Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia

Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-P4HH5NV'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia View ORCID Profile Bedado Dulo , Gamachu Hinsene , Ephrem Mannekulih doi: https://doi.org/10.1101/2024.05.31.24308236 Bedado Dulo 1 Adama Hospital Medical College, Department of Biomedical Sciences, Microbiology and Parasitology unity , Adama, Ethiopia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Bedado Dulo For correspondence: bedadodulodafi{at}gmail.com lokotiya1642{at}gmail.com Gamachu Hinsene 2 Adama Regional Laboratory capacity building, Microbiology, and Public Health expertise , Adama, Ethiopia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ephrem Mannekulih 3 Adama Hospital Medical College, Department Public Health Adama , Ethiopia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Background Acute viral origins account for around 80% of respiratory illnesses globally. The influenza virus, respiratory syncytial virus, coronavirus, adenovirus, and rhinovirus are the main viruses that cause these illnesses. All ages are susceptible to severe acute respiratory infections, which have a high rate of morbidity and mortality. This study aims to determine the prevalence of viral etiology of respiratory infections among patients attending the Oromia Sentinel Surveillance Sites between July 2022 and April 2023. Methods A facility-based cross-sectional study design was employed. We followed the WHO case definitions for each patient with a severe acute respiratory infection. The throat-swab specimens were sent to the Adama Public Health Referral and Research Capacity Building Centre after being collected in viral transport media. After that, the CDC Multiplex RT-PCR amplification procedures were applied to the specimens to detect the presence of viral RNA using CDC Real-Time reverse transcription PCR techniques. Data quality assurance was maintained. SPSS version 29 statistical software was used to compute all analyses. At 95% CI and P-value <0.05, inferential analysis was performed. Results The results of this study showed that out of three hundred twenty-two throat-swab specimens collected, 100% underwent testing. Eleven (28.2%) of the thirty-nine (12.9%) who tested positive for influenza were influenza B, twenty-five (89.3%) were influenza A (H3N2), three (10.7%) were influenza A (H1N1) pdm2009. The rates of influenza positivity by age group were 58.9%, 25.6%, 5.1%, 5.1%, and 5.1% for children under five years old, 5–14 years old, 15–49 years old, 50–64 years old, and older than or equal to 65 years old. Three hundred and twenty-two (100%), twenty-two (7.3%), and eleven (3.6%) of the specimens examined for severe acute respiratory infections proved positive for the RSV and SARS-CoV-2 viruses, respectively. Furthermore, of the severe acute respiratory infection specimens that tested positive for Respiratory syncytial virus, 91% were from under five age groups. Conclusion Children under five are at risk of co-infection with various viruses, potentially leading to epidemics and severe illnesses. A comprehensive approach to IPC measures is needed to reduce these risks. INTRODUCTION Acute respiratory infection (ARI) is a significant global health concern, with influenza being the leading cause [ 1 - 2 ]. Influenza viruses are enveloped negative-stranded RNA viruses with segmented genomes containing eight gene segments [ 4 ]. They have a wide range of hosts, including humans, birds, pigs, horses, and marine mammals [ 3 ]. Seasonal epidemics are generally caused by types A and B, responsible for 3 to 5 million cases of severe acute respiratory infection (SARI), resulting in significant global morbidity and mortality every year and 290,000 to 500,000 deaths per year [ 5 - 6 ]. The severity of influenza viruses is mainly due to aggravations of