Burden of Influenza in Less Than 5-Year-Old Children Admitted to Hospital with Pneumonia in Developing and Emerging Countries: A Descriptive, Multicenter Study

Abstract

This descriptive 4-year study reports the proportion of detection of influenza viruses in less than 5-year-old children hospitalized for pneumonia in eight developing and emerging countries and describes clinical and microbiological characteristics of influenza-related pneumonia cases. Hospitalized children presenting radiologically confirmed pneumonia aged 2-60 months were prospectively enrolled in this observational standardized study. Mean proportion of isolated influenza virus was 9.7% (95% confidence interval: 7.9-11.8%) among 888 pneumonia children analyzed, with moderate heterogeneity between countries-ranging from 6.2% in Cambodia to 18.8% in Haiti. The clinical characteristics of children with influenza-related pneumonia were not substantially different from those of other pneumonia cases. Influenza A H1N1-related pneumonia cases appeared as more severe than pneumonia cases related to other strains of influenza. was detected more often in blood samples from influenza-related cases than in those without detected influenza viruses (19.7% versus 9.5%, = 0.018). Influenza-related pneumonia is frequent among children less than 5 years old with pneumonia, living in developing and emerging countries. Influenza might be a frequent etiologic agent responsible for pneumonia or a predisposing status factor for pneumococcal-related pneumonia in this population.

Epidemiology of severe cases of influenza and other acute respiratory infections in the Eastern Mediterranean Region, July 2016 to June 2018

“…According to our study findings, the incidence of influenza virus infection was highest in children less than 5 years, which is consistent with findings from other studies conducted in different regions [19]. Children are more susceptible to influenza viruses; therefore, they have a higher incidence of severe cases of influenza than other age groups [20].…”

Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study

“…Though influenza virus also increases risk for secondary bacterial infections and is a major cause of childhood morbidity and mortality worldwide, data from developing countries is scarce 37. In a previous Indonesian study of hospitalised patients with a SARI, the prevalence of the influenza virus was 10.6% in children under 5 years old, and was never diagnosed during hospitalisation 38.…”

Aetiology of childhood pneumonia in low- and middle-income countries in the era of vaccination: a systematic review

“…The 12 remaining studies [53][54][55][56][57][58][59][60][61][62][63][64], included a variety of study designs (Table 7; Table S7 in the Online Supplementary Document). One study was a secondary data analysis from the GABRIEL Network [56], which reported the detection of influenza viruses in 888 hospitalised children aged 2 to 60 months with radiologically confirmed pneumonia.…”