Pediatric Hospitalizations Associated with 2009 Pandemic Influenza A (H1N1): An Experience from a Tertiary Care Center in North India

Parakh, Ankit; Kumar, Amit; Kumar, Virendra; Dutta, A. K.; Khare, Shashi

doi:10.1007/s12098-010-0168-0

Cited by 18 publications

(29 citation statements)

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“…Five studies conducted in India reported the number of deaths among hospitalized adults and the pooled prevalence was 15% (95% CI: 7–23%) [67], [68], [70], [73], [74]. Two reported this information among Indian children and the pooled prevalence was 8% (95% CI: 2–13%) [69], [79].…”

Section: Resultsmentioning

confidence: 99%

Impact of H1N1 on Socially Disadvantaged Populations: Systematic Review

et al. 2012

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Background The burden of H1N1 among socially disadvantaged populations is unclear. We aimed to synthesize hospitalization, severe illness, and mortality data associated with pandemic A/H1N1/2009 among socially disadvantaged populations. Methods/Principal Findings Studies were identified through searching MEDLINE, EMBASE, scanning reference lists, and contacting experts. Studies reporting hospitalization, severe illness, and mortality attributable to laboratory-confirmed 2009 H1N1 pandemic among socially disadvantaged populations (e.g., ethnic minorities, low-income or lower-middle-income economy countries [LIC/LMIC]) were included. Two independent reviewers conducted screening, data abstraction, and quality appraisal (Newcastle Ottawa Scale). Random effects meta-analysis was conducted using SAS and Review Manager. Conclusions/Significance Sixty-two studies including 44,777 patients were included after screening 787 citations and 164 full-text articles. The prevalence of hospitalization for H1N1 ranged from 17–87% in high-income economy countries (HIC) and 11–45% in LIC/LMIC. Of those hospitalized, the prevalence of intensive care unit (ICU) admission and mortality was 6–76% and 1–25% in HIC; and 30% and 8–15%, in LIC/LMIC, respectively. There were significantly more hospitalizations among ethnic minorities versus non-ethnic minorities in two studies conducted in North America (1,313 patients, OR 2.26 [95% CI: 1.53–3.32]). There were no differences in ICU admissions (n = 8 studies, 15,352 patients, OR 0.84 [0.69–1.02]) or deaths (n = 6 studies, 14,757 patients, OR 0.85 [95% CI: 0.73–1.01]) among hospitalized patients in HIC. Sub-group analysis indicated that the meta-analysis results were not likely affected by confounding. Overall, the prevalence of hospitalization, severe illness, and mortality due to H1N1 was high for ethnic minorities in HIC and individuals from LIC/LMIC. However, our results suggest that there were little differences in the proportion of hospitalization, severe illness, and mortality between ethnic minorities and non-ethnic minorities living in HIC.

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Section: Resultsmentioning

confidence: 99%

Impact of H1N1 on Socially Disadvantaged Populations: Systematic Review

et al. 2012

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“…After screening 787 titles and abstracts and 164 full‐text articles, 48 cohort studies plus 14 companion reports met eligibility criteria and were included 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73. These studies examined H1N1 between March 1, 2009 and October 24, 2010, and the most common factor of social disadvantage reported was ethnic minority status (36/48 studies), except in 12 studies that considered H1N1‐infected patients from LIC/LMIC, which were analyzed separately for each country (one study from Guatemala,57 two from Morocco,60, 61 one from Pakistan,73 and eight from India, plus four companion reports) 60, …”

Section: Resultsmentioning

confidence: 99%

“…These studies examined H1N1 between March 1, 2009 and October 24, 2010, and the most common factor of social disadvantage reported was ethnic minority status (36/48 studies), except in 12 studies that considered H1N1‐infected patients from LIC/LMIC, which were analyzed separately for each country (one study from Guatemala,57 two from Morocco,60, 61 one from Pakistan,73 and eight from India, plus four companion reports) 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71…”

Section: Resultsmentioning

confidence: 99%

“…Exceptions were that 10 studies did not use a representative sample15, 24, 30, 36, 38, 42, 51, 62, 72 and four studies included patients who were severely ill, hospitalized, or dead at the beginning of the study. In addition, only 13 studies controlled for comorbidities17, 24, 27, 34, 36, 41, 42, 49, 51, 53, 54, 56 and 18 studies did not report their follow‐up rate or had a withdrawal rate of 10% or greater 16, 17, 24, 38, 41, 49, 51, 53, 55, 58, 60, 61, 62, 65, 66, 72, 73…”