underlying conditions, such as bacterial co-infection and secondary infection that synergize influenza viruses, leading to severe complications like respiratory distress syndrome (ARDS), respiratory failure, and death [ 7 - 9 ]. Seasonal influenza viruses evolve continuously and cause severe disease annually, particularly in the elderly, children, pregnant women, and people with underlying chronic conditions [ 10 - 12 ]. In Africa, influenza-related incidence data remain inadequate and outcome data are still very limited. Seasonality patterns of influenza in eastern Africa, including Ethiopia, have not been established [ 13 - 15 ]. Co-infection with various viral pathogens has been confirmed in a substantial number of patients with respiratory tract diseases, but the association between the occurrence of co-infection and substantially higher severity of disease is still unclear [ 16 - 21 ]. The influenza virus, causing significant illness and death, is a major cause of respiratory tract illnesses, hospitalization, and mortality, especially in infants and young children [ 22 - 23 ]. The COVID-19 pandemic has significantly impacted healthcare services worldwide [ 24 - 26 ]. Measures to reduce coronavirus transmission have also reduced the transmission of other respiratory viruses. However, the clinical outcomes of respiratory viral co-infections with coronavirus remain unknown. The Ethiopian Influenza sentinel surveillance system faced challenges, including weak follow-up of influenza-positive cases, high SARI patient enrollment, and limited data collection [ 27 - 28 ]. This study aims to identify influenza virus types and subtypes and determine their association with disease outcomes and socio-demographic variables. Materials and Methods Study area The Adama Public Health Research and Referral Laboratory Center (APHRRLC ) , established in 1996, is located in Oromia Regional State, Adama City, and 100 km from Addis Ababa. Launched in 2003, it serves as a study site for Oromia severe acute respiratory infections Sentinel Surveillance reports. Study design and period The studyconducted from July 2022 to April 2023, was a prospective hospital-based study utilizing data from severe acute respiratory infection sentinel surveillance. Population Source population The patient list for the 2022/2023 season, from July 2022 to April 2023, includes all those attending Adama Hospital Medical College. Study population Sentinel surveillance staff collect data on patients with severe acute respiratory infection, following the World Health Organization case definition, as part of epidemiological surveillance. Sample size determination and sampling technique During the study period, 322 sample sizes were included from sentinel surveillance sites, following the World Health Organization case definition for severe acute respiratory infection. Inclusion criteria Legible cases meeting the World Health Organization case definitions for severe acute respiratory infection from the catchment of Adama Hospital Medical College sentinel surveillance were included. Exclusion criteria The patients were included in the Severe acute respiratory infection case definitions protocol guideline. Those patients did not meet the protocol, and or refused to provide the sample excluded. Study variables Dependent variable The positivity rate of influenza and co-infection with severe acute respiratory syndrome -CoV -2 or Respiratory syncytia viruses were the dependent variables Independent variables The patient’s demographic data, including age, sex, address, occupation, pre-existing conditions, vaccinations, influenza exposure, travel history, and other factors, were considered independent variables.. Operational definition Who’s severe acute respiratory infection case definitions A severe acute respiratory infection case is a patient over 5 years old with sudden