Anjorin Abdul Azeez Adeyemi, Nwammadu Juliet Ebere
Department of Microbiology (Virology Research), Lagos State University, Ojo, Lagos, Nigeria.
Infez Med. 2020 Sep 1;28(3):407-415.
Nigeria is the most populous African nation in the world having a population of over 200 million with little or no data on maternal influenza and its co-morbidities. In most developing countries, there is paucity of data for prioritization of strategies for the prevention and control of influenza with possible co-morbidities common in pregnancy. We therefore investigated recent infection of seasonal influenza virus with co-infection of malaria parasitaemia and typhoid fever in pregnant women in Lagos State, Nigeria. A descriptive hospital-based cross-sectional study was designed according to the Consortium for the Standardization of Influenza Seroepidemiology (CONSISE) guideline in 6 public health institutions between July 2016 and October 2018. Enzyme Immunoassay (Demeditec, Germany) was used to detect IgM specific antibodies to influenza A (H1N1) and (H3N2). P-values were determined with Chi-square using GraphPad Prism, USA. Demographic characteristics of the patients showed median age of 29 (mean 29.3; mode, 28; and range, 18-45) years. Out of 182 pregnant women screened, 103 (56.6%) were IgM seropositive for influenza A. Patients with underlying diseases accounted for 72%, approximately three-times higher compared to 28% without underlying disease. Co-infection was detected with malaria parasitaemia (54%), typhoid fever (50.5%), and malaria and typhoid fever (33%). The most commonly reported symptoms were fever, cold, dizziness, swollen legs, and cough. Age group 21-30 years was the most affected while patients from densely populated area had the highest seroprevalence. This study revealed that seasonal influenza circulates with co-morbidities in pregnant women in Lagos. This may exacerbate their immunosuppressed state and lead to complication in pregnancy. Apt treatment of influenza-like illness should be considered in such women. Furthermore, there is need for enhanced surveillance including monitoring of the potential transmissibility of influenza to the foetus and newborns. We therefore recommend sturdy advocacy on preventing exposure to influenza virus, its optimal early diagnosis, vaccination and disease management in pregnancy.
尼日利亚是世界上人口最多的非洲国家，人口超过2亿，但关于孕产妇流感及其合并症的数据很少或几乎没有。在大多数发展中国家，缺乏数据来确定预防和控制流感以及孕期常见合并症的策略的优先级。因此，我们调查了尼日利亚拉各斯州孕妇近期季节性流感病毒感染情况以及合并疟疾寄生虫血症和伤寒热的情况。根据流感血清流行病学标准化联盟（CONSISE）指南，于2016年7月至2018年10月在6家公共卫生机构开展了一项基于医院的描述性横断面研究。采用酶免疫测定法（德国德美泰克公司）检测甲型流感病毒（H1N1）和（H3N2）的IgM特异性抗体。使用美国GraphPad Prism软件通过卡方检验确定P值。患者的人口统计学特征显示，中位年龄为29岁（平均29.3岁；众数28岁；范围18 - 45岁）。在182名接受筛查的孕妇中，103名（56.6%）甲型流感IgM血清学呈阳性。患有基础疾病的患者占72%，比无基础疾病的患者（28%）高出约三倍。检测到合并感染疟疾寄生虫血症（54%）、伤寒热（50.5%）以及疟疾和伤寒热（33%）。最常报告的症状是发热、感冒、头晕、腿部肿胀和咳嗽。21 - 30岁年龄组受影响最大，而来自人口密集地区的患者血清阳性率最高。这项研究表明，拉各斯州孕妇中季节性流感与合并症同时存在。这可能会加剧她们的免疫抑制状态并导致孕期并发症。对于此类女性应考虑对流感样疾病进行适当治疗。此外，需要加强监测，包括监测流感向胎儿和新生儿的潜在传播性。因此，我们建议大力倡导预防接触流感病毒、对其进行最佳早期诊断、接种疫苗以及孕期疾病管理。
