Secondary Household Transmission of 2009 Pandemic Influenza A (H1N1) Virus among an Urban and Rural Population in Kenya, 2009–2010

Kim, Clara Y.; Breiman, Robert F.; Cosmas, Leonard; Audi, Allan; Aura, Barrack; Bigogo, Godfrey; Njuguna, Henry; Lebo, Emmaculate; Waiboci, Lilian W.; Njenga, M. Kariuki; Feikin, Daniel R.; Katz, Mark A.

doi:10.1371/journal.pone.0038166

Cited by 11 publications

(17 citation statements)

References 22 publications

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“…Briefly, trained community interviewers visited participants every 2 weeks, collecting data on illnesses and deaths during the 2 weeks before visit; after September 1, 2009, household visits were increased in frequency to every week to allow for more intensive data collection during the pandemic of influenza A H1N1. 10 Surveillance participants have free access to a well-staffed and supplied field clinic centrally located within 5 km and 1 km of all residences in Lwak and Kibera, respectively.…”

Section: Methodsmentioning

confidence: 99%

Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

Breiman¹,

Cosmas²,

Audi³

et al. 2014

Pediatric Infectious Disease Journal

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Background Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. Methods We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Results Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Conclusions Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission.

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Section: Methodsmentioning

confidence: 99%

Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

Breiman¹,

Cosmas²,

Audi³

et al. 2014

Pediatric Infectious Disease Journal

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“…In addition, new diagnostic technologies, including the advent of more readily available, highly sensitive molecular diagnostics, have enhanced the ability to detect respiratory pathogens [ 14 , 15 ]. Finally, with massive urbanization in Africa and advent of densely populated informal settlements or slums [ 16 ], different respiratory pathogen transmission patterns [ 17 ], co-morbidities, and access to health care [ 18 , 19 ] must be considered when comparing with sparsely populated rural areas from where most data on pneumonia epidemiology and etiology have been collected.…”

Section: Introductionmentioning

confidence: 99%

Severe acute respiratory infection in children in a densely populated urban slum in Kenya, 2007–2011

et al. 2015

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BackgroundReducing acute respiratory infection burden in children in Africa remains a major priority and challenge. We analyzed data from population-based infectious disease surveillance for severe acute respiratory illness (SARI) among children <5 years of age in Kibera, a densely populated urban slum in Nairobi, Kenya.MethodsSurveillance was conducted among a monthly mean of 5,874 (range = 5,778-6,411) children <5 years old in two contiguous villages in Kibera. Participants had free access to the study clinic and their health events and utilization were noted during biweekly home visits. Patients meeting criteria for SARI (WHO-defined severe or very severe pneumonia, or oxygen saturation <90%) from March 1, 2007-February 28, 2011 had blood cultures processed for bacteria, and naso- and oro- pharyngeal swabs collected for quantitative real-time reverse transcription polymerase chain reaction testing for influenza viruses, parainfluenza viruses (PIV), respiratory syncytial virus (RSV), adenovirus, and human metapneumovirus (hMPV). Swabs collected during January 1, 2009 – February 28, 2010 were also tested for rhinoviruses, enterovirus, parechovirus, Mycoplasma pneumoniae, and Legionella species. Swabs were collected for simultaneous testing from a selected group of control-children visiting the clinic without recent respiratory or diarrheal illnesses.ResultsSARI overall incidence was 12.4 cases/100 person-years of observation (PYO) and 30.4 cases/100 PYO in infants. When comparing detection frequency in swabs from 815 SARI cases and 115 healthy controls, only RSV and influenza A virus were significantly more frequently detected in cases, although similar trends neared statistical significance for PIV, adenovirus and hMPV. The incidence for RSV was 2.8 cases/100 PYO and for influenza A was 1.0 cases/100 PYO. When considering all PIV, the rate was 1.1 case/100 PYO and the rate per 100 PYO for SARI-associated disease was 1.5 for adenovirus and 0.9 for hMPV. RSV and influenza A and B viruses were estimated to account for 16.2% and 6.7% of SARI cases, respectively; when taken together, PIV, adenovirus, and hMPV may account for >20% additional cases.ConclusionsInfluenza viruses and RSV (and possibly PIV, hMPV and adenoviruses) are important pathogens to consider when developing technologies and formulating strategies to treat and prevent SARI in children.

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“…Recent studies have begun to identify key epidemiological characteristics of household transmission of pandemic (H1N1) 2009[6,14-18]. A variety of household-level risk factors have been identified including age of index patient, size of the home, number of household members, exposure during the index patient’s symptomatic phase, as well as medication initiated from the onset of fever[7,13,16,19].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Household Transmission of Pandemic (H1N1) 2009 among Self-Quarantined Patients in Beijing, China

et al. 2013

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As the pandemic (H1N1) 2009 progressed, the Ministry of Health of China advised cases with mild symptoms to remain home for isolation and observation, which may have increased the risk for infection among other household members. Describing the transmission characteristics of this novel virus is indispensable to effectively controlling the spread of disease; thus, the aim of this study was to assess risk factors associated with household transmission of pandemic H1N1 from self-quarantined patients in Beijing, the capital city of China. A 1:2 case-control study with 54 case households and 108 control households was conducted between August 1 and September 30, 2009 in Beijing. Cases were households with a self-quarantined index patient and a secondary case, while controls were households with a self-quarantined index patient and a close contact. Controls were also matched to cases for sex and age of index case-patient. A structured interview guide was used to collect the data. Conditional logistical models were employed to estimate Odds Ratios (OR) with 95% confidence intervals (95% CI). Results indicated that higher education level (OR 0.42; 95% CI 0.22-0.83), sharing room with an index case-patient (OR 3.29; 95%CI 1.23-8.78), daily room ventilation (OR 0.28; 95%CI 0.08-0.93), and hand washing ≥3/d (OR 0.71; 95%CI 0.48-0.94) were related to the household transmission of pandemic H1N1 from self-quarantined patients. These results highlight that health education, as well as the quarantine of the index case-patient immediately after infection, frequent hand hygiene, and ventilation are critical to mitigating household spread of pandemic H1N1 virus and minimizing its impact. Household contacts should be educated to promote these in-home practices to contain transmission, particularly when household members are quarantined at home.

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Secondary Household Transmission of 2009 Pandemic Influenza A (H1N1) Virus among an Urban and Rural Population in Kenya, 2009–2010

Cited by 11 publications

References 22 publications

Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

Severe acute respiratory infection in children in a densely populated urban slum in Kenya, 2007–2011

Factors Associated with Household Transmission of Pandemic (H1N1) 2009 among Self-Quarantined Patients in Beijing, China

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