Carlos Grijalva
Last active: 7/27/2018

Impact of home environment interventions on the risk of influenza-associated ARI in Andean children: observations from a prospective household-based cohort study.

Budge PJ, Griffin MR, Edwards KM, Williams JV, Verastegui H, Hartinger SM, Mäusezahl D, Johnson M, Klemenc JM, Zhu Y, Gil AI, Lanata CF, Grigalva CG, RESPIRA PERU Group
PLoS One. 2014 9 (3): e91247

PMID: 24622044 · PMCID: PMC3951509 · DOI:10.1371/journal.pone.0091247

BACKGROUND - The Respiratory Infections in Andean Peruvian Children (RESPIRA-PERU) study enrolled children who participated in a community-cluster randomized trial of improved stoves, solar water disinfection, and kitchen sinks (IHIP trial) and children from additional Andean households. We quantified the burden of influenza-associated acute respiratory illness (ARI) in this household-based cohort.

METHODS - From May 2009 to September 2011, we conducted active weekly ARI surveillance in 892 children age <3 years, of whom 272 (30.5%) had participated in the IHIP trial. We collected nasal swabs during ARI, tested for influenza and other respiratory viruses by RT-PCR, and determined influenza incidence and risk factors using mixed-effects regression models.

RESULTS - The overall incidence of influenza-associated ARI was 36.6/100 child-years; incidence of influenza A, B, and C was 20.5, 8.7, and 5.2/100 child-years, respectively. Influenza C was associated with fewer days of subjective fever (median 1 vs. 2) and malaise (median 0 vs. 2) compared to influenza A. Non-influenza ARI also resulted in fewer days of fever and malaise, and fewer healthcare visits than influenza A-associated ARI. Influenza incidence varied by calendar year (80% occurred in the 2010 season) and IHIP trial participation. Among households that participated in the IHIP trial, influenza-associated ARI incidence was significantly lower in intervention than in control households (RR 0.40, 95% CI: 0.20-0.82).

CONCLUSIONS - Influenza burden is high among Andean children. ARI associated with influenza A and B had longer symptom duration and higher healthcare utilization than influenza C-associated ARI or non-influenza ARI. Environmental community interventions may reduce influenza morbidity.

MeSH Terms (14)

Acute Disease Cohort Studies Environment Female Housing Humans Incidence Infant Male Orthomyxoviridae Peru Prospective Studies Respiratory Tract Diseases Risk Factors

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