Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0201497
Title: Severe Acute Respiratory Infection (SARI) sentinel surveillance in the country of Georgia, 2015-2017
Authors: Chakhunashvili G.
Wagner A.L.
Power L.E.
Janusz C.B.
Machablishvili A.
Karseladze I.
Tarkhan-Mouravi O.
Zakhashvili K.
Imnadze P.
Gray G.C. 
Anderson B.
Boulton M.L.
Keywords: influenza vaccine
adolescent
adult
aged
Article
artificial ventilation
child
comorbidity
controlled study
demography
disease severity
drug efficacy
dyspnea
female
Georgia (U.S.)
hospital patient
hospitalization
human
Human metapneumovirus
Human respiratory syncytial virus
infant
influenza A
intensive care unit
major clinical study
male
Mycoplasma pneumoniae
nonhuman
pathogenesis
respiratory tract infection
Rhinovirus
seasonal influenza
seasonal variation
sentinel surveillance
severe acute respiratory tract infection
throat culture
vaccination
acute disease
Georgia (republic)
influenza
isolation and purification
microbiology
middle aged
newborn
pregnancy
pregnancy complication
preschool child
respiratory failure
respiratory syncytial virus infection
respiratory tract infection
severity of illness index
survival analysis
very elderly
virology
young adult
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Comorbidity
Female
Georgia (Republic)
Humans
Infant
Infant, Newborn
Influenza, Human
Male
Middle Aged
Pregnancy
Pregnancy Complications, Infectious
Respiratory Insufficiency
Respiratory Syncytial Virus Infections
Respiratory Syncytial Virus, Human
Respiratory Tract Infections
Sentinel Surveillance
Severity of Illness Index
Survival Analysis
Young Adult
Issue Date: 2018
Citation: Chakhunashvili G., Wagner A.L., Power L.E., Janusz C.B., Machablishvili A., Karseladze I., Tarkhan-Mouravi O., Zakhashvili K., Imnadze P., Gray G.C., Anderson B., Boulton M.L. (2018). Severe Acute Respiratory Infection (SARI) sentinel surveillance in the country of Georgia, 2015-2017. PLoS ONE 13 (7) : e0201497. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0201497
Abstract: Background Severe Acute Respiratory Infection (SARI) causes substantial mortality and morbidity worldwide. The country of Georgia conducts sentinel surveillance to monitor SARI activity and changes in its infectious etiology. This study characterizes the epidemiology of SARI in Georgia over the 2015/16 and 2016/17 influenza seasons, compares clinical presentations by etiology, and estimates influenza vaccine effectiveness using a test-negative design. Methods SARI cases were selected through alternate day systematic sampling between September 2015 and March 2017 at five sentinel surveillance inpatient sites. Nasopharyngeal swabs were tested for respiratory viruses and Mycoplasma pneumoniae using a multiplex diagnostic system. We present SARI case frequencies by demographic characteristics, co-morbidities, and clinical presentation, and used logistic regression to estimate influenza A vaccine effectiveness. Results 1,624 patients with SARI were identified. More cases occurred in February (28.7%; 466/ 1624) than other months. Influenza was the dominant pathogen in December-February, respiratory syncytial virus in March-May, and rhinovirus in June-November. Serious clinical symptoms including breathing difficulties, ICU hospitalization, and artificial ventilation were common among influenza A and human metapneumovirus cases. For influenza A/H3, a protective association between vaccination and disease status was observed when cases with unknown vaccination status were combined with those who were unvaccinated (OR: 0.53, 95% CI: 0.30, 0.97). Conclusions Multi-pathogen diagnostic testing through Georgia’s sentinel surveillance provides useful information on etiology, seasonality, and demographic associations. Influenza A and B were associated with more severe outcomes, although the majority of the population studied was unvaccinated. Findings from sentinel surveillance can assist in prevention planning. © 2018 Chakhunashvili et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161220
ISSN: 19326203
DOI: 10.1371/journal.pone.0201497
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