fever, cough, sore throat, shortness of breath, hospitalization, or a child under 5 years [ 37 ]. Co-infection: Infection with Influenza and either coronavirus or Respiratory syncytial virus. Co-circulation: The availability of various viruses together in the community either infecting a patient separately or in the form of co-infection. Data collection tools and technique A severe acute respiratory infection case-based data collection form was used to gather demographic and clinical data from adult patients and parents. Symptoms, comorbidities, and samples were collected from nasopharyngeal swabs after clinical examination. The samples were transported to the Ethiopian Health Institute and APHRRLC for diagnosis, and stored at -20oc until testing. The data was then sent to other laboratories for further testing. Data quality assurance Data quality assurance was maintained through orienting data collectors and supervisors on data collection, sample collection, and transportation. Supervisors check severe acute respiratory infection case-based data forms for completeness, accuracy, and timeliness before sending them weekly to APHRRLC or EPHI. Data arrives at laboratories, is checked for completeness, accuracy, and timeliness, and is cleaned before being entered into Epi info version 7.2.5 and exported to SPSS version 26 for analysis. Data management and analysis The study used descriptive statistics, Pearson chi-square, and Fisher’s exact tests to compare categorical variables and two-sample t-tests for continuous variables. Seasonality and trends of influenza type and subtype were evaluated using an epidemiologic curve. The positivity rate for influenza was calculated, and differences in positivity were tested based on infection severity and age group. Ethical review In Ethiopia, Oromia region is one of the National Influenza Sentinel surveillance sites for Severe Acute Respiratory infections studies framed with protocol and supervised by the Ethiopian Public Health Institute. The Adama Public Health Research and Referral Laboratory Center conduct a routine surveillance patients fulfilling the nation protocol to address the national target. Ethical clearance was obtained from the Oromia Health Bureau Research Ethical Review Board with letter reference no/Lkk: BFI/HBTH/ 1-16/4035 written on date 21/3/2015 E.C. Unwritten consent was obtained from parents for underaged patients. Dissemination of study the findings The study aids stakeholders in decision-making on interventional prevention against seasonal influenza, including vaccination, reducing severe acute respiratory infection incidence, hospitalization, and case fatality, and will be presented at health institutes and conferences. Results Demographic and clinical Characteristics of study subjects A study enrolled 302 patients with severe acute respiratory infections, with a mean age of 9.6 years and a median age of 3.1 years. Males accounted for 56.6% of the patients, with comorbidities including liver disease, chronic heart disease, and heart disease. Symptoms included difficulty breathing, sore throat, and runny nose. Only 3 patients were vaccinated [ Table 1 ]. View this table: View inline View popup Table 1: Demographic and clinical Characteristics of study subjects at Adama Hospital Medical College’s Influenza Sentinel Surveillance Site from July 2022 through April 2023. Prevalence of Influenza Virus, Types, and Subtypes A total of 302 samples were tested for influenza using multiplex RT-PCR, with 39 positive (12.9%) of the samples being positive for different types and subtypes. Influenza type A accounted for 28 (71.8%) cases, with A (H1N1) pdm2009 and H3N2 contributing 89.3% and 28.2% respectively. Males accounted for 69.2% of positive cases, while A (H3N2) contributed 89.3%, with 36%, 28%, and 20% attributed to age categories. Influenza type B distribution was 36.4%, 