Influenza Virus Surveillance in Pakistan during 2008-2011

Badar, Nazish; Aamir, Uzma Bashir; Mehmood, Muhammad Rashid; Nisar, Nadia; Alam, Muhammad Masroor; Kazi, Birjees Mazher; Zaidi, Syed Sohail Zahoor

doi:10.1371/journal.pone.0079959

Cited by 27 publications

(44 citation statements)

References 24 publications

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“…Furthermore, no difference in the severity of symptoms between PCR positive and PCR negative patients indicate that treatment may be considered in the lines of Influenza A infections by the attending physician in the light of current influenza epidemic. This is supported by previous studies which showed that clinical characteristics of patients presenting with ILI or SARI were significantly associated with the presence of influenza A(H1N1)pdm09 [8,9].…”

Section: Discussionsupporting

confidence: 88%

Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome

Ijaz

Khan

et al. 2017

Monaldi Arch Chest Dis

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Clinical judgement and suspicion of influenza based on signs and symptoms of influenza-like illness and severe acute respiratory illness are critical for better patient outcome. Whether clinical characteristics of patients are associated with the development of acute respiratory distress syndrome was the aim of this study. We included all patients (n=37) presenting with influenza like illness (ILI) or severe acute respiratory illness (SARI) to a tertiary care hospital in northwest Pakistan during December 2015 until the end of January 2016. Each patient was assessed for signs and symptoms, clinical features, treatment, complications and outcome of ILI and SARI. Throat or nasopharyngeal swabs were obtained from 36 patient and analyzed for the presence of Influenza virus by quantitative PCR. Patients presenting with ILI or SARI were febrile (p<0.001, one sample t-test), significantly tachypneic (p<0.001) and had critically lower oxygen saturation (p<0.001). Nasal congestion at presentation (p=0.006, chi-square test for association) and infiltrates on chest radiographs (p=0.025) were significantly associated with acute respiratory distress syndrome. Likelihood of the occurrence of ARDS was significantly increased with decrease in oxygen saturation (Odds ratio; 0.75, 95% CI; 0.46, 1.21, p=0.048) and marginally significantly increased in lower age (Odds ratio; 0.82, 95% CI; 0.58, 1.15, p=0.055) and higher white cell count (Odds ratio; 1.001, 95% CI; 0.99, 1.002, p=0.054).The presence of Influenza type A/H1N1pdm09 strains was confirmed in 7/11 patients. However no significant difference was observed in the clinical features and complications of PCR positive and negative patients. Clinical signs and symptoms of influenza-like illness or severe acute respiratory illness significantly predict the development of complications irrespective of the positivity or negativity of laboratory qPCR reports.

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Section: Discussionsupporting

confidence: 88%

Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome

Ijaz

Khan

et al. 2017

Monaldi Arch Chest Dis

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“…This positivity rate is much lower than that reported from neighbouring and Asian countries like Pakistan (24%), China (30%), Bangladesh (10%), and Jordan (9%) (14)(15)(16)(17), which have similar sentinel surveillance systems, and may suggest some underestimation. Nonetheless, it should be noted that after more than 3 decades of war and conflict, the system was able to detect and respond successfully to the novel influenza virus circulating during the influenza A (H1N1) pandemic in 2009.…”

Section: Discussioncontrasting

confidence: 69%

Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting

Rasooly

Sahak

Saeed

et al. 2016

East Mediterr Health J

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Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre (NIC) database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 (3.6%), predominantly H1N1 (63%); most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance. ‫والتحديات‬ ‫التقدم‬ ‫(أفغانستان):

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“…Seasonal pattern of influenza is different based on temperate zones: June‐September in the Southern Hemisphere, and December‐April in the Northern Hemisphere. Moreover, this pattern in tropical regions has seasonal variations and mostly related to the rainy season …”

Section: Introduction and Objectivesmentioning

confidence: 99%

Prevalence of influenza A infection in the Middle‐East: A systematic review and meta‐analysis

Moghoofei

Monavari

Mostafaei

et al. 2018

Clinical Respiratory J

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Influenza Virus Surveillance in Pakistan during 2008-2011

Cited by 27 publications

References 24 publications

Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome

Association of clinical characteristics of patients presenting with influenza like illness or severe acute respiratory illness with development of acute respiratory distress syndrome

Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting

Prevalence of influenza A infection in the Middle‐East: A systematic review and meta‐analysis

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