Description of the study participants in case-control study of risk factors for hospitalized influenza, Bondo District, Kenya, 2007-9.

<p>Description of the study participants in case-control study of risk factors for hospitalized influenza, Bondo District, Kenya, 2007-9.</p

Results of bivariate and multivariable analysis of risk factors for hospitalized influenza A and B, indicating the factors that were included in the multivariate model (p<0.10), Bondo District, Kenya, 2007-9.

a<p>Total number of cases and controls tested was 53 and 136 respectively. Reference group is HIV-negative.</p

Results of bivariate and multivariable analysis of risk factors for hospitalized influenza A, indicating the factors that were included in the multivariate model (p<0.10), Bondo District, Kenya, 2007-9.

a<p>Total number of cases and controls tested was 32 and 82 respectively. Reference group is HIV-negative.</p

Annual rates^a for hospitalizations and outpatient visits attributable to influenza and RSV by year (per 1,000 persons) in Western Kenya, Aug 2009– Jul 2012.

a<p>Adjusted for those that met the case definition for SARI/ILI without laboratory test results;^bAugust 2009– July 2010; ^cAugust 2010– July 2011; ^dAugust 2011– July 2012.</p

Seasonality of Influenza and RSV in Western Kenya, Aug 2009– Jul 2012.

<p>Seasonality of Influenza and RSV in Western Kenya, Aug 2009– Jul 2012.</p

Results of bivariate and multivariable analysis of risk factors for hospitalized influenza B, indicating the factors that were included in the multivariate model (p<0.10), Bondo District, Kenya, 2007-9.

a<p>Total number of cases and controls tested was 21 and 53 respectively. Reference group is HIV-negative.</p

Characteristics of patients who were admitted at SDH with SARI and those who presented to THC with ILI and were tested for respiratory pathogens, August 2009– July 2012.

¥<p>18% of those with known HIV status were HIV infected; *Denominator is the number of those who tested for Influenza and RSV; **Denominator in the number of influenza A cases.</p

Age-specific average annual rates for hospitalizations and outpatient visits attributable to influenza and RSV (per 1,000 persons) in Western Kenya, August 2009– July 2012^a.

a<p>Includes only data for residents of the HDSS area of Keremo Division (2009–2012); ^bAdjusted for those that met the case definition for SARI/ILI without laboratory test results; ^cAdjusted for persons with pneumonia who did not seek care, using the results of a 2005 HUS; 48% (95% CI 35–62) of children <5 years and 34% (95% CI 23–48) of persons ≥5 years sought care for pneumonia at a hospital (Burton et al, 2005); ^dAdjusted for persons with ILI who did not seek care, using the results of a 2005 HUS; 42%(95% CI 33–51) of children <5 years and 44%(95% CI 40–53) of persons ≥5 years sought care at any facility for ARI (Burton et al, 2005).</p><p>* Estimates not calculated because there were fewer than 30 specimens tested in this age-specific stratum.</p

Predicting Mortality among Hospitalized Children with Respiratory Illness in Western Kenya, 2009–2012

<div><p>Background</p><p>Pediatric respiratory disease is a major cause of morbidity and mortality in the developing world. We evaluated a modified respiratory index of severity in children (mRISC) scoring system as a standard tool to identify children at greater risk of death from respiratory illness in Kenya.</p><p>Materials and Methods</p><p>We analyzed data from children <5 years old who were hospitalized with respiratory illness at Siaya District Hospital from 2009–2012. We used a multivariable logistic regression model to identify patient characteristics predictive for in-hospital mortality. Model discrimination was evaluated using the concordance statistic. Using bootstrap samples, we re-estimated the coefficients and the optimism of the model. The mRISC score for each child was developed by adding up the points assigned to each factor associated with mortality based on the coefficients in the multivariable model.</p><p>Results</p><p>We analyzed data from 3,581 children hospitalized with respiratory illness; including 218 (6%) who died. Low weight-for-age [adjusted odds ratio (aOR) = 2.1; 95% CI 1.3–3.2], very low weight-for-age (aOR = 3.8; 95% CI 2.7–5.4), caretaker-reported history of unconsciousness (aOR = 2.3; 95% CI 1.6–3.4), inability to drink or breastfeed (aOR = 1.8; 95% CI 1.2–2.8), chest wall in-drawing (aOR = 2.2; 95% CI 1.5–3.1), and being not fully conscious on physical exam (aOR = 8.0; 95% CI 5.1–12.6) were independently associated with mortality. The positive predictive value for mortality increased with increasing mRISC scores.</p><p>Conclusions</p><p>A modified RISC scoring system based on a set of easily measurable clinical features at admission was able to identify children at greater risk of death from respiratory illness in Kenya.</p></div

Rates of influenza and RSV associated SARI by distance from SDH, Aug 2009– Jul 2012.

<p>Rates of influenza and RSV associated SARI by distance from SDH, Aug 2009– Jul 2012.</p