua, Nicaragua.
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DOI：
10.1097/inf.0000000000000944
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
Gordon A
中科院分区：
文献类型：
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作者：
Gresh L;Kuan G;Sanchez N;Azziz-Baumgartner E;Ojeda S;Melendez M;Lopez R;Martin ET;Widdowson MA;Bresee J;Harris E;Balmaseda A;Gordon A
文本中提供了补充数字内容。流感是全球范围内的一个主要公共卫生问题;然而，对热带地区的流感，特别是婴儿的流感知之甚少。需要更多的信息，为公共卫生政策的制定提供信息，特别是疫苗接种指南。在2011年9月至2013年7月期间，我们将新生儿纳入了哥伦比亚出生队列研究。婴儿提供初级医疗保健，并积极随访逆转录聚合酶链反应证实的流感病毒感染时，出现流感样疾病或未分化发热。本报告提供了与生命第一年有关的数据。在参加研究的518名儿童中，441人在他们生命的第一年参与了研究，71人退出，6人死亡。总体而言，13%的参与者经历了至少1次实验室确认的流感病毒感染。流感的总体发病率为15.5例/100人-年[95%置信区间（CI）：12.2-19.5]。6-11月龄婴儿实验室确诊流感的发生率显著高于0-5月龄婴儿（发病率比：2.1; 95% CI：1.3-3.4）。肺炎的总发生率为52.6例/100人-年（95% CI：46.3-59.6）。3%的肺炎病例与流感相关，流感相关肺炎和住院的发生率分别为1.7（95% CI：0.9-3.5）和0.22（95% CI：0.03-1.55）例/100人-年。我们发现婴儿流感和流感相关严重呼吸系统疾病的负担很大。我们的研究结果支持了探索孕妇和6个月以上婴儿接种疫苗的潜在价值的必要性，正如世界卫生组织在2012年建议的那样。
Supplemental Digital Content is available in the text. 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. 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. Of the 518 children enrolled in the study, 441 participated throughout their first year of life, 71 were withdrawn, and 6 died.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. 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.