Influenza Disease Burden Study

Title: Influenza Disease Burden in India (IDBI)

Duration: September 2008 to August 2013

Collaborator: National Institute of Virology, Pune

Sponsor: Centres for Disease Control, Atlanta, US (CDC)

Investigator(s):Dr.Akhilesh Chandra Mishra, Dr.MandeepChadha,  Dr.SiddhivinayakHirve,  Dr. Sanjay Juvekar.

Rationale

The burden of disease related to influenza virus infection in India is not well defined but likely to be substantial given that India accounts for 20% of global childhood deaths due to acute respiratory infections. To address this issue a population-based longitudinal burden of disease study was implemented at two study sites in rural India: Vadu and Ballabgarh. Each of these sites has ongoing Health and Demographic surveillance systems that make them suitable locations for study implementation. The sites are situated in the second most populous country in the world and the results obtained may also be useful for program planning in other tropical developing countries.

Aim

The primary aim of this study is to determine the incidence of severe hospitalized and medically attended non-hospitalized influenza in each of these communities.

Objectives

  1. 1.Estimate the incidence of laboratory confirmed influenza among persons hospitalized for acute respiratory illnesses and acute exacerbations of chronic medical conditions
  2. 2.Estimate the incidence of laboratory confirmed influenza among medically attended outpatients seeking care for acute respiratory illnesses and acute exacerbations of chronic medical conditions
  3. 3.Characterize the clinical spectrum of inpatient and outpatient disease related to influenza, evaluate different clinical case definitions and syndromes to predict influenza, and describe the seasonality of influenza.
  4. 4.Determine risk factors for severe disease due to influenza, including underlying chronic conditions, demographics, smoking, and socio-economic status.
  5. 5.Describe the health care utilization of the population and define the burden of respiratory disease that did not seek care or refused hospitalization for severe respiratory illness, describe obstacles to care.
  6. 6.Estimate the annual mortality rate due to severe respiratory disease and influenza in the population.

 Methodology:

 

Activity

Duration

Cases / sample/ population

Information collected

Measurements / specimens

Hospital based surveillance

May 2009 -  April 2013

5000+ cases enrolled so far

Symptoms, diagnostic tests, chronic illness etc.

Nasal /throat swab for influenza virus detection and typing

Clinic based  surveillance

January 2010 -  August 2010

1260

Symptoms, diagnostic tests, chronic illness etc.

Nasal /throat swab for influenza virus detection and typing

Health utilisation survey

four rounds of house to house survey during first three years of the study

26000 households

Captured health seeking behaviour, household and individual level risk factors

 

 

NA

 

Publication: 

Hirve S,  Chadha M, Lele P,  Lafond KE, Deoshatwar A, Sambhudas S, Juvekar S,Mounts A, Dawood F, Lal R, Mishra A Performance of case definitions used for influenza surveillance among hospitalized patients in a rural area of India. (Article ID: Article ID: BLT.12.108837) Published online: 27 September 2012            

Website: http://www.who.int/bulletin/online_first/12-108837.pdf

 

 

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