Background: Indonesia has the world's highest reported mortality for human infections with highly pathogenic avian influenza (HPAI) A(H5N1) virus. Indonesia is an agriculturally driven country where human-animal mixing is common and provides a unique environment for zoonotic influenza A virus transmission.
Objectives: To identify potential demographic and ecological risk factors for human infection with seasonal influenza A viruses in rural Indonesia, a population-based study was conducted in Cileunyi and Soreang subdistricts near Bandung in western Java from 2008 to 2011.
Methods: Passive influenza surveillance with RT-PCR confirmation of influenza A viral RNA in respiratory specimens was utilized for case ascertainment. A population census and mapping were utilized for population data collection. The presence of influenza A(H3N2) and A(H1N1)pdm09 virus infections in a household was modeled using Generalized Estimating Equations.
Results: Each additional child aged <5 years in a household increased the odds of H3N2 approximately 5 times (OR=4.59, 95%CI: 3.30-6.24) and H1N1pdm09 by 3.5 times (OR=3.53, 95%CI: 2.51-4.96). In addition, the presence of 16-30 birds in the house was associated with an increased odds of H3N2 (OR=5.08, 95%CI: 2.00-12.92) and H1N1pdm09 (OR=12.51 95%CI: 6.23-25.13).
Conclusion: Our findings suggest an increase in influenza A virus infections in rural Indonesian households with young children and poultry.
Keywords: H1N1pdm09; H3N2; age structure; birds; geographic information system; risk factors.
© 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.