27.3%, and 27.3%, with males contributing 72.7% [ Table 2 ]. View this table: View inline View popup Table 2: Prevalence of Influenza virus, Types, and Subtypes among Study Subjects at Adama Hospital Medical College’s Influenza Sentinel Surveillance Site from July 2022 through April 2023. Prevalence of severe acute respiratory syndrome, and respiratory syncytial viruses Out of 302 Severe acute respiratory infection specimens, 22 (7.3%) and 11 (3.6%) were positive for Severe acute respiratory syndrome, and Respiratory syncytial viruses. Age categories contributed to severe acute respiratory syndrome positivity, with males contributing 63.6%. Respiratory syncytial prevalence was also influenced by age, with males contributing 63.6%. Both positive cases were found in under 2 years and 2-4 years old [ Table 3 ]. View this table: View inline View popup Download powerpoint Table 3: Prevalence of Severe acute respiratory syndrome, and Respiratory syncytial viruses among study subjects at Adama Hospital Medical College’s Influenza Sentinel Surveillance Site from July 2022 through April 2023. Discussion The study found that the proportion of influenza-positive specimens among enrolled severe acute respiratory infection patients at Adama Hospital Medical College was 13.3% from July 2022 to April 2023. The peak in influenza positives was observed during the winter months, with a distinct peak in December 2022. The proportion of influenza A and B was higher than previous reports in Ethiopia 3%[ 40 ], and Egypt, but lower than previous reports in Egypt, Ethiopia, and Pakistan[ 42 , 43 , 47 , 48 ]. However, our current study result (13%) is similar to reports from Beijing(China), Indonesia, Malawi, Kenya, Central China, and Zambia 16.6%, 12.1%, 14.5%, 10%, 13%, and 16.3%[7, 33, 34, 36, 41, 45] respectively. Influenza A (H3N2) was attributed to 25 (89.3%) cases, while A (H1N1) pdm2009 was lower than previous reports. Influenza coinfection with Severe acute respiratory syndrome -CoV-2 was 12.8%, with higher coinfection in influenza subtype A. Co-circulation and co-infection of A(H3N2), A(H1N1) pdm2009, Influenza B, and Severe acute respiratory syndrome-CoV-2 viruses were common in under 5 years old children. During the study, 8 cases of co-infections were detected, with 5 cases of severe acute respiratory syndrome, and influenza and 3 cases of respiratory syncytial virus and influenza. Influenza coinfection with Respiratory syncytial virus was not discussed due to the small number of cases. Other studies reported variable prevalence and clinical outcomes of influenza coinfection with severe acute respiratory syndrome -CoV-2, with differences in regions and geographical locations. Conclusion and Recommendation Children under five age included in this study, are at risk of co-infection with various viruses, potentially leading to epidemics and severe illnesses. A comprehensive approach to Infection Prevention Control (IPC) measures is needed to manage these risks. Multiplex RT-PCR testing for influenza and severe acute respiratory syndrome -CoV-2 is necessary, and public health strategies like vaccination and mask use during high respiratory virus circulation are recommended. Further studies with larger sample sizes are also warranted to study the associated risk factors of coinfection. Data Availability All data produced in the present study are available upon reasonable request to the authors. Acknowledgments The authors express gratitude to the Oromia Health Bureau, Adama Public Health Research & Referral Laboratory Center, Adama Hospital Medical College, Mojo Hospitals, and study participants for their support and volunteerism. References 1. ↵ Mahony JB , Petrich A , Smieja M. Molecular diagnosis of respiratory virus infections . Critical reviews in clinical laboratory sciences . 