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Sayyad AA, Mohamed AM, Alajaimi BA, Matar E, Hasan WF, Aldolabi Q, Abdulmahdi AKA, Yusuf MS. Severe acute respiratory infections: An epidemiological analysis of surveillance data in Bahrain, 2018-2022. Qatar Med J 2024; 2024:28. [PMID: 38974774 PMCID: PMC11227247 DOI: 10.5339/qmj.2024.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/29/2024] [Indexed: 07/09/2024] Open
Abstract
Background Severe acute respiratory tract infections (SARI) pose a health threat to children and adults worldwide. The SARI surveillance program was initiated in 2018 in Bahrain to monitor the activity of respiratory pathogens. Salmaniya Medical Complex (SMC) was chosen as the sentinel site for the SARI surveillance program. This study aimed to describe the epidemiology of SARI patients admitted to SMC from 2018 to 2022. Methods Patients meeting the World Health Organization definition of SARI and presenting with cough and fever within the last 10 days and admitted to SMC from January 2018 until December 2022 were included in the study. Epidemiological data on SARI cases were collected from SARI surveillance data and analyzed using SPSS version 25 and Excel. Results A total of 1362 SARI cases were enrolled from January 2018 to the end of December 2022; the majority were males (57.7%, n = 786). The highest SARI incidence rates were recorded among individuals over 65 years old (155.5 per 100,000) in 2021 and among those under 5 years old (887 per 100,000) in 2020. About half of the patients had at least one comorbidity (54.0%, n = 735), with diabetes (23.0%, n = 313) and hypertension (17.2%, n = 234) being the most common. The highest number of cases was observed in 2021 (27%, n = 373), followed by 2018 (20%, n = 267). A viral pathogen was detected in 30.7% (n = 418) of the SARI patients. The most prevalent pathogen was influenza A (11.5%, n = 156), followed by SARS-CoV-2 (9.7%, n = 132), respiratory syncytial virus (RSV) (5.1%, n = 69), and influenza B (3.9%, n = 53). The highest percentage of SARI cases was recorded in the winter months, mainly January (17%, n = 236). The percentages of influenza A and RSV cases were highest in December, at 22% (n = 39) and 14% (n = 25), respectively. Influenza B cases were recorded predominantly in March (9%, n = 11). Conclusion The incidence of SARI was highest among patients above 65 years old. The majority had comorbidities. Influenza and respiratory syncytial viruses were the most frequent causes of SARI, with influenza A being the most prevalent. December and January were the months with the highest SARI cases and viral detection rates. Promoting vaccination, timely testing, and prompt treatment, especially for the elderly and those with comorbidities, is key to reducing SARI-related morbidity and mortality, especially during peak seasons.
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Affiliation(s)
- Adel Al Sayyad
- Epidemiology & Public Health, Chief of Disease Control Section, Ministry of Health, CMMS, AGU, Manama, Bahrain
| | | | | | - Ebrahim Matar
- Public Health Directorate, Ministry of Health, Manama, Bahrain *
| | - Wafa Fawzi Hasan
- Public Health Directorate, Ministry of Health, Manama, Bahrain *
| | - Qatmeer Aldolabi
- Public Health Directorate, Ministry of Health, Manama, Bahrain *
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Rus MA, Ghițoaica B, Lazăr AL, Man MA, Briciu VT, Muntean MI, Leucuța DC, Lupșe MS. Changes in Epidemiology and Antibiotic Prescription of Influenza: Before and after the Emergence of COVID-19. Pharmaceuticals (Basel) 2024; 17:181. [PMID: 38399395 PMCID: PMC10893202 DOI: 10.3390/ph17020181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The appearance of COVID-19 had a major impact on healthcare and the epidemiology of other diseases. Following the cessation of non-pharmacologic interventions destined to limit the spread of COVID-19, influenza reemerged. The aim of this study was to compare the pre-pandemic influenza seasons with the influenza seasons after the emergence of the COVID-19 pandemic, and to identify differences in terms of clinical characteristics, risk factors, complications, outcomes, and antiviral and antibiotic treatments. METHODS We conducted a retrospective cohort study from the Teaching Hospital of Infectious Diseases database in Cluj-Napoca, Romania. We analyzed four pre-pandemic seasons and the seasons after the onset of COVID-19. We included adult patients hospitalized with confirmed influenza between October 2016 and August 2023. Variables such as age, sex, duration of hospitalization, severity, clinical manifestations, comorbidities, and Charlson comorbidity index were assessed. RESULTS A total of 941 patients were included in the analysis. The percentage of severe influenza was similar in both groups, but mortality from influenza was significantly lower after 2022. Virtually all patients were prescribed antivirals; antibiotic prescriptions decreased in the post-COVID-19 influenza seasons. CONCLUSION The present study suggests that influenza seasons after 2022 had lower mortality and attenuated clinical presentation.
