Potential impact of co-infections and co-morbidities prevalent in Africa on influenza severity and frequency: a systematic review

Adam L Cohen, Meredith McMorrow, Sibongile Walaza, Cheryl Cohen, Stefano Tempia, Marissa Alexander-Scott, Marc-Alain Widdowson

Research output: Contribution to journalA1: Web of Science-article

Abstract

Infectious diseases and underlying medical conditions common to Africa may affect influenza frequency and severity. We conducted a systematic review of published studies on influenza and the following co-infections or co-morbidities that are prevalent in Africa: dengue, malaria, measles, meningococcus, Pneumocystis jirovecii pneumonia (PCP), hemoglobinopathies, and malnutrition. Articles were identified except for influenza and PCP. Very few studies were from Africa. Sickle cell disease, dengue, and measles co-infection were found to increase the severity of influenza disease, though this is based on few studies of dengue and measles and the measles study was of low quality. The frequency of influenza was increased among patients with sickle cell disease. Influenza infection increased the frequency of meningococcal disease. Studies on malaria and malnutrition found mixed results. Age-adjusted morbidity and mortality from influenza may be more common in Africa because infections and diseases common in the region lead to more severe outcomes and increase the influenza burden. However, gaps exist in our knowledge about these interactions.

Original languageEnglish
JournalPLoS ONE
Volume10
Issue number6
Pages (from-to)e0128580
ISSN1932-6203
DOIs
Publication statusPublished - 2015

Keywords

  • Anemia, Sickle Cell/epidemiology
  • Coinfection
  • Comorbidity
  • Dengue/epidemiology
  • Hemoglobinopathies/epidemiology
  • Humans
  • Influenza, Human/epidemiology
  • Malaria/epidemiology
  • Malnutrition/epidemiology
  • Measles/epidemiology
  • Severity of Illness Index

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