• 1.

    Jacobs P , Lier D , Gooch K , Buesch K , Lorimer M , Mitchell I , 2013. A model of the costs of community and nosocomial pediatric respiratory syncytial virus infections in Canadian hospitals. Can J Infect Dis Med Microbiol 24: 2226.

    • Search Google Scholar
    • Export Citation
  • 2.

    Álvarez-Lerma F , Marín-Corral J , Vilà C , Masclans JR , Loeches IM , Barbadillo S , González De Molina FJ , Rodríguez A , 2017. Characteristics of patients with hospital-acquired influenza A (H1N1)pdm09 virus admitted to the intensive care unit. J Hosp Infect 95: 200206.

    • Search Google Scholar
    • Export Citation
  • 3.

    Ortiz JR et al.2016. A global review of national influenza immunization policies: analysis of the 2014 WHO/UNICEF Joint Reporting Form on immunization. Vaccine 34: 54005405.

    • Search Google Scholar
    • Export Citation
  • 4.

    World Bank , 2018. World Bank Open Data: Rural Population. Available at: https://data.worldbank.org/indicator/SP.RUR.TOTL.ZS. Accessed May 28, 2020.

  • 5.

    Gandhi NR et al.2013. Nosocomial transmission of extensively drug-resistant tuberculosis in a rural hospital in South Africa. J Infect Dis 207: 917.

    • Search Google Scholar
    • Export Citation
  • 6.

    Mwananyanda L et al.2021. Covid-19 deaths in Africa: prospective systematic postmortem surveillance study. BMJ 372: n334.

  • 7.

    Loevinsohn G et al.2020. Respiratory pathogen diversity and co-infections in rural Zambia. IJID 102: 291298.

  • 8.

    Burke DF , Smith DJ , 2014. A recommended numbering scheme for influenza A HA subtypes. PLoS One 9: e112302.

  • 9.

    WHO , 2008. Integrated Management of Childhood Illness for High HIV Settings. Available at: http://whqlibdoc.who.int/publications/2008/9789241597388_eng.pdf. Accessed April 10, 2020.

  • 10.

    Daniel SO , 1977. An epidemiological study of nosocomial infections at the Lagos University Teaching Hospital. Public Health 91: 1318.

    • Search Google Scholar
    • Export Citation
  • 11.

    Gurley ES , Zaman RU , Sultana R , Bell M , Fry AM , Srinivasan A , Rahman M , Rahman MW , Hossain MJ , Luby SP , 2010. Rates of hospital-acquired respiratory illness in Bangladeshi tertiary care hospitals: results from a low-cost pilot surveillance strategy. Clin Infect Dis 50: 10841090.

    • Search Google Scholar
    • Export Citation
  • 12.

    Centers for Disease Control and Prevention , 1994. Guideline for prevention of nosocomial pneumonia. Respir Care 39: 11911236.

  • 13.

    Kumpulainen V , Mäkelä M , 1997. Influenza vaccination among healthy employees: a cost-benefit analysis. Scand J Infect Dis 29: 181185.

    • Search Google Scholar
    • Export Citation
  • 14.

    Keitel WA , Cate TR , Couch RB , Huggins LL , Hess KR , 1997. Efficacy of repeated annual immunization with inactivated influenza virus vaccines over a five year period. Vaccine 15: 11141122.

    • Search Google Scholar
    • Export Citation
  • 15.

    Elder AG , O’Donnell B , McCruden EA , Symington IS , Carman WF , 1996. Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993–4 epidemic: results of serum testing and questionnaire. BMJ 313: 12411242.

    • Search Google Scholar
    • Export Citation
  • 16.

    Newall AT , Chaiyakunapruk N , Lambach P , Hutubessy RCW , 2018. WHO guide on the economic evaluation of influenza vaccination. Influenza Other Respir Viruses 12: 211219.

    • Search Google Scholar
    • Export Citation
  • 17.

    Chughtai AA , Wang Q , Dung TC , Macintyre CR , 2017. The presence of fever in adults with influenza and other viral respiratory infections. Epidemiol Infect 145: 148155.