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Affiliation(s)
- Mihai Aronel Rus
- Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (B.G.); (M.I.M.)
| | - Bogdan Ghițoaica
- Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (B.G.); (M.I.M.)
| | | | - Maria Ancuța Man
- Teaching Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania
| | - Violeta Tincuța Briciu
- Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (B.G.); (M.I.M.)
- Teaching Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania
| | - Monica Iuliana Muntean
- Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (B.G.); (M.I.M.)
- Teaching Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Mihaela Sorina Lupșe
- Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania; (B.G.); (M.I.M.)
- Teaching Hospital of Infectious Diseases, 400348 Cluj-Napoca, Romania
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Samal J, Prabhakar T, Prasad M, Rani N, Tarai B, Agarwal R, Padhi A, Tomar A, Maiwall R, Bhattacharyya D, Sharma MK, Gupta E. Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients. Euroasian J Hepatogastroenterol 2023; 13:108-114. [PMID: 38222946 PMCID: PMC10785143 DOI: 10.5005/jp-journals-10018-1400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/04/2023] [Indexed: 01/16/2024] Open
Abstract
Aim and background Respiratory viral infections (RVIs) cause significant hospitalizations every year. Also, RVIs caused by either influenza or noninfluenza group of viruses can have adverse outcomes, especially among immunosuppressed patients. Regular and timely supervision is needed for accurate etiological identification, to prevent inappropriate use of antibiotics in patients with nonbacterial etiology. This study aimed to identify the spectrum of RVIs and clinical characteristics among liver disease patients with influenza-like illness (ILI). Materials and methods In this study, medical records of patients with ILI, whose requests for respiratory viral testing came from September 2016 to December 2022 were retrospectively reviewed. Respiratory viruses were identified using FilmArray 2.0 respiratory panel (BioFire Diagnostics, USA). Results Of the 1,577 liver disease patients with ILI, the overall prevalence of RVI was 28% (n = 449). Infection by noninfluenza viruses (NIVs) was detected in 329 patients (73%), higher than those infected with influenza viruses. In multivariable logistic regression analysis, female gender [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.2], infection with influenza B (OR: 3.3, 95% CI: 1.09-9.9) and decompensated cirrhosis (OR: 3.9, 95% CI: 1.7-8.5) were independent risk factors for mortality. Regarding seasonality, influenza peaked in monsoons and winters, whereas NIVs circulated throughout the year. Conclusion Overall, this study adds new knowledge regarding the incidence of RVI and the distribution of respiratory viral etiologies among liver disease patients with ILI. The findings highlight that female gender, decompensated cirrhosis, and influenza B infection are independently associated with poor clinical outcomes. Early etiological identification of viral causes of ILI could aid in an enhanced understanding of the prevalence of ILI and the timely management of the patients. Clinical significance Respiratory viral infections can cause severe illness in individuals with underlying liver disease. Accurate diagnosis and risk stratification is crucial in mitigating the adverse health effects. How to cite this article Samal J, Prabhakar T, Prasad M, et al. Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients. Euroasian J Hepato-Gastroenterol 2023;13(2):108-114.
