Fally M A, Redlberger-Fritz M, Starzengruber P, Swoboda P, Fuehrer H P, Yunus E B, Khan W A, Noedl H
Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Austria.
J Postgrad Med. 2012 Oct-Dec;58(4):242-5. doi: 10.4103/0022-3859.105441.
Infections caused by influenza viruses are a major health burden, both in developed and developing countries worldwide. Nevertheless, the overwhelming majority of influenza reports originate from industrialized countries in northern and southern temperate zones.
The aim of this study was to determine the epidemiology of influenza viruses in patients seeking treatment for acute febrile illnesses in rural Bangladesh.
As part of our research on the causes of febrile illnesses in rural Bangladesh, nasopharyngeal swabs from patients with signs and symptoms consistent with influenza were collected from 2008 onwards.
Viral infection was established using two independent rapid diagnostic tests (RDTs) and later confirmed by RT-PCR.
A total of 314 fever cases were enrolled in a survey of febrile illnesses carried out in Bandarban District in southeastern Bangladesh, out of whom 38 (12.1%) tested positive by RDT. Molecular subtyping showed that seasonal H3 strains (N=22; 7.0%) as well as the new H1N1v pandemic influenza subtype (N=13; 4.1%) had been circulating at the time of our investigations resulting in a PCR-adjusted positivity rate of 11.1% (95% CI 8.0 - 15.3). The positive predictive values for the RDTs used were 90.9% and 94.4%, respectively.
This study provides a first insight into influenza epidemics in one of the most remote parts of Asia. Our findings suggest that respiratory illnesses due to influenza viruses are underreported in areas with limited access to health care and show a distinct seasonality also in rural areas of tropical countries.
在全球发达国家和发展中国家，流感病毒引起的感染都是一项重大的健康负担。然而，绝大多数流感报告都来自北半球和南半球温带的工业化国家。
本研究的目的是确定在孟加拉国农村地区因急性发热性疾病寻求治疗的患者中流感病毒的流行病学情况。
作为我们对孟加拉国农村地区发热性疾病病因研究的一部分，从2008年起收集有流感症状和体征患者的鼻咽拭子。
使用两种独立的快速诊断测试（RDT）确定病毒感染情况，随后通过逆转录聚合酶链反应（RT-PCR）进行确认。
在孟加拉国东南部班达班区进行的一项发热性疾病调查中，共纳入314例发热病例，其中38例（12.1%）RDT检测呈阳性。分子亚型分析显示，在我们调查期间，季节性H3毒株（N = 22；7.0%）以及新型H1N1v大流行性流感亚型（N = 13；4.1%）一直在传播，经PCR调整后的阳性率为11.1%（95%可信区间8.0 - 15.3）。所使用的RDT的阳性预测值分别为90.9%和94.4%。
本研究首次深入了解了亚洲最偏远地区之一的流感流行情况。我们的研究结果表明，在医疗保健服务有限的地区，流感病毒引起的呼吸道疾病报告不足，并且在热带国家的农村地区也呈现出明显的季节性。
