Influenza is a Major Contributor to Childhood Pneumonia in a Tropical Developing Country

Abstract

Influenza is a major contributor to childhood pneumonia both through high influenza infection incidence and high pneumonia prevalence among infected children. Its contribution to early childhood pneumonia appears under-appreciated in high pneumonia-endemic tropical settings. Influenza vaccine trials against childhood pneumonia are warranted.

Population-based active surveillance cohort studies for influenza: lessons from Peru

“…To our knowledge, influenza surveillance efforts similar to the one described in this paper have been undertaken only in a few developing countries, including Bangladesh, Guatemala, India, Kenya and Nicaragua. [7][8][9][10][11] However, cohort studies with active household surveillance and specimen collection generate data that are critical to understanding the epidemiologic distribution and behaviour of respiratory pathogens, including influenza viruses, and to detect disease of all degrees of severity in the early stages of a pandemic. Mustering the resources to include this valuable complement to passive surveillance systems should be a priority.…”

“…We are presently exploring multiplex diagnostic platforms to simultaneously detect a broad array of respiratory pathogens, which is essential given the importance of possible recombination events and the historical evidence of viral-bacterial coinfection as a major factor in mortality associated with influenza. 7 As with the influenza virus data, incidence and attack rates, disease burden, seasonal trends and disaggregated risk factors can all be calculated. Finally, there is the potential to leverage the existing infrastructure of the influenza cohort study to monitor other syndromes.…”

Influenza-associated mortality in 2009 in four sentinel sites in Bangladesh

“…Despite this, acute respiratory infection, including pneumonia, is the leading cause of childhood death in Bangladesh 27 and influenza is an important contributor to childhood pneumonia and hospitalization. 28 We estimate that A(H1N1)pdm09 killed approximately 6000 people in Bangladesh in 2009, and that the mortality associated with this pathogen in Bangladesh was higher among those aged 5−59 years than in younger or older people. Similar observations on the age-specific mortality associated with the 2009 A(H1N1) pandemic were made in Mexico, the United Kingdom of Great Britain and Northern Ireland and the United States, where confirmed fatal cases were concentrated among young adults.…”

“…Third, fever (as identified by the proxy respondents) was used as a compulsory criterion in identifying ILI, even though children and elderly people with influenza do not always present with this symptom. 28,34 Fourth, some deaths may have gone undetected by the field teams. No attempt was made to perform a house-to-house survey, which might have revealed some more relevant deaths.…”

Design and initiation of a study to assess the direct and indirect effects of influenza vaccine given to children in rural India

“…Although influenza disease is well characterized in both developed and developing countries, the epidemiology in developing countries is less well described, particularly for children [1][2][3]. Furthermore, influenza vaccine use remains very limited in many developing countries and the benefits of immunization in these populations have not been investigated to the same extent as in developed countries [4].…”