Volume 83, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A cross-sectional study was performed in children 5 through 10 years of age presenting to outpatient clinics in Nyanza Province, Kenya, in which nasal swab and blood specimens were collected during the high malaria transmission season. Patients presenting with malaria-like symptoms within 4 days of fever onset were enrolled in the study. parasitemia was determined by blood smear microscopy. Nasal swabs were screened for a panel of respiratory viruses by polymerase chain reaction. Influenza A, rhinoviruses, and other respiratory viruses were detected in 18%, 26%, and 12% of 197 specimens, respectively. Four of 36 patients with influenza A had a positive malaria blood slide, compared with 20 of 52 patients with rhinovirus. A significant burden of disease caused by influenza A in febrile children during the study period was observed, highlighting the need for further research into the burden of influenza disease in regions where malaria is holoendemic.


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  1. Yazdanbakhsh M, Kremsner PG, , 2009. Influenza in Africa. PLoS Med 6: e1000182.[Crossref] [Google Scholar]
  2. Beckett CG, Kosasih H, Ma'roef C, Listiyaningsih E, Elyazar IR, Wuryadi S, Yuwono D, McArdle JL, Corwin AL, Porter KR, , 2004. Influenza surveillance in Indonesia: 1999–2003. Clin Infect Dis 39: 443449.[Crossref] [Google Scholar]
  3. Dosseh A, Ndiaye K, Spiegel A, Sagna M, Mathiot C, , 2000. Epidemiological and virological influenza survey in Dakar, Senegal: 1996–1998. Am J Trop Med Hyg 62: 639643. [Google Scholar]
  4. Moura FE, Perdigao AC, Siqueira MM, , 2009. Seasonality of influenza in the tropics: a distinct pattern in northeastern Brazil. Am J Trop Med Hyg 81: 180183. [Google Scholar]
  5. Nguyen HL, Saito R, Ngiem HK, Nishikawa M, Shobugawa Y, Nguyen DC, Hoang LT, Huynh LP, Suzuki H, , 2007. Epidemiology of influenza in Hanoi, Vietnam, from 2001 to 2003. J Infect 55: 5863.[Crossref] [Google Scholar]
  6. Wong CM, Chan KP, Hedley AJ, Peiris JS, , 2004. Influenza-associated mortality in Hong Kong. Clin Infect Dis 39: 16111617.[Crossref] [Google Scholar]
  7. Zaman RU, Alamgir AS, Rahman M, Azziz-Baumgartner E, Gurley ES, Sharker MA, Brooks WA, Azim T, Fry AM, Lindstrom S, Gubareva LV, Xu X, Garten RJ, Hossain MJ, Khan SU, Faruque LI, Ameer SS, Klimov AI, Luby SP, , 2009. Influenza in outpatient ILI case-patients in national hospital-based surveillance, Bangladesh, 2007–2008. PLoS ONE 4: e8452.[Crossref] [Google Scholar]
  8. Brooks WA, Goswami D, Rahman M, Nahar K, Fry AM, Balish A, Iftekharuddin N, Azim T, Xu X, Klimov A, Bresee J, Bridges C, Luby S, , 2010. Influenza is a major contributor to childhood pneumonia in a tropical developing country. Pediatr Infect Dis J 29: 216221.[Crossref] [Google Scholar]
  9. Berkley JA, Munywoki P, Ngama M, Kazungu S, Abwao J, Bett A, Lassauniere R, Kresfelder T, Cane PA, Venter M, Scott JA, Nokes DJ, , 2010. Viral etiology of severe pneumonia among Kenyan infants and children. JAMA 303: 20512057.[Crossref] [Google Scholar]
  10. Ohrt C, Obare P, Nanakorn A, Adhiambo C, Awuondo K, O'Meara WP, Remich S, Martin K, Cook E, Chretien JP, Lucas C, Osoga J, McEvoy P, Owaga ML, Odera JS, Ogutu B, , 2007. Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya. Malar J 6: 79.[Crossref] [Google Scholar]
  11. Kuypers J, Wright N, Ferrenberg J, Huang ML, Cent A, Corey L, Morrow R, , 2006. Comparison of real-time PCR assays with fluorescent-antibody assays for diagnosis of respiratory virus infections in children. J Clin Microbiol 44: 23822388.[Crossref] [Google Scholar]
