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Hassan H, Kandeel A, Fahim M, ElSood HA, Elghazaly S, Kamel R, El Shourbagy S, Afifi S, Fattah MA, Choi M, Lee SG, Rajaguru V, Han W. Incidence of influenza virus-associated Severe Acute Respiratory Infections in three districts in 2018 at Gharbia governorate, Egypt. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003152. [PMID: 38701044 PMCID: PMC11068184 DOI: 10.1371/journal.pgph.0003152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024]
Abstract
AIMS Influenza remains a contributor to substantial global morbidity and mortality. There is very limited data on disease burden in Egypt. The purpose of this study was to estimate the incidence of influenza-associated Severe Acute Respiratory Illness (SARI) in three districts in Gharbia governorate in 2018. METHODS This study Followed the World Health Organization (WHO) manual for estimating disease burden associated with seasonal influenza. The hospital admission database was screened for SARI patients in three districts at Gharbia governorate in 2018. A hospital admission survey (HAS) was used to define the catchment population. The incidence rate estimation was computed as the number of influenza-positive SARI cases per 100,000 population. RESULTS A total of 180 SARI cases were identified in the catchment area. The median age was 23 years [IQR: 2-53], and 45% were males. Out of the total SARI cases, 33.3% influenza was confirmed by the laboratory test of RP-PCR. Influenza A(H3N2) virus predominated representing 55.0% of patients, thanA(H1N1) 26.7% and Flu-B virus 18.3%. Influenza prevailed in winter and spring; no deaths from influenza were reported. The annual incidence of influenza-associated SARIs found higher in <2 years (282 /100,000) and ≥65 years patients (215/100,000) at significant level p<0.001. CONCLUSION The WHO Manual for estimating disease burden associated with seasonal influenza was successfully operationalized in the three districts of Gharbia governorate. It can be used in other districts. A considerable burden was associated with influenza viruses requiring hospitalization, especially among the older adult group.
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Affiliation(s)
- Hossam Hassan
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
- Department of Global Health and Disease Control, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Hanaa Abu ElSood
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Shereen Elghazaly
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Reham Kamel
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | | | - Salma Afifi
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | | | - Miyoung Choi
- Department of Clinical Evidence Research Team, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, South Korea
| | - Vasuki Rajaguru
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Whiejong Han
- Department of Global Health and Disease Control, Graduate School of Public Health, Yonsei University, Seoul, South Korea
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Kandeel A, Fahim M, Deghedy O, BahaaEldin H, Roshdy WH, Khalifa MK, Kandeil A, El Shesheny R, Naguib A, AbdelFatah M, Afifi S, Abdel Ghaffar K. Comparative analysis of COVID-19 and influenza prevalence among Egyptian pilgrims returning from Hajj and Umrah in 2022: epidemiology, clinical characteristics, and genomic sequencing. Arch Public Health 2024; 82:6. [PMID: 38216978 PMCID: PMC10785524 DOI: 10.1186/s13690-023-01229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/14/2023] [Indexed: 01/14/2024] Open
Abstract
PURPOSE To describe the changes that occurred in the SARS-CoV-2 and influenza Prevalence, epidemiology, clinical picture, and prevalent genotypes among the Egyptian pilgrims returning from Hajj and Umrah 2022 seasons. METHODS Pilgrims were contacted at the airport and invited to participate in the survey. Pilgrims who consented were interviewed using a standardized line list that included participant demographics, respiratory symptoms if any, previous COVID-19 infection, influenza vaccination whereas COVID-19 vaccination information were collected from vaccination cards. Participants were asked to provide throat and nasopharyngeal swabs for SARS-CoV-2 and influenza testing using RT-PCR and a subset of isolates were sequenced. Descriptive data analysis was performed to describe the epidemiology and clinical symptoms of SARS-CoV-2 and influenza. Prevalence rates of SARS-CoV-2 and influenza during Hajj were calculated and compared to Umrah surveys using chi2 and t-test with a significance level < 0.05. RESULTS Overall, 3,862 Egyptian pilgrims enrolled, their mean age was 50.5 ± 47 years, half of them were > 50 years of age and 58.2% were males. Of them, 384 (9.9%) tested positive for SARS-CoV-2 and 51 (1.3%) for influenza viruses. Prevalence of SARS-CoV-2 infections (vaccine breakthrough) increased significantly between the Umrah and Hajj surveys (6.7% vs. 9.9%, p < 0.001), and variants of the virus varied considerably. Whereas no significant difference was found in influenza prevalence, vaccine coverage and vaccine breakthrough infection rates (11.7 vs. 9.2%, 26.9 vs. 26.8%, and 1.4 vs. 1.1% respectively). CONCLUSIONS SARS-CoV-2 prevalence among Egyptian pilgrims returning from Hajj in July increased with reduced vaccine effectiveness compared to Umrah in March 2022 suggesting a possible wave of SARS-CoV-2 in the upcoming winter.
