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1.
World Health Organization, 2014. Influenza (Seasonal) Fact Sheet Number 211. Available at: http://www.who.int/mediacentre/factsheets/fs211/en/. Accessed August 31, 2015.
-
2.
Jamieson DJ, Theiler RN, Rasmussen SA, 2006. Emerging infections and pregnancy. Emerg Infect Dis 12: 1638.
-
3.
Robinson DP, Klein SL, 2012. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav 62: 263–271.
-
4.
Mak TK, Mangtani P, Leese J, Watson JM, Pfeifer D, 2008. Influenza vaccination in pregnancy: current evidence and selected national policies. Lancet Infect Dis 8: 44–52.
-
5.
Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR, 1998. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol 148: 1094–1102.
-
6.
Lieberman RW, Bagdasarian N, Thomas D, Ven CVD, 2011. Seasonal influenza A (H1N1) infection in early pregnancy and second trimester fetal demise. Emerg Infect Dis 17: 107–109.
-
7.
World Health Organization, 2014. Global Health Estimates 2014 Summary Tables: Deaths by Cause, Age and Sex, 2000–2012. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html. Accessed March 10, 2016.
-
8.
Feikin DR, Ope MO, Aura B, Fuller JA, Gikunju S, Vulule J, Ng'ang'a Z, Njenga MK, Breiman RF, Katz M, 2012. The population-based burden of influenza-associated hospitalization in rural western Kenya, 2007–2009. Bull World Health Organ 90: 094326.
-
9.
Mmbaga VM, Mwasekaga MJ, Mmbuji P, Matonya M, Mwafulango A, Moshi S, Emukule G, Katz MA, 2012. Results from the first 30 months of national sentinel surveillance for influenza in Tanzania, 2008–2010. J Infect Dis 206: S80–S86.
-
10.
Ho A, Everett D, Menyere M, Chilombe M, Mallewa J, Heyderman R, French N, 2014. Association between influenza and pneumococcal carriage in patients with severe acute respiratory infection in Malawi. Int J Infect Dis 21: 265.
-
11.
Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, Wilson E, Omer SB, Shahid NS, Breiman RF, Steinhoff MC, 2008. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 359: 1555–1564.
-
12.
Cox N, 2014. Influenza seasonality: timing and formulation of vaccines. Bull World Health Organ 92: 311.
-
13.
Kissling E, Valenciano M, Larrauri A, Oroszi B, Cohen J, Nunes B, Pitigoi D, Rizzo C, Rebolledo J, Paradowska-Stankiewicz I, Jiménez-Jorge S, Horváth JK, Daviaud I, Guiomar R, Necula G, Bella A, O'Donnell J, Głuchowska M, Ciancio BC, Nicoll A, Moren A, 2013. Low and decreasing vaccine effectiveness against influenza A (H3) in 2011/12 among vaccination target groups in Europe: results from the I-MOVE multicentre case-control study. Euro Surveill 18: 20390.
-
14.
Tamerius J, Nelson MI, Zhou SZ, Viboud C, Miller MA, Alonso WJ, 2011. Global influenza seasonality: reconciling patterns across temperate and tropical regions. Environ Health Perspect 119: 439.
-
15.
Gessner BD, Shindo N, Briand S, 2011. Seasonal influenza epidemiology in sub-Saharan Africa: a systematic review. Lancet Infect Dis 11: 223–235.
-
16.
Kalilani-Phiri L, Thesing PC, Nyirenda OM, Mawindo P, Madanitsa M, Membe G, Wylie B, Masonbrink A, Makwakwa K, Kamiza S, Muehlenbachs A, Taylor TE, Laufer MK, 2013. Timing of malaria infection during pregnancy has characteristic maternal, infant and placental outcomes. PLoS One 8: e74643.
-
17.
European Centre for Disease Prevention and Control, 2013. Influenza Case Definitions. Available at: http://ecdc.europa.eu/en/healthtopics/influenza/surveillance/Pages/influenza_case_definitions.aspx. Accessed August 31, 2015.