2011 ; 48 ( 5-6 ): 217 – 49 . OpenUrl CrossRef PubMed 2. ↵ Azar MM , Landry ML . Detection of Influenza A and B Viruses and Respiratory Syncytial Virus by Use of Clinical Laboratory Improvement Amendments of 1988 (CLIA)-Waived Point-of-Care Assays: a Paradigm Shift to Molecular Tests . Journal of clinical microbiology . 2018 ; 56 ( 7 ). 3. ↵ Yoon S-W , Webby RJ , Webster RG . Evolution and ecology of influenza A viruses . Influenza pathogenesis and control-volume I . 2014 : 359 – 75 . 4. ↵ Meng X , Zhao H , Ou R , Zeng Q , Lv H , Zhu H , et al. Epidemiological and Clinical Characteristics of Influenza Outbreaks Among Children in Chongqing, China . Frontiers in public health . 2022 ; 10 : 760746 . OpenUrl 5. ↵ Paules C , Subbarao K. Influenza . The Lancet . 2017 ; 390 ( 10095 ): 697 – 708 . OpenUrl 6. ↵ Fahim M , AbdElGawad B , Hassan H , Naguib A , Ahmed E , Afifi S , et al. Epidemiology and outcome of influenza-associated infections among hospitalized patients with acute respiratory infections, Egypt national surveillance system, 2016-2019 . Influenza and Other Respiratory Viruses . 2021 ; 15 ( 5 ): 589 – 98 . OpenUrl 7. ↵ Zhang Y , Muscatello D , Wang Q , Yang P , Pan Y , Huo D , et al. Hospitalizations for Influenza-Associated Severe Acute Respiratory Infection, Beijing, China, 2014–2016 . Emerging Infectious Disease journal . 2018 ; 24 ( 11 ): 2098 . OpenUrl 8. Iuliano AD , Roguski KM , Chang HH , Muscatello DJ , Palekar R , Tempia S , et al. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study . The Lancet . 2018 ; 391 ( 10127 ): 1285 – 300 . OpenUrl CrossRef 9. ↵ Bellos A , Mulholland K , O’Brien KL , Qazi SA , Gayer M , Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review . Conflict and health . 2010 ; 4 : 3 . OpenUrl 10. ↵ Centers for Disease C, Prevention . Influenza outbreak--Madagascar, July-August 2002 . MMWR Morbidity and mortality weekly report . 2002 ; 51 ( 45 ): 1016 – 8 . OpenUrl PubMed 11. World Health O . Global influenza strategy 2019-2030 . Geneva : World Health Organization ; 2019 2019 . 12. ↵ Viboud C , Alonso WJ , Simonsen L. Influenza in tropical regions . PLoS Med . 2006 ; 3 ( 4 ): e89 . OpenUrl CrossRef PubMed 13. ↵ Katz MA , Schoub BD , Heraud JM , Breiman RF , Njenga MK , Widdowson MA . Influenza in Africa: uncovering the epidemiology of a long-overlooked disease . The Journal of infectious diseases . 2012 ; 206 Suppl 1 : S1 – 4 . OpenUrl CrossRef PubMed 14. Manirakiza A , Ketta MB , Vickos U , Komoyo GF , Garba-Ouangole S , Bangue C , et al. Sentinel surveillance of influenza-like illness in the Central African Republic, 2010-2015 . Archives of public health = Archives belges de sante publique . 2017 ; 75 : 61 . OpenUrl 15. ↵ Stefanska I , Romanowska M , Donevski S , Gawryluk D , Brydak LB . Co-infections with influenza and other respiratory viruses . Advances in experimental medicine and biology . 2013 ; 756 : 291 – 301 . OpenUrl CrossRef PubMed 16. ↵ Peci A , Tran V , Guthrie JL , Li Y , Nelson P , Schwartz KL , et al. Prevalence of Co-Infections with Respiratory Viruses in Individuals Investigated for SARS-CoV-2 in Ontario, Canada . Viruses . 2021 ; 13 ( 1 ). 17. Burki TK . Circulation of influenza, RSV, and SARS-CoV-2: an uncertain season ahead . The Lancet Respiratory Medicine . 2021 ; 9 ( 10 ): e103 . OpenUrl 18. Dolores A , Stephanie G , Mercedes SN , Érica G , Mistchenko AS , Mariana V. RSV reemergence in Argentina since the SARS-CoV-2 pandemic . Journal of Clinical Virology: the official publication of the Pan American Society for Clinical Virology . 2022 ; 149 : 105126 . OpenUrl 19. Hammond A , Cozza V , Hirve S , Medina MJ , Pereyaslov D , Zhang W. Leveraging Global Influenza Surveillance and Response System for the COVID-19 Pandemic Response and Beyond . China CDC weekly . 2021 ; 3 ( 44 ): 937 – 40 . OpenUrl 20. Woyessa AB , Mengesha M , Belay D , Tayachew A , Ayele W , Beyene B , et al. Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009-2015 . BMC Infect Dis . 2018 ; 18 ( 1 ): 449 . OpenUrl PubMed 21. ↵ Woyessa AB , Mengesha M , Belay D , Tayachew A , Ayele W , Beyene B , et al. Epidemiology of influenza in Ethiopia: findings from influenza sentinel surveillance and respiratory infection outbreak investigations, 2009–2015 . BMC Infectious Diseases . 2018 ; 18 ( 1 ): 449 . OpenUrl PubMed 22. ↵ Emukule GO , Khagayi S , McMorrow ML , Ochola R , Otieno N , Widdowson MA , et al. The burden of influenza and RSV among inpatients and outpatients in rural western Kenya, 2009-2012 . PloS one . 2014 ; 9 ( 8 ): e105543 . OpenUrl CrossRef 23. ↵ Nukiwa N , Burmaa A , Kamigaki T , Darmaa B , Od J , Od I , et al. Evaluating influenza disease burden during the 2008-2009 and 2009-2010 influenza seasons in Mongolia . Western Pacific surveillance and response journal: WPSAR . 2011 ; 2 ( 1 ): 16 – 22 . OpenUrl 24. ↵ Garg I , Shekhar R , Sheikh AB , Pal S. Impact of COVID-19 on the Changing Patterns of Respiratory Syncytial Virus Infections . Infectious disease reports . 2022 ; 14 ( 4 ): 558 – 68 . OpenUrl 25. Suleiman-Martos N , Caballero-Vázquez A , Gómez-Urquiza JL , Albendín-García L , Romero-Béjar JL , Cañadas-De la Fuente GA. Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis . Journal of personalized medicine . 2021 ; 11 ( 5 ). 26. ↵ Li X , Willem L , Antillon M , Bilcke J , Jit M , Beutels P. Health and economic burden of respiratory syncytial virus (RSV) disease and the cost-effectiveness of potential interventions against RSV among children under 5 years in 72 Gavi-eligible countries . BMC Medicine . 2020 ; 18 ( 1 ): 82 . OpenUrl 27. ↵ Arunachala S , Venkatesh BT , Tusharbhai Bhatt M , Puranik A , Rao S , Ravindranath S. COVID-19 Pandemic: Impact on Admission, Diagnosis, and Treatment of Non-COVID-19 Patients Admitted to SARI ICU . Indian Journal of Critical Care Medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine . 2021 ; 25 ( 8 ): 853 – 9 . OpenUrl 28. ↵ Swets MC , Russell CD , Harrison EM , Docherty AB , Lone N , Girvan M , et al. SARS-CoV-2 co-infection with influenza viruses, respiratory syncytial virus, or adenoviruses . The Lancet . 2022 ; 399 ( 10334 ): 1463 – 4 . OpenUrl 29. Swets MC , Russell CD , Harrison EM , Docherty AB , Lone N , Girvan M , et al. SARS-CoV-2 co-infection with influenza viruses, respiratory syncytial virus, or adenoviruses : Elsevier ; 2022 [cited 399 10334]. 1463-4]. Available from : doi: 10.1016/S0140-6736(22)00383-X . OpenUrl CrossRef PubMed 30. Li Y , Wang X , Blau DM , Caballero MT , Feikin DR , Gill CJ , et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis . The Lancet . 2022 ; 399 ( 10340 ): 2047 – 64 . OpenUrl CrossRef PubMed 31. Hien NT , Thi Thuong N , Thiem VD , Minh NQ , Duong TN . Epidemiology and viral etiologies of Severe Acute Respiratory Infections (SARI) in the Northern Vietnam . BMC Proceedings . 2011 ; 5 ( 1 ): P118 . OpenUrl 32. Machablishvili A , Chakhunashvili G , Zakhashvili K , Karseladze I , Tarkhan-Mouravi O , Gavashelidze M , et al. Overview of three influenza seasons in Georgia, 2014-2017 . PloS one . 2018 ; 13 ( 7 ): e0201207 . OpenUrl 33. Aman AT , Wibawa T , Kosasih H , Asdie RH , Safitri I , Intansari US , et al. Etiologies of severe acute respiratory infection (SARI) and misdiagnosis of influenza in Indonesia, 2013-2016 . Influenza Other Respir Viruses . 2021 ; 15 ( 1 ): 34 – 44 . OpenUrl PubMed 34. Ho A , Mallewa J , Peterson I , SanJoaquin M , Garg S , Bar-Zeev N , et al. Epidemiology of Severe Acute Respiratory Illness and Risk Factors for Influenza Infection and Clinical Severity among Adults in Malawi, 2011-2013 . The American journal of tropical medicine and hygiene . 2018 ; 99 ( 3 ): 772 – 9 . OpenUrl 35. Ali ST , Lau YC , Shan S , Ryu S , Du Z , Wang L , et al. Prediction of upcoming global infection burden of influenza seasons after relaxation of public health and social measures during the COVID-19 pandemic: a modeling study . The Lancet Global Health . 