Program for Influenza and Other Respiratory Viruses, Center for Health Studies, Research Institute, Universidad del Valle de Guatemala (UVG), Guatemala City, Guatemala.
U.S. Centers for Disease Control and Prevention (CDC), Atlanta, USA.
BMC Public Health. 2022 Aug 13;22(1):1541. doi: 10.1186/s12889-022-13962-8.
We aimed to characterize the proportion of clients presenting to community pharmacies with influenza-like illness (ILI) and the severity of their illness; the proportion with detectable influenza A, influenza B, and other pathogens (i.e., parainfluenza I, II, and III, adenovirus, respiratory syncytial virus, human metapneumovirus); and to describe their self-medication practices.
A cross-sectional study was conducted in six pharmacies in Guatemala City. Study personnel collected nasopharyngeal and oropharyngeal swabs from participants who met the ILI case definition and who were self-medicating for the current episode. Participants were tested for influenza A and B and other pathogens using real-time RT-PCR. Participants' ILI-associated self-medication practices were documented using a questionnaire.
Of all patients entering the pharmacy during peak hours who responded to a screening survey (n = 18,016) 6% (n = 1029) self-reported ILI symptoms, of which 45% (n = 470/1029) met the study case definition of ILI. Thirty-one percent (148/470) met inclusion criteria, of which 87% (130/148) accepted participation and were enrolled in the study. Among 130 participants, nearly half tested positive for viral infection (n = 55, 42.3%) and belonged to groups at low risk for complications from influenza. The prevalence of influenza A was 29% (n = 35). Thirteen percent of the study population (n = 17) tested positive for a respiratory virus other than influenza. Sixty-four percent of participants (n = 83) reported interest in receiving influenza vaccination if it were to become available in the pharmacy. Medications purchased included symptom-relieving multi-ingredient cold medications (n = 43/100, 43%), nonsteroidal anti-inflammatory drugs (n = 23, 23%), and antibiotics (n = 16, 16%). Antibiotic use was essentially equal among antibiotic users regardless of viral status. The broad-spectrum antibiotics ceftriaxone and azithromycin were the most common antibiotics purchased.
During a typical influenza season, a relatively low proportion of all pharmacy visitors were experiencing influenza symptoms. A high proportion of clients presenting to pharmacies with ILI tested positive for a respiratory virus. Programs that guide appropriate use of antibiotics in this population are needed and become increasingly important during pandemics caused by respiratory viral pathogens.
本研究旨在描述因流感样疾病（ILI）就诊于社区药房的患者比例及其疾病严重程度；检测到的甲型流感、乙型流感和其他病原体（即副流感 1、2 和 3、腺病毒、呼吸道合胞病毒、人偏肺病毒）的比例；并描述他们的自我用药情况。
在危地马拉市的六家药店进行了一项横断面研究。研究人员从正在自我治疗当前发作的符合 ILI 病例定义的参与者中采集鼻咽和口咽拭子。使用实时 RT-PCR 对参与者进行甲型流感和乙型流感及其他病原体检测。使用问卷记录参与者与 ILI 相关的自我用药情况。
在高峰时段进入药房并对筛查调查做出回应的所有患者中（n=18016），6%（n=1029）自我报告有 ILI 症状，其中 45%（n=470/1029）符合研究 ILI 病例定义。31%（148/470）符合纳入标准，其中 87%（130/148）接受参与并被纳入研究。在 130 名参与者中，近一半的病毒检测呈阳性（n=55，42.3%），且属于流感并发症风险较低的人群。甲型流感的患病率为 29%（n=35）。13%的研究人群（n=17）检测出除流感以外的呼吸道病毒阳性。64%的参与者（n=83）表示，如果流感疫苗在药房供应，他们有兴趣接种流感疫苗。购买的药物包括缓解症状的多种成分感冒药（n=43/100，43%）、非甾体抗炎药（n=23，23%）和抗生素（n=16，16%）。无论病毒状态如何，抗生素使用者的抗生素使用率基本相等。最常购买的广谱抗生素是头孢曲松和阿奇霉素。
在典型的流感季节，相对较少比例的所有药房访客出现流感症状。到药房就诊的 ILI 患者中有很大比例的患者检测出呼吸道病毒阳性。需要为这一人群制定指导抗生素合理使用的方案，在由呼吸道病毒病原体引起的大流行期间，这些方案变得越来越重要。
