Departments of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Vanderbilt University School of Medicine, Nashville, TN, USA.
Influenza Other Respir Viruses. 2021 Mar;15(2):284-292. doi: 10.1111/irv.12813. Epub 2020 Nov 11.
The disease burden of influenza-associated hospitalizations among children in Jordan is not well established. We aimed to characterize hospitalizations attributed to influenza in a pediatric population.
We conducted a cross-sectional study from our viral surveillance cohort in children under 2 years hospitalized with acute respiratory symptoms and/or fever from March 2010 to March 2013. We collected demographic and clinical characteristics, and calculated the frequency of children who met the severe acute respiratory illness (SARI) criteria. Nasal specimens were tested using real-time reverse transcriptase polymerase chain reaction to detect influenza A, B, or C. Further subtyping for influenza A-positive isolates was conducted.
Of the 3168 children enrolled in our study, 119 (4%) were influenza-positive. Influenza types and subtypes varied by season but were predominantly detected between December and February. Codetection of multiple respiratory pathogens was identified in 58% of children with the majority occurring among those <6 months. Bronchopneumonia and rule-out sepsis were the most common admission diagnoses, with influenza A accounting for over 2/3 of children with a rule-out sepsis admission status. One-third of children under 6 months compared to 3/4 of children 6-23 months met the SARI criteria.
Influenza was an important cause of acute respiratory illness in children under 2 years. Children <6 months had the highest burden of influenza-associated hospitalizations and were less likely to meet the SARI global surveillance case definition. Additional surveillance is needed in the Middle East to determine the true influenza burden on a global scale.
约旦儿童因流感住院的疾病负担尚未得到充分证实。本研究旨在明确儿科人群中因流感导致的住院情况。
我们开展了一项横断面研究，对象为 2010 年 3 月至 2013 年 3 月期间因急性呼吸道症状和/或发热住院的 2 岁以下儿童。我们收集了人口统计学和临床特征，并计算了符合严重急性呼吸道感染（SARI）标准的儿童频率。采用实时逆转录聚合酶链反应检测鼻拭子中是否存在流感 A、B 和 C 型病毒。进一步对流感 A 阳性分离株进行了亚型鉴定。
本研究共纳入了 3168 名儿童，其中 119 名（4%）为流感阳性。流感的类型和亚型因季节而异，但主要在 12 月至 2 月间检出。58%的患儿合并检测到多种呼吸道病原体，而大多数这种混合感染发生在 6 个月以下的患儿中。支气管肺炎和排除败血症是最常见的入院诊断，排除败血症入院的患儿中，超过 2/3 为流感 A 型感染。与 6-23 月龄儿童相比，6 月龄以下儿童中约有 1/3 符合 SARI 全球监测病例定义，而 4/5 为 6-23 月龄儿童。
流感是 2 岁以下儿童急性呼吸道感染的重要病因。6 月龄以下儿童的流感相关住院负担最高，且不太可能符合 SARI 的全球监测病例定义。需要在中东地区开展更多的监测，以确定全球范围内流感的实际负担。
