Burden of Influenza in Less Than 5-Year-Old Children Admitted to Hospital with Pneumonia in Developing and Emerging Countries: A Descriptive, Multicenter Study

Cédric Dananché Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;
Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France;

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Valentina Sánchez Picot Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;

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Thomas Bénet Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;
Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France;

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Mélina Messaoudi Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;

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Monidarin Chou Faculty of Pharmacy, University of Health Sciences, Phnom Penh, Cambodia;

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Jianwei Wang MOH Key Laboratory of the Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, Fondation Mérieux, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;

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Jean-William Pape Centres GHESKIO (Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti;

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Shally Awasthi Chatrapati Shahu Ji Maharaj Medical University, Lucknow, India;

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Ashish Bavdekar KEM Hospital Research Center, Pune, India;

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Mala Rakoto-Andrianarivelo Fondation Mérieux, Centre d’Infectiologie Charles Mérieux, Antananarivo, Madagascar;

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Mariam Sylla Gabriel Touré Hospital, Bamako, Mali;

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Pagbajabyn Nymadawa Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia;

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Graciela Russomando Research Institute of Health, Asunción, Paraguay;

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Florence Komurian-Pradel Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;

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Hubert Endtz Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;
Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands

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Gláucia Paranhos-Baccalà Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;

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Philippe Vanhems Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;
Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France;

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for the GABRIEL Network Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France;
Infection Control and Epidemiology Department, Hospices Civils de Lyon, Lyon, France;
Faculty of Pharmacy, University of Health Sciences, Phnom Penh, Cambodia;
MOH Key Laboratory of the Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, Fondation Mérieux, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;
Centres GHESKIO (Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes), Port-au-Prince, Haiti;
Chatrapati Shahu Ji Maharaj Medical University, Lucknow, India;
KEM Hospital Research Center, Pune, India;
Fondation Mérieux, Centre d’Infectiologie Charles Mérieux, Antananarivo, Madagascar;
Gabriel Touré Hospital, Bamako, Mali;
Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia;
Research Institute of Health, Asunción, Paraguay;
Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands

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DOI:
https://doi.org/10.4269/ajtmh.17-0494
Volume/Issue:
Volume 98: Issue 6
Page(s):
1805–1810
Restricted access
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This descriptive 4-year study reports the proportion of detection of influenza viruses in less than 5-year-old children hospitalized for pneumonia in eight developing and emerging countries and describes clinical and microbiological characteristics of influenza-related pneumonia cases. Hospitalized children presenting radiologically confirmed pneumonia aged 2–60 months were prospectively enrolled in this observational standardized study. Mean proportion of isolated influenza virus was 9.7% (95% confidence interval: 7.9–11.8%) among 888 pneumonia children analyzed, with moderate heterogeneity between countries—ranging from 6.2% in Cambodia to 18.8% in Haiti. The clinical characteristics of children with influenza-related pneumonia were not substantially different from those of other pneumonia cases. Influenza A H1N1-related pneumonia cases appeared as more severe than pneumonia cases related to other strains of influenza. Streptococcus pneumoniae was detected more often in blood samples from influenza-related cases than in those without detected influenza viruses (19.7% versus 9.5%, P = 0.018). Influenza-related pneumonia is frequent among children less than 5 years old with pneumonia, living in developing and emerging countries. Influenza might be a frequent etiologic agent responsible for pneumonia or a predisposing status factor for pneumococcal-related pneumonia in this population.

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Author Notes

Address correspondence to Cédric Dananché, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, 7-11, rue Guillaume Paradin, F-69372 Lyon Cedex 08, France. E-mail: cedric.dananche@chu-lyon.fr

Ethics statement: The study protocol, informed consent statement, clinical research form, amendments, and all other study documents were submitted to and approved by the Institutional Research Ethics Committee of each site.

Authors’ addresses: Cédric Dananché, Thomas Bénet, and Philippe Vanhems, Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France, and Service Hygiène, Epidémiologie et Prévention, Centre Hospitalier Universitaire de Lyon, Lyon, France, E-mails: cedric.dananche@chu-lyon.fr, thomas.benet@chu-lyon.fr, and philippe.vanhems@chu-lyon.fr. Valentina Sánchez Picot, Mélina Messaoudi, and Florence Komurian-Pradel, Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France, E-mails: valentina.picot@fondation-merieux.org, melina.messaoudi@fondation-merieux.org, and florence.pradel@fondation-merieux.org. Monidarin Chou, Faculty of Pharmacy, University of Health Sciences, Phnom Penh, Cambodia, E-mail: cmonidarin@uhs.edu.kh. Jianwei Wang, MOH Key Laboratory of the Systems Biology of Pathogens and Dr. Christophe Mérieux Laboratory, Fondation Mérieux, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, E-mail: wangjw28@163.com. Jean-William Pape, Groupe Haïtien d’Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti, E-mail: jwpape@gheskio.org. Shally Awasthi, Chatrapati Shahuji Maharaj University, Lucknow, India, E-mail: shally07@gmail.com. Ashish Bavdekar, KEM Hospital, Pune, India, E-mail: bavdekar@vsnl.com. Mala Rakoto-Andrianarivelo, Centre d’Infectiologie Charles Mérieux, Antananarivo, Madagascar, E-mail: mala@cicm-madagascar.com. Mariam Sylla, Gabriel Touré Hospital, Bamako, Mali, E-mail: dr_mame@yahoo.fr. Pagbajabyn Nymadawa, Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia, E-mail: nymadawa@gyals.mn. Graciela Russomando, Molecular Biology Department, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, Asunción, Paraguay, E-mail: grusso@rieder.net.py. Hubert Endtz, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Emerging Pathogens Laboratory, Lyon, France, and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands, E-mail: hubert.endtz@fondation-merieux.org. Gláucia Paranhos-Baccalà, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Emerging Pathogens Laboratory, Lyon, France, E-mail: glaucia.baccala@fondation-merieux.org.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2018
Received:
20 Jun 2017
|
Accepted:
13 Feb 2018
|
Published Online:
16 Apr 2018
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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