Incidence of Laboratory-Confirmed Influenza among HIV-Infected versus HIV-Uninfected Individuals in Two Districts of Ghana, 2014 to 2016

Neha Balachandran Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
Emory Rollins School of Public Health, Atlanta, Georgia

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Michael Ntiri Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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Jazmin Duque Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
Battelle Atlanta, Atlanta, Georgia;

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Christabel Addo Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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Elijah Edu-Quansah Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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Edem Badji Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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Kennedy Brightson Ghana Health Service, Accra, Ghana;

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Ekua Essumanma Houphouet University of Ghana Hospital, Legon, Ghana;

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Talla Nzussouo Ndahwouh Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;
MassGenics, Atlanta, Georgia;

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Kwadwo Koram Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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Meredith McMorrow Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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William Ampofo Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana;

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ABSTRACT.

Influenza is known to cause severe respiratory illness in HIV-infected adults, but there are few data describing the relationship between HIV infection and influenza in West African countries such as Ghana. We conducted a prospective cohort study in the Shai-Osudoku and Ningo Prampram districts of Ghana from 2014 to 2016. Beginning May 2014, 266 HIV-infected and 510 HIV-uninfected participants age 18 to 73 years were enrolled and monitored for 12 months. We observed 4 and 11 laboratory-confirmed influenza cases among HIV-infected and HIV-uninfected persons, respectively. The overall rate of laboratory-confirmed influenza among HIV-infected participants was 15.0 per 1,000 person years (PY) (95% CI, 0.3–29.80 per 1,000 PY), whereas that among HIV-uninfected participants was 21.6 per 1,000 PY (95% CI, 8.8–34.3 per 1,000 PY) (incidence density ratio, 0.70; P = 0.56). Our study found no significant difference in the incidence of laboratory-confirmed influenza-associated illness among HIV-infected and HIV-uninfected individuals in Ghana.

Author Notes

Address correspondence to Neha Balachandran, Cherokee Nation Assurance, Arlington, VA, contracting agency to the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Diseases Control and Prevention, 1600 Clifton Road, Bldg. 24, Atlanta, GA 30333, E-mail: nuu9@cdc.gov or Meredith McMorrow, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, E-mail: mmcmorrow@cdc.gov.

These authors contributed equally to this work.

Financial support: This study was funded by the U.S. Department of Health and Human Services, U.S. CDC (award no. U011P000607).

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.

Authors’ addresses: Neha Balachandran, Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, and Emory Rollins School of Public Health, Atlanta, GA, E-mail: nuu9@cdc.gov. Michael Ntiri, Christabel Addo, Elijah Edu-Quansah, Edem Badji, Kwadwo Koram, and William Ampofo, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana, E-mails: mntiri@noguchi.ug.edu.gh, caddo@noguchi.ug.edu, ghpaaeliquansah@gmail.com, edembadji@yahoo.com, kkoram@noguchi.ug.edu.gh, and wampofo@noguchi.ug.edu.gh. Jazmin Duque, Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, and Battelle Atlanta, Atlanta, GA, E-mail: jazminduque@gmail.com. Kennedy Brightson, Ghana Health Service, Accra, Ghana, E-mail: kbrightson@yahoo.com. Ekua Essumanma Houphouet, University of Ghana Hospital, Legon, Ghana, E-mail: ekuaa@yahoo.co.uk. Talla Nzussouo Ndahwouh, Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana, and MassGenics, Atlanta, GA, E-mail: tallus5@yahoo.fr. Meredith McMorrow, Influenza Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mail: bwe3@cdc.gov.

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