2022 ; 10 ( 11 ): e1612 – e22 . OpenUrl 36. Gachari MN , Ndegwa L , Emukule GO , Kirui L , Kalani R , Juma B , et al. Severe acute respiratory illness surveillance for influenza in Kenya: Patient characteristics and lessons learned . Influenza Other Respir Viruses . 2022 ; 16 ( 4 ): 740 – 8 . OpenUrl 37. ↵ Khuri-Bulos N , Piya B , Shehabi A , Faouri S , Williams JV , Vermund S , et al. WHO Severe Acute Respiratory Infections (SARI) Definition often Underdiagnoses Serious Respiratory Viral Infections in Hospitalized Jordanian Children . Open Forum Infectious Diseases . 2017 ; 4 ( suppl_1 ): S461 – S . OpenUrl 38. World Health Organization . Regional Office for Africa. Integrated Disease Surveillance Programme. Health S, Emergencies C . Protocol for national influenza sentinel surveillance . Brazzaville : World Health Organization.Regional Office for Africa ; 2015 2015 . 39. Nisar N , Badar N , Aamir UB , Yaqoob A , Tripathy JP , Laxmeshwar C , et al. Seasonality of influenza and its association with meteorological parameters in two cities of Pakistan: A time series analysis . PloS one . 2019 ; 14 . 40. ↵ Nisar N , Aamir UB , Badar N , Mahmood MR , Yaqoob A , Tripathy JP , et al. Epidemiology of Influenza among patients with influenza-like illness and severe acute respiratory illness in Pakistan: A 10-year surveillance study 2008-17 . Journal of medical virology . 2020 ; 92 ( 12 ): 3028 – 37 . OpenUrl 41. Yu H , Huang J , Huai Y , Guan X , Klena J , Liu S , et al. The substantial hospitalization burden of influenza in central China: surveillance for severe, acute respiratory infection, and influenza viruses, 2010-2012 . Influenza Other Respir Viruses . 2014 ; 8 ( 1 ): 53 – 65 . OpenUrl CrossRef PubMed 42. ↵ Zhang Y , Qiao L , Yao J , Yu N , Mu X , Huang S , et al. Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China . BMC Pediatrics . 2021 ; 21 ( 1 ): 284 . OpenUrl 43. ↵ Hasan S , Webby RJ , Iqbal M , Rashid HB , Ahmad M-u-D , Nazir J , et al. Sentinel surveillance for influenza A viruses in Lahore District Pakistan in flu season 2015–2016 . BMC Infectious Diseases . 2022 ; 22 ( 1 ): 38 . OpenUrl 44. Tadesse M , Mengesha M , Tayachew A , Belay D , Hassen A , Woyessa AB , et al. Burden and seasonality of medically attended influenza-like illness (ILI) in Ethiopia, 2012 to 2017 . BMC Infect Dis . 2020 ; 20 ( 1 ): 148 . OpenUrl PubMed 45. Theo A , Tempia S , Cohen AL , Simusika P , Chentulo E , Chikamukwa CM , et al. The national burden of influenza-associated severe acute respiratory illness hospitalization in Zambia, 2011-2014 . Influenza Other Respir Viruses . 2018 ; 12 ( 1 ): 46 – 53 . OpenUrl 46. Salman M , Badar N , Ikram A , Nisar N , Farooq U. Estimation of seasonal influenza disease burden using sentinel site data in Pakistan 2017-2019: A cross-sectional study . Influenza Other Respir Viruses . 2023 ; 17 ( 3 ): e13125 . OpenUrl 47. ↵ Xing Q-s , Li G-j , Xing Y-h , Chen T , Li W-j , Ni W , et al. Precautions are Needed for COVID-19 Patients with Coinfection of Common Respiratory Pathogens . medRxiv . 2020 :2020.02.29.20027698. 48. ↵ Ma S , Lai X , Chen Z , Tu S , Qin K. Clinical characteristics of critically ill patients co-infected with SARS-CoV-2 and the influenza virus in Wuhan, China . International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases . 2020 ; 96 : 683 – 7 . OpenUrl 49. Ozaras R , Cirpin R , Duran A , Duman H , Arslan O , Bakcan Y , et al. Influenza and COVID-19 coinfection: Report of six cases and review of the literature . Journal of medical virology . 2020 ; 92 ( 11 ): 2657 – 65 . OpenUrl 50. Kim D , Quinn J , Pinsky B , Shah NH , Brown I. Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens . Jama . 