Burden of influenza among hospitalized febrile children in Ghana

SummaryBackground Influenza surveillance data from Africa indicate a substantial disease burden with high mortality. However local influenza data from district hospitals with limited laboratory facilities are still scarce. Objectives To identify the frequency and seasonal distribution of influenza among hospitalized febrile children in a rural hospital in Ghana and to describe differential diagnoses to other severe febrile infections. Methods Between January 2014 and April 2015 all children with a temperature of ≥38°C admitted to a district hospital in Ghana were screened for influenza A and B by RT-PCR and differentiated to subtypes A(H1N1)pdm09 and A(H3N2). Malaria microscopy and blood cultures were performed for each patient. Results A total of 1,063 children with a median age of 2 years (IQR: 1–4 years) were recruited. Of those, 271 (21%) were classified as severe acute respiratory infection (SARI) and 47 (4%) were positive for influenza, namely 26 (55%) influenza B, 15 (32%) A(H1N1)pdm09 and 6 (13%) A(H3N2) cases. Influenza predominantly occurred in children aged 3–5 years and was more frequently detected in the major rainy season (OR=2.9; 95%CI: 1.47–6.19) during the first half of the year. Two (4%) and seven (15%) influenza-positive children were co-diagnosed with an invasive bloodstream infection or malaria respectively. Conclusion Influenza contributes substantially to the burden of hospitalized febrile children in Ghana being strongly dependent on age and corresponds with the major rainy season during the first half-year. This article is protected by copyright. All rights reserved.