Global Role and Burden of Influenza in Pediatric Respiratory Hospitalizations, 1982-2012:A Systematic Analysis

BACKGROUND:The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide. METHODS AND FINDINGS:We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings. CONCLUSIONS:Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo

A Recent Update Of Schistomiasis Mansoni Endemicity Around Lake Rweru

Background: Schistosomiasis remains a global public health challenge with an estimated 200 million cases reported each year. In Rwanda, the prevalence of schistosomiasis was recently examined by a countrywide mapping conducted by the Neglected Tropical Disease (NTD) Control Programme of the Rwandan Ministry of Health in partnership with The Access Project. Unfortunately, that study failed to consider one area of endemicity -- Lake Rweru, located in Bugesera District, Eastern Province, Rwanda. This screening aimed to evaluate Lake Rweru and its environs in order to determine next steps for disease control. Methods: The lake’s shore inhabitants, including children and adults, were invited to be screened for intestinal schistosomiasis. The stool examination was performed by Kato-Katz technique. Results: A total of 270 children and adults were parasitologically screened. Fifty seven (57) cases of schistosomiasis mansoni were confirmed (21.1%). The highest proportion of S. mansoni infection was observed at Mazane Island (30.1% of 93 island inhabitants screened). Conclusion: The present results confirm that Lake Rweru is a significant source of S. mansoni infection in the country. We recommend further future investigations in order to know the true disease prevalence. While the mass de-worming campaign against schistosomiasis in addition to soil-transmitted helminthiasis is being regularly conducted by the Ministry of Health in all endemic areas, the population surrounding Lake Rweru should receive special attention.Contexte: La schistosomiase demeure un problème important de santé publique globalement avec environ 200 millions de cas rapportés chaque année. Au Rwanda, la situation de la schistosomiase a été récemment mise à jour par une cartographie nationale conduite par le Programme de Contrôle des Maladies Tropicales Négligées (MTN) du Ministère de la Santé en collaboration avec The Access Project. Cependant, le lac Rweru situé dans le District de Bugesera, Province de l’Est, Rwanda, a été incorrectement manqué parmi les foyers les plus endémiques. L’investigation visait à confirmer le foyer afin de déterminer de prochaines étapes pour le contrôle de l’infestation à Schistosoma mansoni. Méthodes: La population habitant aux alentours du lac Rweru comprenant des enfants et des adultes a été invitée à fournir leurs échantillons de selles en vue d’être examinés pour la schistosomiase intestinale. L’examen de selles a été réalisé par la technique de Kato-Katz. Résultats: Un total de 270 individus (des enfants et des adultes) ont été examinés parasitologiquement. Cinquante-sept (57) cas de schistosomiase mansoni ont été confirmés (21.1%). On a observé la proportion la plus élevée de l’infection à S. mansoni à l’île de Mazane (30.1% de 93 habitants insulaires testés). Conclusion: Les résultats actuels confirment que le lac Rweru est une source importante de S. mansoni dans le pays. Nous recommandons des enquêtes postérieures afin de connaître la vraie prévalence de la maladie dans cette zone. Pendant que la campagne de déparasitage de masse contre la schistosomiase en plus des géo-helminthiases est régulièrement organisée par le Ministère de la Santé dans toutes les zones endémiques, la population environnant le lac Rweru devrait recevoir une attention particulière

Severe Acute Respiratory Illness Deaths in Sub-Saharan Africa and the Role of Influenza: A Case Series From 8 Countries

Item does not contain fulltextBACKGROUND: Data on causes of death due to respiratory illness in Africa are limited. METHODS: From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)-associated deaths identified from influenza surveillance during 2009-2012. RESULTS: Twenty-three countries (82%) responded, 11 (48%) collect mortality data, and 8 provided data. Data were collected from 37 714 SARI cases, and 3091 (8.2%; range by country, 5.1%-25.9%) tested positive for influenza virus. There were 1073 deaths (2.8%; range by country, 0.1%-5.3%) reported, among which influenza virus was detected in 57 (5.3%). Case-fatality proportion (CFP) was higher among countries with systematic death reporting than among those with sporadic reporting. The influenza-associated CFP was 1.8% (57 of 3091), compared with 2.9% (1016 of 34 623) for influenza virus-negative cases (P /=50 years. CONCLUSIONS: Few African countries systematically collect data on outcomes of people hospitalized with respiratory illness. Stronger surveillance for deaths due to respiratory illness may identify risk groups for targeted vaccine use and other prevention strategies