Section: Resultsmentioning

confidence: 99%

“…In six of the studies, the proportion of deaths among hospitalized patients was reported by ethnicity and no statistically significant differences were observed between ethnic minority and nonethnic minority patients (OR 0·85, 95% CI: 0·73–1·01, Table 1). 19, 21, 25, 37, 44 In India, the pooled prevalence of deaths was 15% among hospitalized adults (95% CI: 7–23%)60, 61, 63, 66, 67 and 8% among hospitalized children (95% CI: 2–13%) 62, 72…”

Section: Resultsmentioning

confidence: 99%

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Impact of H1N1 on socially disadvantaged populations: summary of a systematic review

Tricco

Lillie

Soobiah

et al. 2013

Influenza Resp Viruses

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BackgroundPrevious reviews found that the H1N1 pandemic was associated with a large proportion of hospitalizations, severe illness, workplace absenteeism, and high costs. However, the burden among socially disadvantaged groups of the population is unclear. This is a summary of a previously published systematic review commissioned by the World Health Organization on the burden of H1N1 pandemic (influenza A/Mexico/2009 (H1N1)) among socially disadvantaged populations.Methods MEDLINE and EMBASE were searched to identify studies reporting hospitalization, severe illness, and mortality attributable to the 2009 H1N1 pandemic among socially disadvantaged populations, including ethnic minorities and low‐income or lower‐middle‐income economy countries (LIC/LMIC). SAS and Review Manager were used to conduct random effects meta‐analysis.ResultsForty‐eight cohort studies and 14 companion reports including 44 777 patients were included after screening 787 citations and 164 full‐text articles. Twelve of the included studies provided data on LIC/LMIC, including one study from Guatemala, two from Morocco, one from Pakistan, and eight from India, plus four companion reports. The rest provided data on ethnic minorities living in high‐income economy countries (HIC). Significantly more hospitalizations were observed among ethnic minorities versus nonethnic minorities in two North American studies [1313 patients, odds ratio (OR) 2·26 (95% confidence interval: 1·53–3·32)]. Among hospitalized patients in HIC, statistically significant differences in intensive care unit admissions (n = 8 studies, 15 352 patients, OR 0·84 [0·69–1·02]) and deaths (n = 6 studies, 14 757 patients, OR 0·85 [95% CI: 0·73–1·01]) were not observed.ConclusionWe found significantly more hospitalizations among ethnic minorities versus nonethnic minorities in North America, yet no differences in intensive care unit admissions or deaths among H1N1‐infected hospitalized patients were observed in North America and Australia. Our results suggest a similar burden of H1N1 between ethnic minorities and nonethnic minorities living in HIC.

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Asymmetry in a pterobranch hemichordate and the evolution of left–right patterning

Sato

Holland

2008

Developmental Dynamics

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To investigate the possible origin of vertebrate asymmetry, we reexamined the long-described asymmetry of pterobranch hemichordates, a group of tiny, mostly colonial marine filter feeders. As first described over a century ago, we found left-right (LR) asymmetry in localization of the gonad. However, contrary to early descriptions, the direction of asymmetry is random, displaying antisymmetry rather than directional asymmetry. We found that the direction of gonad localization is significantly related to the shape of the tube in which the zooid lives. We also reexamined other anatomical features described to have directional asymmetry, the shape of the oral lamella and localization of the gonopore; however, we did not confirm asymmetry in these examples. Together with previous studies, our results suggest that hemichordates have undergone degeneration in the precision of asymmetry from an ancestral asymmetrical condition that existed before the divergence of deuterostomes. Developmental Dynamics 237:3634 -3639, 2008.

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Pediatric Hospitalizations Associated with 2009 Pandemic Influenza A (H1N1): An Experience from a Tertiary Care Center in North India

Abstract: The exact incidence of Pandemic 2009 H1N1 influenza on morbidity and mortality is difficult to calculate since only Category "C" patients were screened.

Cited by 18 publications

References 10 publications

Impact of H1N1 on Socially Disadvantaged Populations: Systematic Review

Impact of H1N1 on Socially Disadvantaged Populations: Systematic Review

Impact of H1N1 on socially disadvantaged populations: summary of a systematic review

Asymmetry in a pterobranch hemichordate and the evolution of left–right patterning

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