Rachmat Agus, Kelly Gerard C, Tran Long Khanh, Christy Nathaniel, Supaprom Chonthida, Heang Vireak, Dul Sokha, Garcia-Rivera Jose A, Prom Satharath, Sopheab Heng, Brooks John S, Sutherland Ian J, Corson Karen S, Letizia Andrew G
AC Investment Co, contractor for NAMRU INDO PACIFIC, Phnom Penh, Cambodia.
Vysnova Partners, Inc., Landover, Maryland, USA.
Open Forum Infect Dis. 2024 Feb 22;11(3):ofae062. doi: 10.1093/ofid/ofae062. eCollection 2024 Mar.
Despite its global significance, challenges associated with understanding the epidemiology and accurately detecting, measuring, and characterizing the true burden of seasonal influenza remain in many resource-poor settings.
A prospective observational study was conducted in Cambodia at 28 health facilities between 2007 and 2020 utilizing passive surveillance data of patients presenting with acute undifferentiated febrile illness (AUFI) to describe the prevalence of influenza A and B and characterize associated risk factors and symptoms using a questionnaire. A comparison of rapid influenza diagnostic tests (RIDTs) and real-time reverse transcription polymerase chain reaction (rRT-PCR) results was also conducted.
Of 30 586 total participants, 5634 (18.4%) tested positive for either influenza A or B, with 3557 (11.6%) positive for influenza A and 2288 (7.5%) positive for influenza B during the study. Influenza A and B were strongly associated with the rainy season (odds ratio [OR], 2.30; < .001) and being from an urban area (OR, 1.45; < .001). Analysis of individual symptoms identified cough (OR, 2.8; < .001), chills (OR, 1.4; < .001), and sore throat (OR, 1.4; < .001) as having the strongest positive associations with influenza among patients with AUFI. Analysis comparing RIDTs and rRT-PCR calculated the overall sensitivity of rapid tests to be 0.492 (95% CI, 0.479-0.505) and specificity to be 0.993 (95% CI, 0.992-0.994) for both influenza type A and B.
Findings from this 14-year study include describing the epidemiology of seasonal influenza over a prolonged time period and identifying key risk factors and clinical symptoms associated with infection; we also demonstrate the poor sensitivity of RIDTs in Cambodia.
尽管季节性流感具有全球重要性，但在许多资源匮乏地区，在理解其流行病学以及准确检测、测量和确定季节性流感的真正负担方面仍存在挑战。
2007年至2020年期间，在柬埔寨的28家医疗机构开展了一项前瞻性观察性研究，利用急性未分化发热性疾病（AUFI）患者的被动监测数据来描述甲型和乙型流感的患病率，并通过问卷调查确定相关危险因素和症状。同时还对快速流感诊断试验（RIDT）和实时逆转录聚合酶链反应（rRT-PCR）结果进行了比较。
在30586名参与者中，5634人（18.4%）甲型或乙型流感检测呈阳性，研究期间甲型流感阳性3557人（11.6%），乙型流感阳性2288人（7.5%）。甲型和乙型流感与雨季（优势比[OR]，2.30；P<0.001）以及来自城市地区（OR，1.45；P<0.001）密切相关。对个体症状的分析表明，在AUFI患者中，咳嗽（OR，2.8；P<0.001）、寒战（OR，1.4；P<0.001）和喉咙痛（OR，1.4；P<0.001）与流感的正相关性最强。对RIDT和rRT-PCR的比较分析得出，甲型和乙型流感快速检测的总体灵敏度为0.492（95%CI，0.479-0.505），特异性为0.993（95%CI，0.992-0.994）。
这项为期14年的研究结果包括描述了长时间内季节性流感的流行病学情况，确定了与感染相关的关键危险因素和临床症状；我们还证明了柬埔寨RIDT的灵敏度较低。
