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

Budge, Philip J. and Griffin, Marie R. and Edwards, Kathryn M. and Williams, John V. and Verastegui, Hector and Hartinger, Stella M. and Mäusezahl, Daniel and Johnson, Monika and Klemenc, Jennifer M. and Zhu, Yuwei and Gil, Ana I. and Lanata, Claudio F. and Grigalva, Carlos G. and Respira Peru Group, . (2014) Impact of home environment interventions on the risk of influenza-associated ARI in Andean children : observations from a prospective household-based cohort study. PLoS ONE, Vol. 9, H. 3 , e91247.

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Abstract

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.; 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.; 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).; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Household Health Systems (Mäusezahl)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Hartinger, Stella and Mäusezahl, Daniel
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Public Library of Science
e-ISSN:1932-6203
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:31 Aug 2018 06:39
Deposited On:18 Jul 2014 09:10

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