Clinical and epidemiological characterization of influenza virus infections in children with severe acute respiratory infection in Maputo, Mozambique: Results from the implementation of sentinel surveillance, 2014 – 2016

Abstract

In Sub-Saharan Africa, where burden, impact, and incidence of acute respiratory infections (ARI) are the highest in the world, conversely, the epidemiology of influenza-associated severe acute respiratory infections (SARI) is incompletely known. The aim of this study was to describe the clinical and epidemiological features of influenza-associated SARI in hospitalized children in Maputo city, Mozambique. Nasopharyngeal and oropharyngeal swabs were collected from children aged 0–14 years old who met the case definition for SARI in two hospitals in Maputo city after their parents or legal representative consented to participate. A structured questionnaire was used to collect clinical and demographic data. Typing and subtyping of influenza were performed by real-time PCR. From January 2014 to December 2016, a total of 2,007 eligible children were recruited, of whom 1,997 (99.5%) were screened for influenza by real-time PCR. The median age of participants was 16.9 months (IQR: 7.0–38.9 months) and 53.9% (1076/1991) were male. A total of 77 were positive for influenza, yielding a frequency of 3.9% (77/1,991), with the highest frequency being reported in the age group 1–5 years old. Cases of influenza peaked twice each year, during which, its frequency reached up to 60%-80%. Among all influenza confirmed cases, 33.7% (26/77), 35.1% (27/77) and 28.6% (22/77) were typed as influenza A/H3N2, A/H1N1pdm09, and B, respectively. This represents the first report of influenza in urban/sub urban setting in Mozambique and the first evidence of distribution of strains of influenza in the country. Our data showed that frequency of influenza was lower than reported in a rural setting in Mozambique and the frequency of seasonal (A/H1N1pdm09) and (A/H3N2) subtypes were similar in children with SARI.

Etiological and epidemiological characteristics of severe acute respiratory infection caused by multiple viruses and Mycoplasma pneumoniae in adult patients in Jinshan, Shanghai: A pilot hospital-based surveillance study

“…the burden of SARI focus on viral infections in children [8][9][10][11]. A SARI surveillance study in China revealed that 90% of patients were aged <15 years [12].…”

Tuberculosis space-temporal distribution from 2011 to 2016 in the municipality of Maputo, Mozambique

“…it is possible to raise the hypothesis of an underdiagnosis of pediatric cases in Maputo. Although, in recent years, there has been an improvement in the tracking and diagnosis of these cases, resulting from the qualification and training of clinicians in the field of pediatric TB (Ministry of Health of Mozambique, 2014; Nguenha et al 2018).…”

“…In the southern region of Mozambique, where Maputo is located, almost 70,000 people migrate annually to work in the mines of South Africa, a country that holds 3% of the TB load in the world (Southern Africa Tuberculosis and Health Systems [SATBHSS], 2017;WHO, 18;Mathema et al 2015). In Mozambique, in the district of Manhiça, TB notifications from 1997 to 2012 are three times higher than in other areas, being higher for men than for women (Nguenha et al 2018). Despite data being available at the regional level, the temporal trend of TB in the capital Maputo has been little explored to support intervention measures aimed at TB prevention and control.…”

Genetic polymorphisms of rs9313422 G>C and rs41297579 G>A at the promoter of TIM‐1 gene contribute to the risk of community‐acquired pneumonia in children

“…While, the acute infection of the pulmonary parenchyma, developing outside the hospital or diagnosing within 48 hours of admission to the hospital, was credited as community‐acquired pneumonia (CAP), which was common in children . According to the epidemiological investigation, CAP was believed as one of the most severe acute respiratory infections (ARI), approximately accounting for 80% of all deaths suffering from this disease, which was more frequent in developing countries . Moreover, the incidence rate of CAP in children was nearly 22%, and there were about 55,000 children deaths every year caused by CAP in China .…”

“…respiratory infections (ARI), approximately accounting for 80% of all deaths suffering from this disease, 5 which was more frequent in developing countries. 6 Moreover, the incidence rate of CAP in children was nearly 22%, and there were about 55,000 children deaths every year caused by CAP in China. 7 Although the pathological mechanism of CAP has not been clearly elucidated, many researchers have focused their attentions on genetic factors in CAP.…”