The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review

Background: Influenza infection is a serious public health problem that causes an estimated 3 to 5 million cases and 250,000 deaths worldwide every year. The epidemiology of influenza is well-documented in high- and middle-income countries, however minimal effort had been made to understand the epidemiology, burden and seasonality of influenza in Africa. This study aims to assess the state of knowledge of seasonal influenza epidemiology in Africa and identify potential data gaps for policy formulation following the 2009 pandemic. Method: We reviewed articles from Africa published into four databases namely: MEDLINE (PubMed), Google Scholar, Cochrane Library and Scientific Research Publishing from 2010 to 2019. Results: We screened titles and abstracts of 2070 studies of which 311 were selected for full content evaluation and 199 studies were considered. Selected articles varied substantially on the basis of the topics they addressed covering the field of influenza surveillance (n=80); influenza risk factors and co-morbidities (n=15); influenza burden (n=37); influenza vaccina- tion (n=40); influenza and other respiratory pathogens (n=22) and influenza diagnosis (n=5). Conclusion: Significant progress has been made since the last pandemic in understanding the influenza epidemiology in Africa. However, efforts still remain for most countries to have sufficient data to allow countries to prioritize strategies for influenza prevention and control. Keywords: Influenza; epidemiology; review; Africa; post pandemic.

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Importation and spread of pandemic influenza virus a(H1N1) in Autonomous Province of vojvodina in preepidemic period

Medicinski pregled ◽

10.2298/mpns1008502r ◽

2010 ◽

Vol 63 (7-8) ◽

pp. 502-505 ◽

Cited By ~ 2

Author(s):

Mioljub Ristic ◽

Zorica Seguljev ◽

Jasminka Nedeljkovic ◽

Svetlana Ilic ◽

Dragica Injac ◽

...

Keyword(s):

Pandemic Influenza ◽

Communicable Disease ◽

Influenza Pandemic ◽

Influenza Infection ◽

Influenza Surveillance ◽

Epidemic Period ◽

Imported Cases ◽

Autonomous Province ◽

Influenza Outbreaks ◽

Local Transmission

Introduction. Influenza is the most frequently reported communicable disease, having epidemic and pandemic potential. The first influenza pandemic in this century started in Mexico and spread quickly throughout the world. This paper analyses importation of pandemic influenza cases and local transmission among population in the Autonomous Province of Vojvodina. Material and methods. According to the WHO guidelines and national recommendations, the influenza surveillance activities were conducted in Vojvodina in order to detect, isolate and treat affected international travelers and their close contacts. Patients whose pandemic influenza infection was laboratory confirmed were classified as confirmed cases, while those with symptoms who were epidemiologically linked with confirmed cases were classified as probable cases. Results. During the period from the 24th of June to 17th of August 2009, 123 pandemic influenza cases were recorded in Vojvodina. Infection was imported through international travelers and our citizens coming from countries affected by influenza outbreaks. Majority of cases had mild clinical picture. Most frequently reported symptoms were high fever (above 38oC) (85.6%), and cough (61.6%). Difficulty in breathing was recorded in 20 (16.0%) cases, while pneumonia developed in 4 (3.2%) cases but none of the cases required mechanical ventilation. Conclusion. The imported cases of pandemic influenza in the pre-epidemic period led to limited local transmission in general population and caused a small outbreak among visitors of International music festival called EXIT.

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Future Pandemic Influenza Virus Detection Relies on the Existing Influenza Surveillance Systems: A Perspective from Australia and New Zealand

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4040121 ◽

2019 ◽

Vol 4 (4) ◽

pp. 121

Author(s):

Lance C. Jennings ◽

Ian G. Barr

Keyword(s):

New Zealand ◽

Influenza A ◽

Seasonal Influenza ◽

Control Strategies ◽

Influenza Pandemic ◽

Virus Detection ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Influenza A H1n1

The anniversary of the 1918–1919 influenza pandemic has allowed a refocusing on the global burden of influenza and the importance of co-ordinated international surveillance for both seasonal influenza and the identification of control strategies for future pandemics. Since the introduction of the International Health Regulations (IHR), progress had been slow, until the emergence of the novel influenza A(H1N1)2009 virus and its global spread, which has led to the World Health Organization (WHO) developing a series of guidance documents on global influenza surveillance procedures, severity and risk assessments, and essential measurements for the determination of national pandemic responses. However, the greatest burden of disease from influenza occurs between pandemics during seasonal influenza outbreaks and epidemics. Both Australia and New Zealand utilise seasonal influenza surveillance to support national influenza awareness programs focused on seasonal influenza vaccination education and promotion. These programs also serve to promote the importance of pandemic preparedness.

