Epidemiology and Surveillance of Influenza Viruses in Uganda between 2008 and 2014

PLoS One. 2016 Oct 18;11(10):e0164861. doi: 10.1371/journal.pone.0164861. eCollection 2016.

Abstract

Introduction: Influenza surveillance was conducted in Uganda from October 2008 to December 2014 to identify and understand the epidemiology of circulating influenza strains in out-patient clinic attendees with influenza-like illness and inform control strategies.

Methodology: Surveillance was conducted at five hospital-based sentinel sites. Nasopharyngeal and/or oropharyngeal samples, epidemiological and clinical data were collected from enrolled patients. Real-time reverse transcription polymerase chain reaction (RT-PCR) was performed to identify and subtype influenza strains. Data were double-entered into an Epi Info 3.5.3 database and exported to STATA 13.0 software for analysis.

Results: Of the 6,628 patient samples tested, influenza virus infection was detected in 10.4% (n = 687/6,628) of the specimens. Several trends were observed: influenza circulates throughout the year with two peaks; the major one from September to November and a minor one from March to June. The predominant strains of influenza varied over the years: Seasonal Influenza A(H3) virus was predominant from 2008 to 2009 and from 2012 to 2014; Influenza A(H1N1)pdm01 was dominant in 2010; and Influenza B virus was dominant in 2011. The peaks generally coincided with times of higher humidity, lower temperature, and higher rainfall.

Conclusion: Influenza circulated throughout the year in Uganda with two major peaks of outbreaks with similar strains circulating elsewhere in the region. Data on the circulating strains of influenza and its patterns of occurrence provided critical insights to informing the design and timing of influenza vaccines for influenza prevention in tropical regions of sub-Saharan Africa.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Humans
  • Humidity
  • Infant
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / isolation & purification
  • Influenza B virus / genetics
  • Influenza B virus / isolation & purification
  • Influenza, Human / epidemiology*
  • Influenza, Human / virology
  • Male
  • Nasopharynx / virology
  • Oropharynx / virology
  • Prevalence
  • RNA, Viral / metabolism
  • Rain
  • Real-Time Polymerase Chain Reaction
  • Seasons
  • Temperature
  • Uganda / epidemiology

Substances

  • RNA, Viral

Grants and funding

This study was supported by the US Department of Defense through the Armed Forces Health Surveillance Branch - Global Emerging Infections Surveillance and Response System (DoD AFHSB-GEIS) and Henry Jackson Foundation for Advancement of Medicine Grant #W81XWH-09-R-0041. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.