Emukule Gideon O, Khagayi Sammy, McMorrow Meredith L, Ochola Rachel, Otieno Nancy, Widdowson Marc-Alain, Ochieng Melvin, Feikin Daniel R, Katz Mark A, Mott Joshua A
Centers for Disease Control and Prevention (CDC)-Kenya Country Office, Nairobi, Kenya.
Kenya Medical Research Institute (KEMRI), Nairobi and Kisumu, Kenya.
PLoS One. 2014 Aug 18;9(8):e105543. doi: 10.1371/journal.pone.0105543. eCollection 2014.
In Kenya, detailed data on the age-specific burden of influenza and RSV are essential to inform use of limited vaccination and treatment resources.
We analyzed surveillance data from August 2009 to July 2012 for hospitalized severe acute respiratory illness (SARI) and outpatient influenza-like illness (ILI) at two health facilities in western Kenya to estimate the burden of influenza and respiratory syncytial virus (RSV). Incidence rates were estimated by dividing the number of cases with laboratory-confirmed virus infections by the mid-year population. Rates were adjusted for healthcare-seeking behavior, and to account for patients who met the SARI/ILI case definitions but were not tested.
The average annual incidence of influenza-associated SARI hospitalization per 1,000 persons was 2.7 (95% CI 1.8-3.9) among children <5 years and 0.3 (95% CI 0.2-0.4) among persons ≥5 years; for RSV-associated SARI hospitalization, it was 5.2 (95% CI 4.0-6.8) among children <5 years and 0.1 (95% CI 0.0-0.2) among persons ≥5 years. The incidence of influenza-associated medically-attended ILI per 1,000 was 24.0 (95% CI 16.6-34.7) among children <5 years and 3.8 (95% CI 2.6-5.7) among persons ≥5 years. The incidence of RSV-associated medically-attended ILI was 24.6 (95% CI 17.0-35.4) among children <5 years and 0.8 (95% CI 0.3-1.9) among persons ≥5 years.
Influenza and RSV both exact an important burden in children. This highlights the possible value of influenza vaccines, and future RSV vaccines, for Kenyan children.
在肯尼亚，有关流感和呼吸道合胞病毒（RSV）特定年龄负担的详细数据对于合理使用有限的疫苗接种和治疗资源至关重要。
我们分析了2009年8月至2012年7月肯尼亚西部两家医疗机构中住院的严重急性呼吸道疾病（SARI）和门诊流感样疾病（ILI）的监测数据，以估算流感和呼吸道合胞病毒（RSV）的负担。发病率通过将实验室确诊的病毒感染病例数除以年中人口数来估算。对寻求医疗行为进行了调整，并考虑了符合SARI/ILI病例定义但未进行检测的患者。
每1000人中，5岁以下儿童流感相关SARI住院的年均发病率为2.7（95%置信区间1.8 - 3.9），5岁及以上人群为0.3（95%置信区间0.2 - 0.4）；对于RSV相关SARI住院，5岁以下儿童为5.2（95%置信区间4.0 - 6.8），5岁及以上人群为0.1（95%置信区间0.0 - 0.2）。每1000人中，5岁以下儿童流感相关需就医的ILI发病率为24.0（95%置信区间16.6 - 34.7），5岁及以上人群为3.8（95%置信区间2.6 - 5.7）。RSV相关需就医的ILI发病率在5岁以下儿童中为24.6（95%置信区间17.0 - 35.4），5岁及以上人群为0.8（95%置信区间0.3 - 1.9）。
流感和RSV在儿童中均造成了重要负担。这凸显了流感疫苗以及未来的RSV疫苗对肯尼亚儿童的潜在价值。