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Affiliation(s)
- Jasmine Samal
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Tushar Prabhakar
- Department of Epidemiology and Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Manya Prasad
- Department of Epidemiology and Clinical Research, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Nitiksha Rani
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Bansidhar Tarai
- Department of Microbiology and Infection Control Services, Max Super Speciality Hospital (A Unit of Devki Devi Foundation), Max Healthcare, New Delhi, India
| | - Reshu Agarwal
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Abhishek Padhi
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Arvind Tomar
- Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | | | - Manoj Kumar Sharma
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ekta Gupta
- Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India
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Al Amad M, Almoayed K. Influenza circulating viruses, positivity rate and risk factors for influenza associated severe acute respiratory infection during 2018/2019 winter season, Yemen. BMC Infect Dis 2022; 22:111. [PMID: 35105332 PMCID: PMC8804082 DOI: 10.1186/s12879-022-07090-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden of seasonal influenza in conflict counties is exacerbated due to limited resource and collapse of health system. During 2018 /2019 season, two-fold increase in the incidence of influenza was reported in Yemen with 22% case fatality of severe acute respiratory infection (SARI). The aims are to analyze the influenza circulating viruses, positivity rate and risk factors for hospitalizing influenza associated-SARI. METHODOLOGY We used a retrospective analytical study based on surveillance data. All reported patients during 2018/2019 season, fulfilling the WHO cases definition for SARI or influenza like illness (ILI), and had laboratory result from the National Laboratory were included. Influenza positivity rate was calculated, all SARI and ILI patients with positive influenza were included for further analysis by univariate and multivariate binary logistic regression. Crude and adjusted Odds ratio (AOR), 95% confidence interval and P-value < 0.05 were used for statistically significant. RESULTS Out of 2186 patients enrolled, 768 patients were tested for influenza viruses,: 19% were children < 15 years, 15% were ≥ 65 years, 69% males and 18% had co-morbidity with chronic diseases. Patients with SARI were 37% and 63% were ILI patients. Influenza viruses were detected in 411 (53.5%), 68% were influenza A subtype (H1N1)pdm09, 27% influenza B and 5% was influenza A not subtyped. The influenza positivity was significantly higher in SARI compared to ILI for patients < 15 years (95% vs, 66%, p < 0.001), and patients ≥ 65 years (83% vs. 56%, p < 0.002), respectively. The highest positivity for influenza type A and B reached 44% and 33% for patients ≥ 65 years and < 15 years, respectively. The risk factors for influenza-associated SARI in multivariate analysis included age < 5 [AOR 2.8] and ≥ 65 years old [AOR 3.1] compared to age 5- < 25 years, diabetes [AOR 4.7], heart diseases [AOR 3.1] and chronic respiratory diseases [AOR 5.0]. CONCLUSION The influenza positivity during 2018/2019 winter season was high in Yemen and varied by age distribution. Influenza subtype A (H1N1) pdm09 was the predominant and co circulated with influenza B. An influenza vaccination program for the risk group is necessary. Strengthening lab capacity to detect respiratory pathogens and further prospective study for more comprehensive picture are recommended.
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Peace O, Rachakonda K, Kress M, Villalta F, Rachakonda G. Respiratory and Neurological Disease across Different Ethnic Groups Is Influenced by the Microbiome. Microorganisms 2021; 9:1965. [PMID: 34576860 PMCID: PMC8468464 DOI: 10.3390/microorganisms9091965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/20/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022] Open
Abstract
Acute and chronic upper respiratory illnesses such as asthma, and allergic rhinitis (AR) have been linked to the presence of microorganisms in the nose. Microorganisms can exist in symbiotic or commensal relationships with the human body. However, in certain cases, opportunistic pathogens can take over, leading to altered states (dysbiosis) and causing disease. Thus, the microflora present in a host can be useful to reflect health status. The human body contains 10 trillion to 100 trillion microorganisms. Of these populations, certain pathogens have been identified to promote or undermine wellbeing. Therefore, knowledge of the microbiome is potentially helpful as a diagnostic tool for many diseases. Variations have been recognized in the types of microbes that inhabit various populations based on geography, diet, and lifestyle choices and various microbiota have been shown to modulate immune responses in allergic disease. Interestingly, the diseases affected by these changes are prevalent in certain racial or ethnic populations. These prevalent microbiome variations in these groups suggest that the presence of these microorganisms may be significantly associated with health disparities. We review current research in the search for correlations between ethnic diversity, microbiome communities in the nasal cavity and health outcomes in neurological and respiratory functions.
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Affiliation(s)
- Odiase Peace
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (O.P.); (F.V.)
| | - Kartik Rachakonda
- School of Arts and Science, Vanderbilt University, Nashville, TN 37212, USA;
| | - Miller Kress
- División of Molecular Diagnosticas, Phase2Labs, Nashville, TN 37217, USA;
| | - Fernando Villalta
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (O.P.); (F.V.)
| | - Girish Rachakonda
- Department of Microbiology, Immunology and Physiology, Meharry Medical College, Nashville, TN 37208, USA; (O.P.); (F.V.)
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