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Affiliation(s)
- Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Ola Deghedy
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Hala BahaaEldin
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt.
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Mohamed Kamal Khalifa
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622 Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622 Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Mohamad AbdelFatah
- Preventive Sector, Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Consultant, Governmental District, New Administrative Capital, Cairo, Egypt
| | - Khaled Abdel Ghaffar
- Ministry of Health and Population, Governmental District, New Administrative Capital, Cairo, Egypt
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Kandeel A, Fahim M, Deghedy O, H Roshdy W, K Khalifa M, El Shesheny R, Kandeil A, Wagdy S, Naguib A, Afifi S, Abdelghaffar K. Multicenter study to describe viral etiologies, clinical profiles, and outcomes of hospitalized children with severe acute respiratory infections, Egypt 2022. Sci Rep 2023; 13:21860. [PMID: 38071208 PMCID: PMC10710477 DOI: 10.1038/s41598-023-48814-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
In late 2022, severe acute respiratory infections (SARI) surveillance reported an abrupt increase in non-COVID-19 infections among children after three years of drastic reductions. Signals of increased absenteeism due to respiratory symptoms among primary and preparatory school children were detected by Event-Based Surveillance. We conducted a hospital-based survey of children who were admitted with SARI to identify the causative pathogen(s) and estimate the burden of infection. A survey was conducted among children < 16 years in 21 referral hospitals in the three governorates with the highest SARI rates. Patients' demographics, clinical symptoms, and severity were collected from medical records using a line list. Patients were swabbed and tested for a panel of 33 respiratory pathogens by RT-PCR at the Central Laboratory in Cairo. Descriptive data analysis was performed for demographic data. Patients' characteristics were compared by causative agents' clinical picture and severity using Chi2 with a p < 0.05 significance. Overall, 317 patients were enrolled, 58.3% were ≤ 1 year of age, 61.5% were males. Of 229 (72.7%) of positively tested patients, viruses caused 92.1% including RSV 63.8%, Rhinovirus 10.0%, Influenza 9.2%, Adenovirus 5.2%, and 1.3% co-infected with two viruses. Bacteria caused 3.5% of cases and 4.4% had mixed viral-bacterial infections. Rhinovirus was the most common cause of death among children with SARI, followed by RSV (8.7% and 1.4%), whereas influenza and Adenovirus did not result in any deaths. Patients with viral-bacterial infections are more likely to be admitted to ICU and die at the hospital than bacterial or viral infections (60% and 20% vs. 31.8% and 1.9% vs. 12.5% and 12.5%, p < 0.001). Viruses particularly RSV are the leading cause of SARI causing significant health problem among children < 16 years in Egypt. Bacterial on top of viral infection can worsen disease courses and outcomes. Studies are required to estimate the SARI burden accurately among Egyptian children and a comprehensive approach tailored to Egypt is necessary to reduce its burden.
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Affiliation(s)
- Amr Kandeel
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Preventive Sector, Ministry of Health and Population, Cairo, Egypt.