  12. Kuypers J, Martin ET, Heugel J, Wright N, Morrow R, Englund JA, , 2007. Clinical disease in children associated with newly described coronavirus subtypes. Pediatrics 119: e70e76.[Crossref] [Google Scholar]
  13. Lu X, Holloway B, Dare RK, Kuypers J, Yagi S, Williams JV, Hall CB, Erdman DD, , 2008. Real-time reverse transcription-PCR assay for comprehensive detection of human rhinoviruses. J Clin Microbiol 46: 533539.[Crossref] [Google Scholar]
  14. van Elden LJ, Nijhuis M, Schipper P, Schuurman R, van Loon AM, , 2001. Simultaneous detection of influenza viruses A and B using real-time quantitative PCR. J Clin Microbiol 39: 196200.[Crossref] [Google Scholar]
  15. Bulimo WD, Garner JL, Schnabel DC, Bedno SA, Njenga MK, Ochieng WO, Amukoye E, Magana JM, Simwa JM, Ofula VO, Lifumo SM, Wangui J, Breiman RF, Martin SK, , 2008. Genetic analysis of H3N2 influenza A viruses isolated in 2006–2007 in Nairobi, Kenya. Influenza Other Respir Viruses 2: 107113.[Crossref] [Google Scholar]
  16. Hazlett DT, Bell TM, Tukei PM, Ademba GR, Ochieng WO, Magana JM, Gathara GW, Wafula EM, Pamba A, Ndinya-Achola JO, , 1988. Viral etiology and epidemiology of acute respiratory infections in children in Nairobi, Kenya. Am J Trop Med Hyg 39: 632640. [Google Scholar]
  17. Nokes DJ, Ngama M, Bett A, Abwao J, Munywoki P, English M, Scott JA, Cane PA, Medley GF, , 2009. Incidence and severity of respiratory syncytial virus pneumonia in rural Kenyan children identified through hospital surveillance. Clin Infect Dis 49: 13411349.[Crossref] [Google Scholar]
  18. Miller EK, Lu X, Erdman DD, Poehling KA, Zhu Y, Griffin MR, Hartert TV, Anderson LJ, Weinberg GA, Hall CB, Iwane MK, Edwards KM, , 2007. Rhinovirus-associated hospitalizations in young children. J Infect Dis 195: 773781.[Crossref] [Google Scholar]
  19. Peltola V, Ruuskanen O, , 2008. Editorial commentary: respiratory viral infections in developing countries: common, severe, and unrecognized. Clin Infect Dis 46: 5860.[Crossref] [Google Scholar]
  20. Wright PF, Deatly AM, Karron RA, Belshe RB, Shi JR, Gruber WC, Zhu Y, Randolph VB, , 2007. Comparison of results of detection of rhinovirus by PCR and viral culture in human nasal wash specimens from subjects with and without clinical symptoms of respiratory illness. J Clin Microbiol 45: 21262129.[Crossref] [Google Scholar]
  21. Wilson ME, Weld LH, Boggild A, Keystone JS, Kain KC, von Sonnenburg F, Schwartz E, , 2007. Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis 44: 15601568.[Crossref] [Google Scholar]
  22. Askling HH, Lesko B, Vene S, Berndtson A, Bjorkman P, Blackberg J, Bronner U, Follin P, Hellgren U, Palmerus M, Ekdahl K, Tegnell A, Struwe J, , 2009. Serologic analysis of returned travelers with fever, Sweden. Emerg Infect Dis 15: 18051808.[Crossref] [Google Scholar]
  23. Clark IA, Alleva LM, Mills AC, Cowden WB, , 2004. Pathogenesis of malaria and clinically similar conditions. Clin Microbiol Rev 17: 509539 table.[Crossref] [Google Scholar]
  24. Rooth IB, Bjorkman A, , 1992. Suppression of Plasmodium falciparum infections during concomitant measles or influenza but not during pertussis. Am J Trop Med Hyg 47: 675681. [Google Scholar]

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  • Received : 23 Mar 2010
  • Accepted : 18 Aug 2010
  • Published online : 05 Nov 2010

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