    • Search Google Scholar
    • Export Citation
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Nosocomial Respiratory Infections in a Rural Zambian Hospital

Gideon LoevinsohnDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland;
Johns Hopkins School of Medicine, Baltimore, Maryland;

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Justin HardickDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Thomas MehokeApplied Physics Laboratory, Johns Hopkins University, Laurel, Maryland;

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Pamela SinywimaanziMacha Research Trust, Choma, Zambia;

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Mutinta HamahuwaMacha Research Trust, Choma, Zambia;

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Katherine Z. J. FenstermacherDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Kathryn Shaw-SalibaDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Peter ThielenApplied Physics Laboratory, Johns Hopkins University, Laurel, Maryland;

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Jared EvansApplied Physics Laboratory, Johns Hopkins University, Laurel, Maryland;

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Kenneth BowdenApplied Physics Laboratory, Johns Hopkins University, Laurel, Maryland;

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Kristina ZudockApplied Physics Laboratory, Johns Hopkins University, Laurel, Maryland;

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Lauren M. SauerDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Mwaka MonzeVirology Laboratory, University Teaching Hospital, Lusaka, Zambia;

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Charlotte A. GaydosDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Richard E. RothmanDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

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Andrew PekoszDepartment of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Philip E. ThumaMacha Research Trust, Choma, Zambia;
Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

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Catherine G. SutcliffeDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland;

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ABSTRACT.

The burden of nosocomial respiratory infections in rural southern Africa is poorly understood. We established a surveillance program at a rural Zambian hospital to detect influenza-like illness (ILI) and respiratory infections among hospitalized patients and a cohort of healthcare workers (HCWs). Nasopharyngeal specimens from symptomatic patients and HCWs underwent broadly multiplexed molecular testing to detect viruses and atypical bacteria. During 1 year of surveillance, 15 patients (1.7% of admissions) developed ILI more than 48 hours after admission. Among 44 HCWs, 19 (43%) experienced at least one ILI episode, with a total of 31 ILI episodes detected. Respiratory viruses were detected in 45% of patient and 55% of HCW specimens. The cumulative incidence of influenza infection among HCWs over 1 year was 9%. Overall, respiratory viruses were commonly found among patients and HCWs in a rural Zambian hospital with limited infection control infrastructure.

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Author Notes

Address correspondence to Catherine Sutcliffe, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6535, Baltimore, MD 21205. E-mail: csutcli1@jhu.edu

Financial support: The work was supported by the National Institute of Allergy and Infectious Diseases contract HHSN272201400007C awarded to the Johns Hopkins Center of Excellence in Influenza Research and Surveillance (JHCEIRS) at the Johns Hopkins University. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not represent the policy or position of NIAID or NIH. The funding agency had no role in the analysis of the data, writing of the manuscript, or the decision to submit the manuscript for publication.

Authors’ addresses: Gideon Loevinsohn and Catherine G. Sutcliffe, Johns Hopkins University Bloomberg School of Public Health, Epidemiology, Baltimore, MD, E-mails: gloevin1@jhmi.edu and csutcli1@jhu.edu. Justin Hardick and Charlotte A. Gaydos, Johns Hopkins School of Medicine, Medicine, Infectious Diseases, Baltimore, MD, E-mails: jhardic1@jhmi.edu and cgaydos@jhmi.edu. Thomas Mehoke, Johns Hopkins, Applied Physics Laboratory, Baltimore, MD, E-mail: thomas.mehoke@jhuapl.edu. Pamela Sinywimaanzi, Macha Research Trust, Influenza Study, Choma, Zambia, E-mail: pamela.sinywimaanzi@macharesearch.org. Mutinta Hamahuwa, Macha Research Trust, Clinical Research Laboratory, Choma, Southern Province, Zambia, E-mail: mutintahamahuwa@gmail.com. Katherine Z. J. Fenstermacher, Richard E. Rothman, and Lauren M. Sauer, Johns Hopkins School of Medicine, Emergency Medicine, Baltimore, MD, E-mails: kfenste1@jhu.edu, rrothma1@jhmi.edu, and lsauer2@jhmi.edu. Kathryn Shaw-Saliba, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD, E-mail: kshawsaliba@gmail.com. Peter Thielen, Jared Evans, Kenneth Bowden, and Kristina Zudock, Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, E-mails: peter.thielen@jhuapl.edu, jared.evans@jhuapl.edu, kbowden2@jhmi.edu, and kzudock2@jhu.edu. Mwaka Monze, National Influenza Centre, Virology Laboratory, Lusaka, Lusaka, Zambia, E-mail: mwakamonze@hotmail.com. Andrew Pekosz, Johns Hopkins University Bloomberg School of Public Health, Molecular Microbiology and Immunology, Baltimore, MD, E-mail: apekosz1@jhu.edu. Philip E. Thuma, Macha Research Trust, Clinical Research Department, Choma, Zambia, E-mail: phil.thuma@macharesearch.org.

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