Both hospitals provide free care and serve mostly low- and mid-income populations. (2010) Concurrent comparison of epidemiology, clinical presentation and outcome between adult patients suffering from the pandemic influenza A (H1N1) 2009 virus and the seasonal influenza A virus infection. doi: 10.1542/peds.2004-2127. There were no women aged 14 to 44 years old hospitalized with seasonal H1N1; more than a quarter (29%) of the female patients with pH1N1 in this age range was pregnant, but this amounted to only two women. The pH1N1 virus was the most common influenza A virus subtype identified among both the pneumonia (76/138, 55%) and ILI (162/246, 66%) patients. The age distribution of the ILI patients with influenza A differed from that of hospitalized pneumonia patients (Figure 4b) (P<0.001), with the median age of ILI patients (8 years) greater than that for hospitalized pneumonia patients (3 years). Giving the clinician a basic understanding of epidemiology as an analytical instrument for the selection of methods of diagnosis and treatment, it is maintained, is the way to enhance his capacity for critical evaluation. Analyzed the data: KAL WA AE JG JCM LR. SAS v. 9.1 (Cary, NC) was used for analysis. Pagkakaiba ng pagsulat ng ulat at sulating pananaliksik? J Clin Oncol. | Well epidemiological study looks at e.g. The proportion of patients with respiratory distress who required mechanical ventilation was more than three times higher among the hospitalized pneumonia patients with pH1N1 (11%) compared with those with seasonal H1N1 (3%), but the difference was not statistically significant (P = 0.14). In this paper, we present a comparison of the clinical presentation of pH1N1, seasonal influenza A (H1N1) and seasonal influenza A (H3N2) in a resource-limited country in the tropics. Surveillance for ILI in public ambulatory clinics began in Santa Rosa in November 2007 in one health center (staffed by at least one physician) and was then expanded to five additional health posts (staffed by nurses) in June 2009 in response to the pH1N1 pandemic. Diarrhea was defined as three or more liquid or loose stools in a 24-hour period during the last seven days. There were 138 (9%) hospitalized pneumonia and 246 (31%) ILI patients with laboratory-confirmed influenza A virus infection (Figure 1). For non-normally distributed continuous variables, the Mann-Whitney U-test was used when two influenza subtypes were compared, and the Kruskal-Wallis analysis of ranks was used when three influenza subtypes were compared. Patients ≥5 years old were significantly more likely to report muscle aches and shivering than patients <5 years old (data not shown). Educ Med Salud. Pediatrics. Acta Otorhinolaryngol Ital. Copyright © 2020 Multiply Media, LLC. They work hand in hand with a range of other professionals across the field of medicine and the health care industry. In Santa Rosa, surveillance for hospitalized pneumonia began in November 2007 and was conducted at the only hospital in the department, the National Hospital of Cuilapa. A laboratory-confirmed case of influenza A was defined as a case of pneumonia or ILI with influenza A virus infection as determined by real-time reverse transcription polymerase-chain reaction (rRT-PCR). Click through the PLOS taxonomy to find articles in your field. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0015826, http://data.worldbank.org/indicator/NY.GNP.PCAP.CD. Ano ang mga kasabihan sa sa aking kababata? PLOS ONE promises fair, rigorous peer review, Young adults 15 to 29 years old made up a larger proportion of hospitalized pneumonia patients with pH1N1 (10/76; 13%) than seasonal H1N1 (1/38; 3%) but the difference was not statistically significant (P = 0.1). Guatemala, with a population over 14 million, has a gross national income per capita of $2680 and is considered a middle-income country by the World Bank (http://data.worldbank.org/indicator/NY.GNP.PCAP.CD, accessed on 1 September 2010). The protocol received approval from the institutional review boards of the Universidad del Valle de Guatemala (UVG; Guatemala City, Guatemala) and Centers for Disease Control and Prevention (CDC; Atlanta, GA) and approval from the Guatemalan Ministry of Public Health and Social Welfare (MSPAS; Guatemala City, Guatemala). It is possible that our use of a stringent case definition for diarrhea may have missed an association with more mild gastrointestinal symptoms such as nausea. How long will the footprints on the moon last? Panel B: Influenza-like illness patients. Small sample sizes may limit the power of this