2020 ; 323 ( 20 ): 2085 – 6 . OpenUrl CrossRef PubMed 51. Dao TL , Hoang VT , Colson P , Million M , Gautret P. Co-infection of SARS-CoV-2 and influenza viruses: A systematic review and meta-analysis . Journal of Clinical Virology Plus . 2021 ; 1 ( 3 ): 100036 . OpenUrl 52. Meskill SD , O’Bryant SC . Respiratory Virus Co-infection in Acute Respiratory Infections in Children . Current infectious disease reports . 2020 ; 22 ( 1 ): 3 . OpenUrl PubMed 53. Nyamusore J , Rukelibuga J , Mutagoma M , Muhire A , Kabanda A , Williams T , et al. The national burden of influenza-associated severe acute respiratory illness hospitalization in Rwanda, 2012-2014 . Influenza Other Respir Viruses . 2018 ; 12 ( 1 ): 38 – 45 . OpenUrl 54. Peterson I , Bar-Zeev N , Kennedy N , Ho A , Newberry L , SanJoaquin MA , et al. Respiratory Virus-Associated Severe Acute Respiratory Illness and Viral Clustering in Malawian Children in a Setting With a High Prevalence of HIV Infection, Malaria, and Malnutrition . The Journal of Infectious Diseases . 2016 ; 214 ( 11 ): 1700 – 11 . OpenUrl CrossRef PubMed 55. Abadom TR , Smith AD , Tempia S , Madhi SA , Cohen C , Cohen AL . Risk factors associated with hospitalization for influenza-associated severe acute respiratory illness in South Africa: A case-population study . Vaccine . 2016 ; 34 ( 46 ): 5649 – 55 . OpenUrl PubMed 56. Hashemi SA , Safamanesh S , Ghasemzadeh-Moghaddam H , Ghafouri M , Azimian A. High prevalence of SARS-CoV-2 and influenza A virus (H1N1) coinfection in dead patients in Northeastern Iran . Journal of medical virology . 2021 ; 93 ( 2 ): 1008 – 12 . OpenUrl View the discussion thread. Back to top Previous Next Posted May 31, 2024. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia Message Subject (Your Name) has forwarded a page to you from medRxiv Message Body (Your Name) thought you would like to see this page from the medRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia Bedado Dulo , Gamachu Hinsene , Ephrem Mannekulih medRxiv 2024.05.31.24308236; doi: https://doi.org/10.1101/2024.05.31.24308236 Share This Article: Copy Citation Tools Viral etiology of respiratory infections among patients at Adama Hospital Medical College, a facility-based surveillance site in Oromia, Ethiopia Bedado Dulo , Gamachu Hinsene , Ephrem Mannekulih medRxiv 2024.05.31.24308236; doi: https://doi.org/10.1101/2024.05.31.24308236 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Respiratory Medicine Subject Areas All Articles Addiction Medicine (573) Allergy and Immunology (865) Anesthesia (302) Cardiovascular Medicine (4453) Dentistry and Oral Medicine (444) Dermatology (383) Emergency Medicine (609) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1515) Epidemiology (15242) Forensic Medicine (30) Gastroenterology (1131) Genetic and Genomic Medicine (6615) Geriatric Medicine (669) Health Economics (1001) Health Informatics (4552) Health Policy (1372) Health Systems and Quality Improvement (1614) Hematology (543) HIV/AIDS (1270) Infectious Diseases (except HIV/AIDS) (15929) Intensive Care and Critical Care Medicine (1106) Medical Education (624) Medical Ethics (147) Nephrology (670) Neurology (6625) Nursing (346) Nutrition (999) Obstetrics and Gynecology (1148) Occupational and Environmental Health (957) Oncology (3344) Ophthalmology (979) Orthopedics (369) Otolaryngology (421) Pain Medicine (436) Palliative Medicine (130) Pathology (665) Pediatrics (1696) Pharmacology and Therapeutics (693) Primary Care Research (714) Psychiatry and Clinical Psychology (5461) Public and Global Health (9252) Radiology and Imaging (2207) Rehabilitation Medicine and Physical Therapy (1371) Respiratory Medicine (1197) Rheumatology (597) Sexual and Reproductive Health (715) Sports Medicine (530) Surgery (714) Toxicology (99) Transplantation (289) Urology (265) (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'a02c8fccba314193',t:'MTc3OTk2Mzk5Mw=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();