| | - Wael H Roshdy
- Central Public Health Laboratories, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, Dokki, Giza, 12622, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, Dokki, Giza, 12622, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, Dokki, Giza, 12622, Egypt
| | - Saly Wagdy
- Central Public Health Laboratories, Ministry of Health and Population, Cairo, Egypt
| | - Amel Naguib
- Central Public Health Laboratories, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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Kandeel A, Fahim M, Deghedy O, Roshdy WH, Khalifa MK, Shesheny RE, Kandeil A, Naguib A, Afifi S, Mohsen A, Abdelghaffar K. Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022. BMC Public Health 2023; 23:1067. [PMID: 37277781 DOI: 10.1186/s12889-023-15880-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Two years after unprecedented low rates of circulation of most common respiratory viruses (SARS-CoV-2), the Egyptian ARI surveillance system detected an increase in acute respiratory infections (ARIs) with a reduced circulation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), especially among school children. A national survey was conducted to estimate the burden and identify the viral causes of ARIs among children < 16 years of age. METHODS A one-day survey was carried out in 98 governmental outpatient clinics distributed all over Egypt 26 governorates. The four largest referral hospitals in each governorate where most influenza-like illness (ILI) patients seek care were selected. Using the WHO case definition, the first five patients < 16 years of age with ILI symptoms visiting the selected outpatient clinics on the survey day were enrolled. Basic demographic and clinical data of patients were collected using a linelist. Patients were swabbed and tested for SARS-CoV-2, influenza, and Respiratory Syncytial virus (RSV) by RT-PCR at the Central Laboratory in Cairo. RESULTS Overall, 530 patients enrolled, their mean age was 5.8 ± 4.2, 57.1% were males, and 70.2% reside in rural or semi-rural areas. Of all patients, 134 (25.3%) had influenza, 111 (20.9%) RSV, and 14 (2.8%) coinfections. Influenza-positive children were older compared to RSV, (7.2 ± 4.1, 4.3 ± 4.1, p < 0.001), with more than half of them (53.0%) being school students. Dyspnea was reported in RSV more than in influenza (62.2% vs. 49.3%, p < 0.05). Among RSV patients, children < 2 years had a higher rate of dyspnea than others (86.7% vs. 53.1%, < 0.001). CONCLUSIONS A resurgence of influenza and RSV was detected in Egypt in the 2022-2023 winter season. Influenza caused a higher rate of infection than RSV, while RSV caused more severe symptoms than influenza. Monitoring a broader range of respiratory pathogens is recommended to estimate the ARI burden and risky groups for severe disease in Egypt.
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Affiliation(s)
- Amr Kandeel
- Ministry of Health and Population, Cairo, Egypt
| | - Manal Fahim
- Ministry of Health and Population, Cairo, Egypt
| | - Ola Deghedy
- Ministry of Health and Population, Cairo, Egypt
| | - Wael H Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Mohamed K Khalifa
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Rabeh El Shesheny
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Ahmed Kandeil
- Centre of Scientific Excellence for Influenza Viruses, National Research Centre, 12622, Dokki, Giza, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Consultant Ministry of Health and Population, Cairo, Egypt
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Fahim M, Abu ElSood H, AbdElGawad B, Deghedy O, Naguib A, Roshdy WH, Showky S, Kamel R, Elguindy N, Abdel Fattah M, Afifi S, Kandeel A, Abdelghaffar K. Adapting an integrated acute respiratory infections sentinel surveillance to the COVID-19 pandemic requirements, Egypt, 2020-2022. PUBLIC HEALTH IN PRACTICE 2023; 5:100358. [PMID: 36686982 PMCID: PMC9846875 DOI: 10.1016/j.puhip.2023.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/14/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Objectives In Egypt, an integrated surveillance for acute respiratory infections (ARIs) was established in 2016 to identify the causes of ARIs. The surveillance system includes 19 governmental hospitals. In response to the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organisation (WHO) requested surveillance adaptation to address the emerging challenges. This study aims to describe the experience in Egypt of adapting ARI surveillance to the COVID-19 pandemic. Methods WHO case definitions were used to identify patients with ARIs. Nasopharyngeal/oropharyngeal swabs were collected for SARS-CoV-2 and influenza testing. Demographic and clinical information were obtained by interviewing patients at the hospitals. During the COVID-19 pandemic, the first two outpatients daily and every fifth admitted patient were enrolled in the study. To determine the status of ARIs in Egypt during the pandemic, patient demographic, clinical and laboratory data from 2020 to 2022 were obtained and descriptive analyses were performed. Results Overall, 18,160 patients were enrolled in the study, including 7923 (43.6%) seen at outpatient clinics and 10,237 (56.4%) inpatients. Of the study participants, 6453 (35.5%) tested positive for ARIs, including 5620 (87.1%) for SARS-CoV-2, 781 (12.1%) for influenza and 52 (0.8%) for SARS-CoV-2/influenza coinfection. SARS-CoV-2 was the cause for 95.3% of admitted patients and 65.4% of outpatients. Influenza subtypes included A/H3 (55.7%), Influenza-B (29.1%) and H1/pdm09 (14.2%). Compared with influenza, SARS-CoV-2 tended to infect the elderly, in warm weather and in urban governorates, and resulted in more hospitalisations, longer hospital stays and higher case fatalities (16.3% vs 6.6%, p < 0.001). Conclusions ARI surveillance in Egypt was successfully adapted to the COVID-19 pandemic and effectively described the clinical characteristics and severity of circulating viruses. Surveillance reported the re-emergence of influenza with a severe course and high fatality. Surveillance is essential for monitoring the activity of respiratory viruses with the aim of guiding clinical management, including preventative and control measures.
