Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022
BackgroundViral respiratory pathogens have become the leading cause of acute undifferentiated febrile illness (AFI). We determined the fraction of AFI attributable to influenza and SARS-CoV-2 in Ethiopia, along with an understanding of their epidemiological characteristics.MethodsFrom February 2021...
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Frontiers Media S.A.
2025-07-01
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| author | Musse Tadesse Chekol Musse Tadesse Chekol David Sugerman Adamu Tayachew Adamu Tayachew Zelalem Mekuria Neamin Tesfay Aynalem Alemu Aynalem Alemu Andargachew Gashu Andargachew Gashu Wolde Shura Melaku Gonta Admikew Agune Aster Hailemariam Yonas Assefa Mesfin Wossen Abdulhafiz Hassen Parsons Michele Rachel Silver Hulemenaw Delelegn Lozano Briana Tesfu Kasa Nigatu Kebede |
| author_facet | Musse Tadesse Chekol Musse Tadesse Chekol David Sugerman Adamu Tayachew Adamu Tayachew Zelalem Mekuria Neamin Tesfay Aynalem Alemu Aynalem Alemu Andargachew Gashu Andargachew Gashu Wolde Shura Melaku Gonta Admikew Agune Aster Hailemariam Yonas Assefa Mesfin Wossen Abdulhafiz Hassen Parsons Michele Rachel Silver Hulemenaw Delelegn Lozano Briana Tesfu Kasa Nigatu Kebede |
| author_sort | Musse Tadesse Chekol |
| collection | DOAJ |
| description | BackgroundViral respiratory pathogens have become the leading cause of acute undifferentiated febrile illness (AFI). We determined the fraction of AFI attributable to influenza and SARS-CoV-2 in Ethiopia, along with an understanding of their epidemiological characteristics.MethodsFrom February 2021 to June 2022, we enrolled patients meeting an AFI case definition (age >5 years with fever ≥38°C) who presented at one of four selected sentinel hospital sites in Jimma, Harari, Addis Ababa, and Gonder. Clinical and epidemiological information was collected, Nasopharyngeal swab samples were collected and analyzed using real-time PCR for respiratory viruses (influenza and SARS-CoV-2). A quasi-binomial regression model and multivariable regression were performed to compute fractions and establish associations with the agent detected.ResultA total of 737 AFI cases were enrolled. The overall proportion of SARS-CoV-2, influenza A, and influenza B among AFI patients were 7.8, 1.9, and 0.5 per 100,000 population, respectively. Among the enrolled AFI cases tested for SARS-CoV-2 and Influenza virus, SARS-CoV-2 was the most detected pathogen with a positivity rate of 13.7% (95% CI:11.3–16.4), followed by influenza A and influenza B, which have a positivity rate of 3.3% (95% CI: 2.2–5.1) and 0.8% (95% CI:0.3–1.8), respectively. The positivity rate of SARS-CoV-2 peaked at 37.4% in September 2021. Per the multivariable analysis, cases ≥65 years of age were three [AOR = 3.3,95% CI:(1.9–5.7)] times more likely to be positive for SARS-CoV-2.ConclusionSARS-CoV-2 and influenza viruses were highly prevalent among AFI cases. The proportion of SARS-CoV-2 was higher among older adults. Further study is recommended to characterize influenza subtypes, SARS-CoV-2 variants and determine their attributable fraction among a broader panel of AFI-causing pathogens that contributes for guiding the proper diagnostics, treatment and surveillance measures. |
| format | Article |
| id | doaj-art-a75762d19feb4b0b8d40c5a4fe2db96d |
| institution | DOAJ |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj-art-a75762d19feb4b0b8d40c5a4fe2db96d2025-08-20T02:51:59ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15491591549159Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022Musse Tadesse Chekol0Musse Tadesse Chekol1David Sugerman2Adamu Tayachew3Adamu Tayachew4Zelalem Mekuria5Neamin Tesfay6Aynalem Alemu7Aynalem Alemu8Andargachew Gashu9Andargachew Gashu10Wolde Shura11Melaku Gonta12Admikew Agune13Aster Hailemariam14Yonas Assefa15Mesfin Wossen16Abdulhafiz Hassen17Parsons Michele18Rachel Silver19Hulemenaw Delelegn20Lozano Briana21Tesfu Kasa22Nigatu Kebede23Public Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaU.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United StatesPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaGlobal One Health Initiative (GOHi), Ohio State University, Columbus, OH, United StatesPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaPublic Health Emergency Management Center, Ethiopian Public Health Institute, Addis Ababa, EthiopiaU.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United StatesU.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United StatesU.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United StatesU.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, United StatesAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaAklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaBackgroundViral respiratory pathogens have become the leading cause of acute undifferentiated febrile illness (AFI). We determined the fraction of AFI attributable to influenza and SARS-CoV-2 in Ethiopia, along with an understanding of their epidemiological characteristics.MethodsFrom February 2021 to June 2022, we enrolled patients meeting an AFI case definition (age >5 years with fever ≥38°C) who presented at one of four selected sentinel hospital sites in Jimma, Harari, Addis Ababa, and Gonder. Clinical and epidemiological information was collected, Nasopharyngeal swab samples were collected and analyzed using real-time PCR for respiratory viruses (influenza and SARS-CoV-2). A quasi-binomial regression model and multivariable regression were performed to compute fractions and establish associations with the agent detected.ResultA total of 737 AFI cases were enrolled. The overall proportion of SARS-CoV-2, influenza A, and influenza B among AFI patients were 7.8, 1.9, and 0.5 per 100,000 population, respectively. Among the enrolled AFI cases tested for SARS-CoV-2 and Influenza virus, SARS-CoV-2 was the most detected pathogen with a positivity rate of 13.7% (95% CI:11.3–16.4), followed by influenza A and influenza B, which have a positivity rate of 3.3% (95% CI: 2.2–5.1) and 0.8% (95% CI:0.3–1.8), respectively. The positivity rate of SARS-CoV-2 peaked at 37.4% in September 2021. Per the multivariable analysis, cases ≥65 years of age were three [AOR = 3.3,95% CI:(1.9–5.7)] times more likely to be positive for SARS-CoV-2.ConclusionSARS-CoV-2 and influenza viruses were highly prevalent among AFI cases. The proportion of SARS-CoV-2 was higher among older adults. Further study is recommended to characterize influenza subtypes, SARS-CoV-2 variants and determine their attributable fraction among a broader panel of AFI-causing pathogens that contributes for guiding the proper diagnostics, treatment and surveillance measures.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1549159/fullAFIinfluenza virusSARS-CoV-2Ethiopiaproportion |
| spellingShingle | Musse Tadesse Chekol Musse Tadesse Chekol David Sugerman Adamu Tayachew Adamu Tayachew Zelalem Mekuria Neamin Tesfay Aynalem Alemu Aynalem Alemu Andargachew Gashu Andargachew Gashu Wolde Shura Melaku Gonta Admikew Agune Aster Hailemariam Yonas Assefa Mesfin Wossen Abdulhafiz Hassen Parsons Michele Rachel Silver Hulemenaw Delelegn Lozano Briana Tesfu Kasa Nigatu Kebede Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 Frontiers in Public Health AFI influenza virus SARS-CoV-2 Ethiopia proportion |
| title | Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 |
| title_full | Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 |
| title_fullStr | Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 |
| title_full_unstemmed | Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 |
| title_short | Clinical and epidemiological characteristics of influenza and SARS-CoV-2 virus among patients with acute febrile illness in selected sites of Ethiopia 2021–2022 |
| title_sort | clinical and epidemiological characteristics of influenza and sars cov 2 virus among patients with acute febrile illness in selected sites of ethiopia 2021 2022 |
| topic | AFI influenza virus SARS-CoV-2 Ethiopia proportion |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1549159/full |
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