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Empowering Tunisians Youth to seasonal influenza: Auto medication versus empathy

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.425 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F Maaoui ◽

I Moumni

Keyword(s):

Secondary School ◽

Infectious Diseases ◽

Media Coverage ◽

Seasonal Influenza ◽

Influenza Pandemic ◽

Public Health Problem ◽

School Level ◽

Personal Hygiene ◽

Ecological Knowledge ◽

School Students

Abstract Background and aim In Tunisia, self-medication against seasonal influenza is a public health problem that mainly affects low- and middle-income social categories. For implementation of an educational intervention, this study will assess young Tunisians' literacy towards Seasonal Influenza. Health education, socio-demographic (gender and intersectionality) and media variables will be explored. Methods This is a cross-sectional study, which included Tunisian students from different educational levels and residents in different regions of the country. Results The results show that the risk perception and level literacy depend on gender, geographical proximity, media coverage and didactic choices. The fears of male students in preparatory or secondary school focus significantly more than for female school students around seasonal Influenza, respectively (21.5% vs. 10%, p < 0.05) and (25.7% vs 7.4%, p < 0.05). Among the behaviors purposed to students, to protect themselves from infectious diseases, the consumption of antibiotics! ranks second before personal hygiene (hand washing), vaccination and avoidance measures. In general, 'avoid public places' and 'avoid taking public transport' are behaviors that seem little or not adopted in case of influenza whatever the school level or the study specialty of youths. Questions were asked, moreover, on 'the acceptability of the mask wearing in family and in the public space'. Only 14% preparatory school students and 11% of secondary school students would 'totally' agree to wear it at home and away from home. Conclusions Considering the literacy level of young Tunisians towards the seasonal influenza, pandemic and MDR risks remains high. Innovative educational interventions, which combining epidemiological and ecological knowledge (social, economic, scientific, epidemiological and individual contexts), would be better adapted to new and emerging health issues and could reduce social inequalities in health. Key messages Social qualification in the face of infectious diseases. Development of capacities to perceive and manage seasonal Influenza.

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Developing a system to estimate the severity of influenza infection in England: findings from a hospital-based surveillance system between 2010/2011 and 2014/2015

Epidemiology and Infection ◽

10.1017/s095026881700005x ◽

2017 ◽

Vol 145 (7) ◽

pp. 1461-1470 ◽

Cited By ~ 11

Author(s):

N. L. BODDINGTON ◽

N. Q. VERLANDER ◽

R. G. PEBODY

Keyword(s):

Surveillance System ◽

Influenza A ◽

Influenza Pandemic ◽

Influenza Infection ◽

Rapid Assessment ◽

Age Groups ◽

Influenza Viruses ◽

Influenza Surveillance ◽

High Dependency ◽

The Impact

SUMMARYThe UK Severe Influenza Surveillance System (USISS) was established following the 2009 influenza pandemic to monitor severe seasonal influenza. This article describes the severity of influenza observed in five post-2009 pandemic seasons in England. Two key measures were used to assess severity: impact measured through the cumulative incidence of laboratory-confirmed hospitalised influenza and case severity through the proportion of confirmed hospitalised cases admitted into intensive care units (ICU)/high dependency units (HDU). The impact of influenza varied by subtype and age group across the five seasons with the highest crude cumulative hospitalisation incidence for influenza A/H1N1pdm09 cases in 2010/2011 and in 0–4 year olds each season for all-subtypes. Case severity also varied by subtype and season with a higher hospitalisation: ICU ratio for A/H1N1pdm09 and older age groups (older than 45 years). The USISS system provides a tool for measuring severity of influenza each year. Such seasonal surveillance can provide robust baseline estimates to allow for rapid assessment of the severity of seasonal and emerging influenza viruses.

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Incidence of laboratory-confirmed influenza disease among infants under 6 months of age: a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-016526 ◽

2017 ◽

Vol 7 (9) ◽

pp. e016526 ◽

Cited By ~ 14

Author(s):

Deshayne B Fell ◽

Jeanene Johnson ◽

Zohar Mor ◽

Mark A Katz ◽

Becky Skidmore ◽

...

