Serologic evidence of seasonal influenza A and B in HIV patients on combined antiretroviral therapy in Lagos, Nigeria

Background: Influenza and HIV are endemic in Nigeria but there is no epidemiological data on the co-infection of influenza A and B among HIV patients.Objective: We investigated seasonal influenza A and B, and co-infection among HIV patients on combined antiretroviral therapy (cART) in Lagos, Nigeria.Methods: In a prospective cross-sectional study, clear sera collected from 174 HIV-positive patients between August and September 2018 were analysed for immunoglobulin M-specific antibodies to seasonal influenza A subtypes H1N1 and H3N2, and influenza B by enzyme immunoassay. Results: A total of 39.7% (69/174) of HIV patients were seropositive for influenza A or B viruses with 84.1% (58/69) being positive for influenza A, 13.04% (9/69) seropositive for both influenza A and B, and only 2.9% (2/69) positive for influenza B mono-infection. Median age was 44 (mean 45, mode 40, range 18­74) years. The 41­50 years age group had the highest seroprevalence (39.1%; 27/69). Seropositivity was highest among women (65.2%; 45/69). A total of 88.4% (61/69) of HIV patients seropositive for influenza A or B were on fixed dose cART, while 73.9% (51/69) were virologically suppressed. Furthermore, 27.5% (19/69) were immunocompromised, of which 21.1% (4/19) were severely immunosuppressed (cluster of differentiation 4 < 200 cells/mm>3).Conclusion: Influenza A and B was prevalent among HIV patients on cART, which may predispose them to life-threatening complications. We recommend strong advocacy on the need to reduce the risk of exposure to influenza and for the provision of an influenza vaccine in Nigeria

Health-Care Providers' Preparedness for H1N1/09 Influenza Prevention and Treatment in Dar es Salaam; Tanzania

Introduction: In Tanzania; the first case of H1N1/09 influenza was reported in September 2009. By March 2010; the reported number of cases was 770 with one death. Due to shortage of qualified human resources; essential medicines and laboratory supplies in health facilities; it was not known how well health-care providers in the country were prepared to deal with the pandemic.Methodo- logy: The study was conducted from December 2009 to May 2010 in public hospitals and private community pharmacies in Dar es Salaam; Tanzania. Fifty-three prescribers and 200 dispensers were interviewed to assess their knowledge on the prevention and treatment of H1N1/09 influenza; and dissemination of correct information to the public regarding the pandemic. Results: Most participants had inadequate knowledge on the transmission; prevention and management of H1N1/09 influenza. The majority of prescribers knew neither the antiviral drugs recommended for the treatment of H1N1 influenza (64) nor their adverse effects (92.5). The drug dispensers' knowledge was also inadequate regarding the transmission; prevention and treatment of H1N1/09 influenza. Forty-one (20.5) salespersons without formal training in pharmaceutical or medical sciences were found dispensing and supervising the pharmacies. Most participants had misconceptions on how H1N1/09 virus was transmitted. Conclusion: The results of the study revealed gaps in the knowledge of the health-care providers on the prevention and treatment of H1N1/09 influenza infection. This indicates the need for strengthening of health-care systems and provision of continuing education and professional development for health-care providers on new and re-emerging diseases in the community

Pandemic Influenza A(H1N1) 2009 Virus Outbreak among Boarding School Pupils in Madagascar: Compliance and Adverse Effects of Prophylactic Oseltamivir Treatment

Introduction: In October 2009; the first outbreak of pandemic influenza A(H1N1) 2009 virus in Madagascar occurred at a school in Antananarivo. Among the first 12 cases; five were reported in boarding pupils at the school. The school closed 10 days into the outbreak. Mass oseltamivir prophylactic treatment was used to contain the outbreak. This study aimed to determine the transmission of infection among boarding school pupils and to evaluate the adverse effects of oseltamivir chemoprophylactic treatment and their impact on compliance.Methodology: After conducting an initial investigation of the outbreak we administered a questionnaire to 132 boarders who were present after the school re-opened. Questions addressed symptoms of influenza-like illness; compliance with chemoprophylaxis; and adverse effects. Results: Of 59 boarders; 20 (45.0) had confirmed pandemic influenza A (H1N1) infection. Among the asymptomatic boarders; compliance with oseltamivir chemoprophylaxis was moderate: 56.2took the full 10-day course; and 66.9completed at least seven days. In contrast; among symptomatic boarders; only two did not take the full course of oseltamivir. Fifty percent of the boarders receiving oseltamivir experienced symptoms such as fatigue (38.7); difficulty concentrating (22.6) and headaches (19.4). Bad compliance was not associated with adverse effects.Conclusion: Since the symptoms of pandemic influenza A(H1N1) 2009 virus were generally mild; the burden of adverse effects must be considered when deciding on mass oseltamivir chemoprophylaxis among teenagers

A Clinician's Guide to 2009 H1N1 Influenza

N/A