-
18.
Macias AE, Precioso AR, Falsey AR, 2015. The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza. Influenza Other Respi Viruses 9: 31–37.
-
19.
Feikin DR, Njenga MK, Bigogo G, Aura B, Aol G, Audi A, Jagero G, Muluare PO, Gikunju S, Nderitu L, Balish A, Winchell J, Schneider E, Erdman D, Oberste MS, Katz MA, Breiman RF, 2012. Etiology and incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007–2010. PLoS One 7: 24.
-
20.
Hartert TV, Neuzil KM, Shintani AK, Mitchel EF Jr, Snowden MS, Wood LB, Dittus RS, Griffin MR, 2003. Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. Am J Obstet Gynecol 189: 1705–1712.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 63 | 63 | 10 |
| Full Text Views | 303 | 80 | 6 |
| PDF Downloads | 73 | 16 | 0 |
Incidence and Seasonality of Influenza-Like Illnesses Among Pregnant Women in Blantyre, Malawi
Titus H. Divala
Titus H. Divala
Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi.
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Linda Kalilani-Phiri
Linda Kalilani-Phiri
Department of Community Health, University of Malawi College of Medicine, Blantyre, Malawi.
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Patricia Mawindo
Patricia Mawindo
Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi.
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Osward Nyirenda
Osward Nyirenda
Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi.
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Atupele Kapito-Tembo
Atupele Kapito-Tembo
Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi.
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Miriam K. Laufer
Miriam K. Laufer
Institute for Global Health, University of Maryland School of Medicine, Baltimore, Maryland.
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Pregnant women with influenza infection are at increased risk of developing complications compared with other adults. Information about burden of influenza in pregnant women in Africa is limited. To determine incidence and seasonality of influenza-like illness (ILI) in pregnant women in Blantyre, Malawi, we recruited a cohort of 450 pregnant women and conducted surveillance for ILI and malaria infection. We recorded gestational age and birthweight. We accrued 157 person-years of observation (PYO) and detected 37 episodes of ILI (24/100 PYO) and 83 episodes of malaria infection (including all new episodes of parasitemia) (53/100 PYO). ILI was the most common cause of fever, but was not associated with adverse pregnancy outcomes. ILI incidence peaked during the hot dry season. These results indicate that ILI is a significant burden among Malawian pregnant women and it is somewhat seasonal. Studies with molecular diagnostics are needed to establish influenza-specific burden and the potential role of vaccination.
Author Notes
Authors' addresses: Titus H. Divala, Patricia Mawindo, and Osward Nyirenda, Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi, E-mails: tdivala@gmail.com, patmawindo@gmail.com, and omnyirenda@gmail.com. Linda Kalilani-Phiri, Department of Public Health, University of Malawi College of Medicine, Blantyre, Malawi, E-mail: lkalilani@hotmail.com. Atupele Kapito-Tembo, Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi, E-mail: atupelekapito@gmail.com. Miriam K. Laufer, Division of Malaria Research, Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, E-mail: mlaufer@medicine.umaryland.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2014. Influenza (Seasonal) Fact Sheet Number 211. Available at: http://www.who.int/mediacentre/factsheets/fs211/en/. Accessed August 31, 2015.
-
2.
Jamieson DJ, Theiler RN, Rasmussen SA, 2006. Emerging infections and pregnancy. Emerg Infect Dis 12: 1638.
-
3.
Robinson DP, Klein SL, 2012. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav 62: 263–271.
-
4.
Mak TK, Mangtani P, Leese J, Watson JM, Pfeifer D, 2008. Influenza vaccination in pregnancy: current evidence and selected national policies. Lancet Infect Dis 8: 44–52.
-
5.
Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR, 1998. Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol 148: 1094–1102.
-
6.
Lieberman RW, Bagdasarian N, Thomas D, Ven CVD, 2011. Seasonal influenza A (H1N1) infection in early pregnancy and second trimester fetal demise. Emerg Infect Dis 17: 107–109.
-
7.