Keyword(s):

Systematic Review ◽

Seasonal Influenza ◽

Immunisation Programme ◽

Population Based ◽

Incidence Rates ◽

Cochrane Library ◽

Secondary Outcome ◽

Middle Income ◽

Incidence Data ◽

Young Infants

ObjectivesThe aim of this systematic review was to assess incidence rates of laboratory-confirmed influenza (LCI) outcomes among infants under 6 months of age.DesignSystematic literature search and review of indexed studies in PubMed, EMBASE, the Cochrane Library and CINAHL Plus from inception to 19 April 2017.SettingPopulation-based estimates from community or hospital settings.ParticipantsInfants under 6 months of age.Primary and secondary outcome measuresLCI illness in ambulatory care settings, LCI hospitalisation, LCI intensive care unit admission and LCI death. Only studies with population-based incidence data were included.ResultsWe identified 27 primary studies, 11 of which were from the USA, four were from other non-US high-income settings and the remaining were from lower-middle-income or upper-middle-income countries. Most studies (n=23) assessed incidence of LCI hospitalisation, but meta-analysis to pool study-specific rates was not possible due to high statistical and methodological heterogeneity. Among US studies, the reported incidence of LCI hospitalisation ranged from 9.3 to 91.2 per 10 000 infants under 6 months for seasonal influenza, while the only US-based estimate for pandemic H1N1 influenza was 20.2 per 10 000 infants. Reported rates for LCI hospitalisation for seasonal influenza from other countries ranged from 6.2 to 73.0 per 10 000 infants under 6 months, with the exception of one study with an estimated rate of 250 per 10 000 infants. No events were reported in five of the nine studies that evaluated LCI death among infants under 6 months.ConclusionOur review of published studies found limited data on LCI outcomes for infants under 6 months, particularly from non-US settings. Globally representative and reliable incidence data are necessary to fully evaluate influenza disease burden and the potential impact of maternal influenza immunisation programme on morbidity and mortality in young infants.

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Attitudes Toward Intimate Partner Violence Against Women in the European Union: A Systematic Review

European Psychologist ◽

10.1027/1016-9040/a000392 ◽

2020 ◽

Vol 25 (2) ◽

pp. 104-121 ◽

Cited By ~ 5

Author(s):

Enrique Gracia ◽

Marisol Lila ◽

Faraj A. Santirso

Keyword(s):

Systematic Review ◽

Intimate Partner Violence ◽

Violence Against Women ◽

Partner Violence ◽

Public Health Problem ◽

Intimate Partner ◽

Cochrane Library ◽

Effective Prevention ◽

Partner Violence Against Women ◽

The Eu

Abstract. Attitudes toward intimate partner violence against women (IPVAW) are increasingly recognized as central to understanding of this major social and public health problem, and guide the development of more effective prevention efforts. However, to date this area of research is underdeveloped in western societies, and in particular in the EU. The present study aims to provide a systematic review of quantitative studies addressing attitudes toward IPVAW conducted in the EU. The review was conducted through Web of Science, PsychINFO, Medline, EMBASE, PUBMED, and the Cochrane Library, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. This review aimed to identify empirical studies conducted in the EU, published in English in peer-reviewed journals from 2000 to 2018, and analyzing attitudes toward IPVAW. A total of 62 of 176 eligible articles were selected according to inclusion criteria. Four sets of attitudes toward IPVAW were identified as the main focus of the studies: legitimation, acceptability, attitudes toward intervention, and perceived severity. Four main research themes regarding attitudes toward IPVAW emerged: correlates of attitudes, attitudes as predictors, validation of scales, and attitude change interventions. Although interest in this research area has been growing in recent years, the systematic review revealed important gaps in current knowledge on attitudes toward IPVAW in the EU that limits its potential to inform public policy. The review outlines directions for future study and suggests that to better inform policy making, these future research efforts would benefit from an EU-level perspective.