study to find significant differences between seasonal influenza A and pH1N1. population. Four of the patients with pH1N1 who died were <1 year old, two were between one and 15 years old, two were between 20 and 49 years old, and three were between 50 and 59 years old. There was an early peak of seasonal H1N1 and H3N2 from March to May; however, the second peak due to the pH1N1 virus, from June through September, was greater. It is possible that during the pandemic, patients with lower respiratory tract symptoms were more likely to proceed directly to the hospital for treatment. A comparison of epidemiology and clinical outcomes between ... determine the difference in epidemiology, clinical manifestations and outcomes between patients with A(H1N1)pdm09 infection and those with A(H3N2) infection from 2014 to 2018 in South Korea ... of Medicine, Kyungpook National University Hospital, Chonnam Coinfection with another respiratory virus was similar between hospitalized pneumonia patients with seasonal H1N1 and pH1N1 (P = 0.52) (Table 2). The median number of days from onset of symptoms to presentation at an ambulatory clinic for patients with influenza A was two days and was similar across all influenza subtypes (P = 0.11). A rapid antigen test (BinaxNow™, Inverness Medical Professional Diagnostics, Princeton, NJ) to detect infection with Streptococcus pneumoniae was used in urine samples from all persons >10 years of age. There have been few reports of concurrent comparisons of the epidemiology of seasonal influenza and pH1N1 [13]–[18], and only one from a low-resource setting in the tropics where, until recently, influenza was not recognized as a significant problem [19]–[21]. In April 2009, a new influenza A (H1N1) virus with a unique combination of gene segments not previously identified among influenza viruses was reported from the United States and Mexico [1]. Panel A: Hospitalized pneumonia patients. No, Is the Subject Area "Guatemala" applicable to this article? Children <5 years old were more likely to present with cough (65/65, 100%) than persons ≥5 years old (139/148, 94%; p = 0.04). Funding: Funding for these activities was provided by the US Centers for Disease Control and Prevention, in part through a Cooperative Agreement (UO1 GH000028-02) with the Universidad del Valle de Guatemala. There was no difference in the proportion of children and adults ≥10 years old who were coinfected with S. pneumoniae by subtype (Table 2). Clinical Approach vs. Public Health Approach to Health Care • Clinical Approach – primary role is diagnosis and treatment of illness in individuals, preventive medicine (e.g., immunizations, smoking cessation, obesity counselling and other behavioral/lifestyle concerns) has only been addressed recently – focus remains on the individuals. However, a measured temperature ≥38°C within the first 24 hours of admission was less frequent among hospitalized pneumonia patients with pH1N1 (62%) than among those with seasonal H1N1 (84%; P = 0.01). We examined the proportion of hospitalized pneumonia patients with influenza A admitted to the ICU before the pandemic began in May 2009 (7/34, 21%) and after (23/104, 22%), but there was no statistical difference (P = 0.85). The proportion of hospitalized pneumonia patients admitted to the ICU was similar before and after the pandemic began, and although use of antivirals was rare, treatment with antivirals only occurred during the pandemic period. In Guatemala, we have been conducting prospective, population-based surveillance for severe acute respiratory disease and influenza-like illness (ILI) since 2007. Indeed, many clinicians with clinical epidemiology training develop research projects and subsequently research programmes that move beyond clinical decision-making to include a population focus. In addition, because this surveillance system also collects information on gastrointestinal, neurological and febrile illnesses, patients admitted for, or presenting with, complaints related to these syndromes were also screened to determine whether they met the case definition for pneumonia (hospital) or ILI (ambulatory clinic). This hospital is a 176-bed regional referral hospital with a four-bed pediatric intensive care unit (ICU) and a four-bed adult ICU. Both seasonal H1N1 and pH1N1 caused pneumonia primarily in children <1 year old; infants account for approximately 3% of the Guatemalan population, but they made up 37% and 39% of the hospitalized pneumonia patients with pH1N1 and seasonal H1N1, respectively.
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