Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 2012 Dec 1;206(11):1674-84. doi: 10.1093/infdis/jis591. Epub 2012 Sep 14.
Although children <5 years old in sub-Saharan Africa are vulnerable to both malaria and influenza, little is known about coinfection.
This retrospective, cross-sectional study in rural western Kenya examined outpatient visits and hospitalizations associated with febrile acute respiratory illness (ARI) during a 2-year period (July 2009-June 2011) in children <5 years old.
Across sites, 45% (149/331) of influenza-positive patients were coinfected with malaria, whereas only 6% (149/2408) of malaria-positive patients were coinfected with influenza. Depending on age, coinfection was present in 4%-8% of outpatient visits and 1%-3% of inpatient admissions for febrile ARI. Children with influenza were less likely than those without to have malaria (risk ratio [RR], 0.57-0.76 across sites and ages), and children with malaria were less likely than those without to have influenza (RR, 0.36-0.63). Among coinfected children aged 24-59 months, hospital length of stay was 2.7 and 2.8 days longer than influenza-only-infected children at the 2 sites, and 1.3 and 3.1 days longer than those with malaria only (all P < .01).
Coinfection with malaria and influenza was uncommon but associated with longer hospitalization than single infections among children 24-59 months of age.
尽管撒哈拉以南非洲的 5 岁以下儿童易患疟疾和流感，但对两者的合并感染知之甚少。
本研究为回顾性、横断面研究，在肯尼亚西部农村地区，对 2009 年 7 月至 2011 年 6 月期间发生的 5 岁以下儿童发热性急性呼吸道疾病（ARI）门诊就诊和住院病例进行了调查。
在各研究点，45%（149/331）的流感阳性患者合并感染疟疾，而仅 6%（149/2408）的疟疾阳性患者合并感染流感。根据年龄的不同，合并感染在门诊就诊的 4%至 8%和住院的 1%至 3%的发热性 ARI 患者中存在。与无流感的儿童相比，流感阳性儿童合并感染疟疾的可能性较小（各研究点和年龄段的风险比 [RR]为 0.57-0.76），而合并感染疟疾的儿童合并感染流感的可能性较小（RR 为 0.36-0.63）。在 24-59 月龄的合并感染儿童中，2 个研究点的住院时间比流感单一感染儿童分别长 2.7 和 2.8 天，比疟疾单一感染儿童分别长 1.3 和 3.1 天（均 P<.01）。
24-59 月龄儿童合并感染疟疾和流感并不常见，但与单一感染相比，合并感染与住院时间延长有关。