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Affiliation(s)
- Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Hanaa Abu ElSood
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Basma AbdElGawad
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Ola Deghedy
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt,Corresponding author. Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt.
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Wael H. Roshdy
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Shymaa Showky
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Reham Kamel
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Nancy Elguindy
- Central Public Health Laboratory, Ministry of Health and Population, Elsheikh Rehan Street, Cairo, Egypt
| | - Mohammad Abdel Fattah
- Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Consultant, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Amr Kandeel
- Preventive Sector, Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
| | - Khaled Abdelghaffar
- Ministry of Health and Population, 3 Magles ElShaab Street, Kasr Alainy, Cairo, Egypt
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Epidemiology, Disease Severity and Outcome of Severe Acute Respiratory Syndrome Coronavirus 2 and Influenza Viruses Coinfection Seen at Egypt Integrated Acute Respiratory Infections Surveillance, 2020-2022. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:7497500. [PMID: 36437892 PMCID: PMC9691288 DOI: 10.1155/2022/7497500] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
Background Cocirculation of influenza (Flu) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (SARS-CoV-2/Flu) represent a public health concern as it may worsen the severity and increase fatality from coronavirus disease 2019. An increase in the number of patients with coinfection was recently reported. We studied epidemiology, severity, and outcome of patients with SARS-CoV-2/Flu coinfection seen at Egypt's integrated acute respiratory infections surveillance to better describe disease impact and guide effective preventive measures. Methods The first two outpatients were seen daily, and every fifth patient admitted to 19 sentinel hospitals with respiratory symptoms was enrolled. Patients were interviewed using a standardized questionnaire and provided nasopharyngeal swabs to be tested for SARS-CoV-2 and influenza by real-time polymerase chain reaction at the central laboratory. Data from all patients with coinfection were obtained, and descriptive data analysis was performed for patients' demographics, clinical course, and outcome. Results The total number of patients enrolled between January 2020 and April 2022 was 18,160 and 6,453 (35.5%) tested positive for viruses, including 52 (0.8%) coinfection. Of them, 36 (69.2%) were coinfected with Flu A/H3, 9 (17.3%) Flu-B, and 7 (13.5%) Flu A/H1. Patients' mean age was 33.2 ± 21, 55.8% were males, and 20 (38.5%) were hospitalized, with mean hospital days 6.7 ± 6. At the hospital, 14 (70.0%) developed pneumonia, 6 (30.0%) ICU admitted, and 4 (20.0%) died. The hospitalization rate among patients coinfected with Flu-B and Flu A/H3 was 55.6 and 41.7%, with mean hospital days (8.0 ± 6 and 6.4 ± 6), pneumonia infection (40.0 and 80.0%), ICU admission (40.0 and 26.7%), and death (20.0% for both), while no patients hospitalized with A/H1. Conclusions The recent increase in the number of SARS-CoV-2/Flu coinfections was identified in Egypt. The disease could have a severe course and high fatality, especially in those coinfected with Flu-B and Flu A/H3. Monitoring disease severity and impact is required to guide preventive strategy.