World Health Organization, 2014. Global Health Estimates 2014 Summary Tables: Deaths by Cause, Age and Sex, 2000–2012. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html. Accessed March 10, 2016.
-
8.
Feikin DR, Ope MO, Aura B, Fuller JA, Gikunju S, Vulule J, Ng'ang'a Z, Njenga MK, Breiman RF, Katz M, 2012. The population-based burden of influenza-associated hospitalization in rural western Kenya, 2007–2009. Bull World Health Organ 90: 094326.
-
9.
Mmbaga VM, Mwasekaga MJ, Mmbuji P, Matonya M, Mwafulango A, Moshi S, Emukule G, Katz MA, 2012. Results from the first 30 months of national sentinel surveillance for influenza in Tanzania, 2008–2010. J Infect Dis 206: S80–S86.
-
10.
Ho A, Everett D, Menyere M, Chilombe M, Mallewa J, Heyderman R, French N, 2014. Association between influenza and pneumococcal carriage in patients with severe acute respiratory infection in Malawi. Int J Infect Dis 21: 265.
-
11.
Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, Wilson E, Omer SB, Shahid NS, Breiman RF, Steinhoff MC, 2008. Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 359: 1555–1564.
-
12.
Cox N, 2014. Influenza seasonality: timing and formulation of vaccines. Bull World Health Organ 92: 311.
-
13.
Kissling E, Valenciano M, Larrauri A, Oroszi B, Cohen J, Nunes B, Pitigoi D, Rizzo C, Rebolledo J, Paradowska-Stankiewicz I, Jiménez-Jorge S, Horváth JK, Daviaud I, Guiomar R, Necula G, Bella A, O'Donnell J, Głuchowska M, Ciancio BC, Nicoll A, Moren A, 2013. Low and decreasing vaccine effectiveness against influenza A (H3) in 2011/12 among vaccination target groups in Europe: results from the I-MOVE multicentre case-control study. Euro Surveill 18: 20390.
-
14.
Tamerius J, Nelson MI, Zhou SZ, Viboud C, Miller MA, Alonso WJ, 2011. Global influenza seasonality: reconciling patterns across temperate and tropical regions. Environ Health Perspect 119: 439.
-
15.
Gessner BD, Shindo N, Briand S, 2011. Seasonal influenza epidemiology in sub-Saharan Africa: a systematic review. Lancet Infect Dis 11: 223–235.
-
16.
Kalilani-Phiri L, Thesing PC, Nyirenda OM, Mawindo P, Madanitsa M, Membe G, Wylie B, Masonbrink A, Makwakwa K, Kamiza S, Muehlenbachs A, Taylor TE, Laufer MK, 2013. Timing of malaria infection during pregnancy has characteristic maternal, infant and placental outcomes. PLoS One 8: e74643.
-
17.
European Centre for Disease Prevention and Control, 2013. Influenza Case Definitions. Available at: http://ecdc.europa.eu/en/healthtopics/influenza/surveillance/Pages/influenza_case_definitions.aspx. Accessed August 31, 2015.
-
18.
Macias AE, Precioso AR, Falsey AR, 2015. The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza. Influenza Other Respi Viruses 9: 31–37.
-
19.
Feikin DR, Njenga MK, Bigogo G, Aura B, Aol G, Audi A, Jagero G, Muluare PO, Gikunju S, Nderitu L, Balish A, Winchell J, Schneider E, Erdman D, Oberste MS, Katz MA, Breiman RF, 2012. Etiology and incidence of viral and bacterial acute respiratory illness among older children and adults in rural western Kenya, 2007–2010. PLoS One 7: 24.
-
20.
Hartert TV, Neuzil KM, Shintani AK, Mitchel EF Jr, Snowden MS, Wood LB, Dittus RS, Griffin MR, 2003. Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. Am J Obstet Gynecol 189: 1705–1712.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 63 | 63 | 10 |
| Full Text Views | 303 | 80 | 6 |
| PDF Downloads | 73 | 16 | 0 |