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A Fatal and Rare Case of Hydatid Cyst in the Pouch of Douglas

Journal of Laboratory Physicians ◽

10.1055/s-0041-1726668 ◽

2021 ◽

Author(s):

Ritu Asnani ◽

Sunil Kumar Yeshvanth ◽

Lancelot Lobo ◽

Shipra Sonkusare

Keyword(s):

Hydatid Cyst ◽

Rare Case ◽

Frozen Section ◽

Public Health Problem ◽

Zoonotic Infection ◽

Middle Income ◽

Middle Income Countries ◽

Significant Public Health Problem ◽

Significant Public Health ◽

Pouch Of Douglas

Abstract Hydatid cyst is a zoonotic infection and a significant public health problem in low- and middle-income countries. A 79-year-old female patient was presented to the gynecology outpatient department with complaints of pain in the abdomen and difficulty in micturition, with a mass palpable per speculum. The ultrasound was suggestive of an ovarian cystadenocarcinoma, whereas computed tomography of the abdomen favored hydatid cyst with adnexal neoplasm as a differential diagnosis. Considering the contradictory findings, a frozen section was sent to confirm the diagnosis, which showed hooklets of Echinococcus granulosus/hydatid cyst under the microscope. This was a rare case of pelvic hydatid cyst mimicking ovarian malignancy and was associated with a less-preferred mode of investigation (frozen section). This article focuses on how a frozen section, despite its limitations and being expensive, can still be considered for accurate patient management.

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Estimating the number of averted illnesses and deaths as a result of vaccination against an influenza pandemic in nine low- and middle-income countries

Vaccine ◽

10.1016/j.vaccine.2021.05.006 ◽

2021 ◽

Author(s):

Chelsea S. Lutz ◽

Matthew Biggerstaff ◽

Melissa A. Rolfes ◽

Kathryn E. Lafond ◽

Eduardo Azziz-Baumgartner ◽

...

Keyword(s):

Influenza Pandemic ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Effectiveness of Breastfeeding Support Packages in Low- and Middle-Income Countries for Infants under Six Months: A Systematic Review

Nutrients ◽

10.3390/nu13020681 ◽

2021 ◽

Vol 13 (2) ◽

pp. 681

Author(s):

Ritu Rana ◽

Marie McGrath ◽

Ekta Sharma ◽

Paridhi Gupta ◽

Marko Kerac

Keyword(s):

At Risk ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

World Health ◽

Cochrane Library ◽

Breastfeeding Support ◽

Middle Income ◽

Middle Income Countries ◽

Breastfeeding Practices ◽

Low And Middle Income

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother–infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers’ knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

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Countries with delayed COVID-19 introduction – characteristics, drivers, gaps, and opportunities

Globalization and Health ◽

10.1186/s12992-021-00678-4 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Zheng Li ◽

Cynthia Jones ◽

Girum S. Ejigu ◽

Nisha George ◽

Amanda L. Geller ◽

...

Keyword(s):

Geographic Location ◽

Control Measures ◽

World Health ◽

Small Island ◽

Influenza Surveillance ◽

Middle Income ◽

School Closing ◽

Travel Restrictions ◽

Potential Factors ◽

Health Organization

Abstract Background Three months after the first reported cases, COVID-19 had spread to nearly 90% of World Health Organization (WHO) member states and only 24 countries had not reported cases as of 30 March 2020. This analysis aimed to 1) assess characteristics, capability to detect and monitor COVID-19, and disease control measures in these 24 countries, 2) understand potential factors for the reported delayed COVID-19 introduction, and 3) identify gaps and opportunities for outbreak preparedness, particularly in low and middle-income countries (LMICs). We collected and analyzed publicly available information on country characteristics, COVID-19 testing, influenza surveillance, border measures, and preparedness activities in these countries. We also assessed the association between the temporal spread of COVID-19 in all countries with reported cases with globalization indicator and geographic location. Results Temporal spreading of COVID-19 was strongly associated with countries’ globalization indicator and geographic location. Most of the 24 countries with delayed COVID-19 introduction were LMICs; 88% were small island or landlocked developing countries. As of 30 March 2020, only 38% of these countries reported in-country COVID-19 testing capability, and 71% reported conducting influenza surveillance during the past year. All had implemented two or more border measures, (e.g., travel restrictions and border closures) and multiple preparedness activities (e.g., national preparedness plans and school closing). Conclusions Limited testing capacity suggests that most of the 24 delayed countries may have lacked the capability to detect and identify cases early through sentinel and case-based surveillance. Low global connectedness, geographic isolation, and border measures were common among these countries and may have contributed to the delayed introduction of COVID-19 into these countries. This paper contributes to identifying opportunities for pandemic preparedness, such as increasing disease detection, surveillance, and international collaborations. As the global situation continues to evolve, it is essential for countries to improve and prioritize their capacities to rapidly prevent, detect, and respond, not only for COVID-19, but also for future outbreaks.

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