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Hussein YHH, Ibrahim MH, Badran SG, Eldeeb SM. Hesitancy for influenza vaccine among healthcare workers and mothers of preschool children: A cross-sectional study in Zagazig, Egypt. J Family Community Med 2022; 29:108-116. [PMID: 35754752 PMCID: PMC9221228 DOI: 10.4103/jfcm.jfcm_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/29/2022] [Accepted: 04/06/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Vaccine hesitancy is a worldwide issue. To intensify our efforts to find a solution to this problem, we need to comprehend its magnitude and underlying causes. This study aimed to determine the prevalence of influenza vaccine hesitancy and the reasons for it among healthcare workers (HCWs) and mothers of preschool children attending Zagazig Maternal and Child Healthcare (MCH) Center, Sharqia Governorate. MATERIALS AND METHODS: A cross-sectional study was conducted in the Zagazig MCH Center involving 77 HCWs and 210 mothers of preschool children. Two validated questionnaires (one for HCWs and one for mothers of preschool children) were used to collect data on hesitancy to influenza vaccine. Data analysis perfomed using SPSS v 25.0. For quantitative variables, statistical significance was determined using t-test, whereas Chi-square test was employed for quantitative variables. Poisson regression model was used to determine the independent predictors of influenza vaccine hesitancy. P < 0.05 was used as a level of statistical significance. RESULTS: The prevalence of hesitancy to the influenza vaccine was 46.8% among HCWs and 54.3% among mothers of preschool children. Fear of side effects (42.9%) and doubt in the usefulness of the vaccine (42.1%) were the most frequent barriers. Hesitancy was significantly more prevalent in the negative-attitude HCWs (62.0%) than positive-attitude HCWs (18.5%). According to Poisson regression analysis, the age of the index child, the mothers' source of information, and the frequency of vaccination were the critical indicators of influenza vaccine hesitancy in the studied mothers. CONCLUSION: Influenza vaccine hesitancy among the studied sample is high (46.8% among HCWs, and 54.3% among mothers of preschool children). Periodic health education campaigns to increase awareness and change the negative attitude about the influenza vaccine are recommended.
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Affiliation(s)
- Yasmin H H Hussein
- Department of Family Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mona H Ibrahim
- Department of Public Health and Community Medicine, Zagazig University, Zagazig, Egypt
| | - Shahenda G Badran
- Department of Microbiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Seham M Eldeeb
- Department of Public Health and Community Medicine, Zagazig University, Zagazig, Egypt
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Fahim M, AbdElGawad B, Hassan H, Naguib A, Ahmed E, Afifi S, Abu ElSood H, Mohsen A. Epidemiology and outcome of influenza-associated infections among hospitalized patients with acute respiratory infections, Egypt national surveillance system, 2016-2019. Influenza Other Respir Viruses 2021; 15:589-598. [PMID: 33960675 PMCID: PMC8404058 DOI: 10.1111/irv.12867] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/23/2021] [Accepted: 03/28/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction Egypt has established different types of surveillance systems to monitor influenza activities, early detect outbreaks, and tailor efficient prevention and control strategies. This is the first study to describe epidemiology and outcome of influenza‐associated infections among hospitalized patients using the National Electronic Disease Surveillance System (NEDSS) data, 2016‐2019. Methods Data reported from 284 hospitals all over Egypt were extracted from the NEDSS. Data of hospitalized patients with Acute Respiratory Infections (ARI), 2016‐2019, were included in the analysis. Laboratory testing for influenza by RT‐PCR according to US CDC testing protocol was used to confirm influenza type and subtype. Results Overall 46 417 patients hospitalized with ARI were identified, their mean age was 30.9 ± 26 and 52.9% were males. Among 41 512 (89.4%) laboratory‐tested patients, 7167 (17.3%) were positive for one or more types of influenza viruses. Influenza viruses circulated in all ages and throughout the year, with higher rates in winter, late childhood, and middle ages. Mortality from influenza was significantly higher than other causes of ARIs (5.0% vs 3.8%, P < .001), and it was associated with older ages, December‐May, delay in hospital admission, residence in urban and frontier governorates and infection with A/H1N1 virus. The distribution of influenza subtype by time shows alternate pattern between A/H1N1 and H3N2, each subtype peaks every other year with a high peak of A/H1N1 in 2016. Conclusions The national Egyptian surveillance succeeded to describe the epidemiology of hospitalized patients with ARIs and influenza in Egypt over time. Surveillance with strain‐specific laboratory testing and annual assessment of associated severity might be useful to guide influenza prevention and control strategies including vaccination and case management.
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Affiliation(s)
- Manal Fahim
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Basma AbdElGawad
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Hossam Hassan
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health and Population, Cairo, Egypt
| | - ElSabbah Ahmed
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Salma Afifi
- Ministry of Health and Population Consultant, Cairo, Egypt
| | - Hanaa Abu ElSood
- Department of Epidemiology and Surveillance, Preventive Sector, Ministry of Health and Population, Cairo, Egypt
| | - Amira Mohsen
- Egypt Country Office, World Health Organization, Cairo, Egypt
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