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An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013.

Publication ,  Journal Article
Tillekeratne, LG; Bodinayake, CK; Nagahawatte, A; Vidanagama, D; Devasiri, V; Arachchi, WK; Kurukulasooriya, R; De Silva, AD; Østybe, T ...
Published in: Am J Trop Med Hyg
May 2015

Influenza accounts for a large burden of acute respiratory tract infections in high-income countries; data from lower-income settings are limited due to lack of confirmatory testing. Consecutive outpatients presenting to the largest tertiary care hospital in southern Sri Lanka were surveyed for influenza-like illness (ILI), defined as acute onset of fever ≥ 38.0°C and cough. Patients were administered a questionnaire and nasal/nasopharyngeal sampling for rapid influenza A/B testing. We enrolled 311 patients with ILI from March to November 2013: 170 (54.7%) children and 172 (55.3%) males. Approximately half (147, 47.3%) tested positive for influenza, but 253 (81.4%) were prescribed antibiotics. On bivariable analysis, symptoms associated with influenza included pain with breathing (P < 0.001), headache (P = 0.005), fatigue (P = 0.003), arthralgias (P = 0.003), and myalgias (P = 0.006) in children and pain with breathing (P = 0.01), vomiting (P = 0.03), and arthralgias (P = 0.03) in adults. Our final clinical predictive models had low sensitivity and fair specificity-50.0% (95% CI: 38.6-61.4%) and 83.2% (95% CI: 73.4-90.0%), respectively, in children and 52.2% (95% CI: 39.9-64.2%) and 81.4% (95% CI: 70.0-89.4%), respectively, in adults. Our study confirms the ability of rapid influenza testing to identify an influenza epidemic in a setting in which testing is not routinely available.

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Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

May 2015

Volume

92

Issue

5

Start / End Page

1023 / 1029

Location

United States

Related Subject Headings

  • Young Adult
  • Vomiting
  • Tropical Medicine
  • Surveys and Questionnaires
  • Sri Lanka
  • Prevalence
  • Outpatients
  • Nasopharynx
  • Models, Theoretical
  • Middle Aged
 

Citation

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Tillekeratne, L. G., Bodinayake, C. K., Nagahawatte, A., Vidanagama, D., Devasiri, V., Arachchi, W. K., … Woods, C. W. (2015). An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013. Am J Trop Med Hyg, 92(5), 1023–1029. https://doi.org/10.4269/ajtmh.14-0708
Tillekeratne, L Gayani, Champica K. Bodinayake, Ajith Nagahawatte, Dhammika Vidanagama, Vasantha Devasiri, Wasantha Kodikara Arachchi, Ruvini Kurukulasooriya, et al. “An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013.Am J Trop Med Hyg 92, no. 5 (May 2015): 1023–29. https://doi.org/10.4269/ajtmh.14-0708.
Tillekeratne LG, Bodinayake CK, Nagahawatte A, Vidanagama D, Devasiri V, Arachchi WK, et al. An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013. Am J Trop Med Hyg. 2015 May;92(5):1023–9.
Tillekeratne, L. Gayani, et al. “An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013.Am J Trop Med Hyg, vol. 92, no. 5, May 2015, pp. 1023–29. Pubmed, doi:10.4269/ajtmh.14-0708.
Tillekeratne LG, Bodinayake CK, Nagahawatte A, Vidanagama D, Devasiri V, Arachchi WK, Kurukulasooriya R, De Silva AD, Østybe T, Reller ME, Woods CW. An under-recognized influenza epidemic identified by rapid influenza testing, southern Sri Lanka, 2013. Am J Trop Med Hyg. 2015 May;92(5):1023–1029.

Published In

Am J Trop Med Hyg

DOI

EISSN

1476-1645

Publication Date

May 2015

Volume

92

Issue

5

Start / End Page

1023 / 1029

Location

United States

Related Subject Headings

  • Young Adult
  • Vomiting
  • Tropical Medicine
  • Surveys and Questionnaires
  • Sri Lanka
  • Prevalence
  • Outpatients
  • Nasopharynx
  • Models, Theoretical
  • Middle Aged