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J Infect Dis. Author manuscript; available in PMC 2017 March 08. Published in final edited form as: J Infect Dis. 2016 December 01; 214(11): 1700–1711. doi:10.1093/infdis/jiw426.
Respiratory Virus–Associated Severe Acute Respiratory Illness and Viral Clustering in Malawian Children in a Setting With a High Prevalence of HIV Infection, Malaria, and Malnutrition
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Ingrid Peterson1, Naor Bar-Zeev3, Neil Kennedy2, Antonia Ho4, Laura Newberry2, Miguel A. SanJoaquin7, Mavis Menyere1, Maaike Alaerts1, Gugulethu Mapurisa1, Moses Chilombe1, Ivan Mambule1, David G. Lalloo5, Suzanne T. Anderson8, Thembi Katangwe2, Nigel Cunliffe3, Nico Nagelkerke1, Meredith McMorrow9, Marc-Allain Widdowson10, Neil French3, Dean Everett3,a, and Robert S. Heyderman6,a 1Malawi-Liverpool-Wellcome 2Department 3Institute
Trust, Queen Elizabeth Central Hospital, Blantyre, Malawi
of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi
of Infection and Global Health, University of Liverpool, United Kingdom
4Institute
of Ageing and Chronic Disease, Faculty of Health and Life Sciences, University of Liverpool, United Kingdom
5Liverpool 6Division
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7World
School of Tropical Medicine, University College London, United Kingdom
of Infection and Immunity, University College London, United Kingdom
Bank, Hanoi, Vietnam
8Medical
Research Council–Gambia, Banjul
9Influenza
Division, Centers for Disease Control and Prevention (CDC)–South Africa, Johannesburg 10Influenza
Division, CDC, Atlanta, Georgia
Abstract Background—We used data from 4 years of pediatric severe acute respiratory illness (SARI) sentinel surveillance in Blantyre, Malawi, to identify factors associated with clinical severity and coviral clustering.
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Methods—From January 2011 to December 2014, 2363 children aged 3 months to 14 years presenting to the hospital with SARI were enrolled. Nasopharyngeal aspirates were tested for
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[email protected]. Correspondence: D. Everett, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK (
[email protected]). aD. E. and R. S. H. contributed equally to the study. Disclaimer. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC). Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Peterson et al.
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influenza virus and other respiratory viruses. We assessed risk factors for clinical severity and conducted clustering analysis to identify viral clusters in children with viral codetection. Results—Hospital-attended influenza virus–positive SARI incidence was 2.0 cases per 10 000 children annually; it was highest among children aged