Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012.
<h4>Objective</h4>There are few published studies describing severe acute respiratory illness (SARI) epidemiology amongst older children and adults from high HIV-prevalence settings. We aimed to describe SARI epidemiology amongst individuals aged ≥5 years in South Africa.<h4>Method...
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Public Library of Science (PLoS)
2015-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117716&type=printable |
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| author | Cheryl Cohen Sibongile Walaza Jocelyn Moyes Michelle Groome Stefano Tempia Marthi Pretorius Orienka Hellferscee Halima Dawood Summaya Haffejee Ebrahim Variava Kathleen Kahn Akhona Tshangela Anne von Gottberg Nicole Wolter Adam L Cohen Babatyi Kgokong Marietjie Venter Shabir A Madhi |
| author_facet | Cheryl Cohen Sibongile Walaza Jocelyn Moyes Michelle Groome Stefano Tempia Marthi Pretorius Orienka Hellferscee Halima Dawood Summaya Haffejee Ebrahim Variava Kathleen Kahn Akhona Tshangela Anne von Gottberg Nicole Wolter Adam L Cohen Babatyi Kgokong Marietjie Venter Shabir A Madhi |
| author_sort | Cheryl Cohen |
| collection | DOAJ |
| description | <h4>Objective</h4>There are few published studies describing severe acute respiratory illness (SARI) epidemiology amongst older children and adults from high HIV-prevalence settings. We aimed to describe SARI epidemiology amongst individuals aged ≥5 years in South Africa.<h4>Methods</h4>We conducted prospective surveillance for individuals with SARI from 2009-2012. Using polymerase chain reaction, respiratory samples were tested for ten viruses, and blood for pneumococcal DNA. Cumulative annual SARI incidence was estimated at one site with population denominators.<h4>Findings</h4>We enrolled 7193 individuals, 9% (621/7067) tested positive for influenza and 9% (600/6519) for pneumococcus. HIV-prevalence was 74% (4663/6334). Among HIV-infected individuals with available data, 41% of 2629 were receiving antiretroviral therapy (ART). The annual SARI hospitalisation incidence ranged from 325-617/100,000 population. HIV-infected individuals experienced a 13-19 times greater SARI incidence than HIV-uninfected individuals (p<0.001). On multivariable analysis, compared to HIV-uninfected individuals, HIV-infected individuals were more likely to be receiving tuberculosis treatment (odds ratio (OR):1.7; 95%CI:1.1-2.7), have pneumococcal infection (OR 2.4; 95%CI:1.7-3.3) be hospitalised for >7 days rather than <2 days (OR1.7; 95%CI:1.2-2.2) and had a higher case-fatality ratio (8% vs 5%;OR1.7; 95%CI:1.2-2.3), but were less likely to be infected with influenza (OR 0.6; 95%CI:0.5-0.8). On multivariable analysis, independent risk indicators associated with death included HIV infection (OR 1.8;95%CI:1.3-2.4), increasing age-group, receiving mechanical ventilation (OR 6.5; 95%CI:1.3-32.0) and supplemental-oxygen therapy (OR 2.6; 95%CI:2.1-3.2).<h4>Conclusion</h4>The burden of hospitalized SARI amongst individuals aged ≥5 years is high in South Africa. HIV-infected individuals are the most important risk group for SARI hospitalization and mortality in this setting. |
| format | Article |
| id | doaj-art-682e8b43f5fe440b82b50dd291bcbcb5 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-682e8b43f5fe440b82b50dd291bcbcb52025-08-20T03:01:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011771610.1371/journal.pone.0117716Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012.Cheryl CohenSibongile WalazaJocelyn MoyesMichelle GroomeStefano TempiaMarthi PretoriusOrienka HellfersceeHalima DawoodSummaya HaffejeeEbrahim VariavaKathleen KahnAkhona TshangelaAnne von GottbergNicole WolterAdam L CohenBabatyi KgokongMarietjie VenterShabir A Madhi<h4>Objective</h4>There are few published studies describing severe acute respiratory illness (SARI) epidemiology amongst older children and adults from high HIV-prevalence settings. We aimed to describe SARI epidemiology amongst individuals aged ≥5 years in South Africa.<h4>Methods</h4>We conducted prospective surveillance for individuals with SARI from 2009-2012. Using polymerase chain reaction, respiratory samples were tested for ten viruses, and blood for pneumococcal DNA. Cumulative annual SARI incidence was estimated at one site with population denominators.<h4>Findings</h4>We enrolled 7193 individuals, 9% (621/7067) tested positive for influenza and 9% (600/6519) for pneumococcus. HIV-prevalence was 74% (4663/6334). Among HIV-infected individuals with available data, 41% of 2629 were receiving antiretroviral therapy (ART). The annual SARI hospitalisation incidence ranged from 325-617/100,000 population. HIV-infected individuals experienced a 13-19 times greater SARI incidence than HIV-uninfected individuals (p<0.001). On multivariable analysis, compared to HIV-uninfected individuals, HIV-infected individuals were more likely to be receiving tuberculosis treatment (odds ratio (OR):1.7; 95%CI:1.1-2.7), have pneumococcal infection (OR 2.4; 95%CI:1.7-3.3) be hospitalised for >7 days rather than <2 days (OR1.7; 95%CI:1.2-2.2) and had a higher case-fatality ratio (8% vs 5%;OR1.7; 95%CI:1.2-2.3), but were less likely to be infected with influenza (OR 0.6; 95%CI:0.5-0.8). On multivariable analysis, independent risk indicators associated with death included HIV infection (OR 1.8;95%CI:1.3-2.4), increasing age-group, receiving mechanical ventilation (OR 6.5; 95%CI:1.3-32.0) and supplemental-oxygen therapy (OR 2.6; 95%CI:2.1-3.2).<h4>Conclusion</h4>The burden of hospitalized SARI amongst individuals aged ≥5 years is high in South Africa. HIV-infected individuals are the most important risk group for SARI hospitalization and mortality in this setting.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117716&type=printable |
| spellingShingle | Cheryl Cohen Sibongile Walaza Jocelyn Moyes Michelle Groome Stefano Tempia Marthi Pretorius Orienka Hellferscee Halima Dawood Summaya Haffejee Ebrahim Variava Kathleen Kahn Akhona Tshangela Anne von Gottberg Nicole Wolter Adam L Cohen Babatyi Kgokong Marietjie Venter Shabir A Madhi Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. PLoS ONE |
| title | Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. |
| title_full | Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. |
| title_fullStr | Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. |
| title_full_unstemmed | Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. |
| title_short | Epidemiology of severe acute respiratory illness (SARI) among adults and children aged ≥5 years in a high HIV-prevalence setting, 2009-2012. |
| title_sort | epidemiology of severe acute respiratory illness sari among adults and children aged ≥5 years in a high hiv prevalence setting 2009 2012 |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0117716&type=printable |
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