Influenza clinical testing and oseltamivir treatment in hospitalized children with acute respiratory illness, 2015–2016
Year: 2021
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Antiviral treatment is recommended for all hospitalized children with suspected or confirmed influenza, regardless of their risk profile. Few data exist on adherence to these recommendations, so we sought to determine factors associated with influenza testing and antiviral treatment in children. METHODS: Hospitalized children <18 years of age with acute respiratory illness (ARI) were enrolled through active surveillance at pediatric medical centers in seven cities between 11/1/2015 and 6/30/2016; clinical information was obtained from parent interview and chart review. We used generalized linear mixed-effects models to identify factors associated with influenza testing and antiviral treatment. RESULTS: Of the 2299 hospitalized children with ARI enrolled during one influenza season, 51% (n = 1183) were tested clinically for influenza. Clinicians provided antiviral treatment for 61 of 117 (52%) patients with a positive influenza test versus 66 of 1066 (6%) with a negative or unknown test result. In multivariable analyses, factors associated with testing included neuromuscular disease (aOR = 5.35, 95% CI [3.58-8.01]), immunocompromised status (aOR = 2.88, 95% CI [1.66-5.01]), age (aOR = 0.93, 95% CI [0.91-0.96]), private only versus public only insurance (aOR = 0.78, 95% CI [0.63-0.98]), and chronic lung disease (aOR = 0.64, 95% CI [0.51-0.81]). Factors associated with antiviral treatment included neuromuscular disease (aOR = 1.86, 95% CI [1.04, 3.31]), immunocompromised state (aOR = 2.63, 95% CI [1.38, 4.99]), duration of illness (aOR = 0.92, 95% CI [0.84, 0.99]), and chronic lung disease (aOR = 0.60, 95% CI [0.38, 0.95]). CONCLUSION: Approximately half of children hospitalized with influenza during the 2015-2016 influenza season were treated with antivirals. Because antiviral treatment for influenza is associated with better health outcomes, further studies of subsequent seasons would help evaluate current use of antivirals among children and better understand barriers for treatment.
DOI: 10.1111/irv.12927
Authors: Lubna Hamdan, Varvara Probst, Zaid Haddadin, Herdi Rahman, Andrew J. Spieker, Simon Vandekar, Laura S. Stewart, John V. Williams, Julie A. Boom, Flor Munoz, Janet A. Englund, Rangaraj Selvarangan, Mary A. Staat, Geoffrey A. Weinberg, Parvin H. Azimi, Eileen J. Klein, Monica McNeal, Leila C. Sahni, Monica N. Singer, Peter G. Szilagyi, Christopher J. Harrison, Manish Patel, Angela P. Campbell, Natasha B. Halasa
Institutions: Vanderbilt University Medical Center, University of Pittsburgh, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Baylor College of Medicine, Texas Children's Hospital, Seattle Children's Hospital, Children's Mercy Hospital, Cincinnati Children's Hospital Medical Center, University of Cincinnati, University of Rochester Medicine, University of California, Los Angeles, Mattel Children's Hospital, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,267
Awards: IP21-002, ENHANCED SURVEILLANCE TO ASSESS VACCINE PREVENTABLE ENTERIC AND RESPIRATORY VIRUS ILLNESSES, IP21-002, ENHANCED SURVEILLANCE NETWORK FOR ENTERIC AND RESPIRATORY VIRUSES IN CHILDREN: ASSESSING DISEASE BURDEN, NATURAL HISTORY, AND VACCINE EFFECTIVENESS, ENHANCED SURVEILLANCE FOR NEWLY PREVENTABLE DISEASES (ARI AND AGE SURVEILLANCE) ROCHESTER, NY, The Vanderbilt Institute for Clinical and Translational Research (VICTR), ENHANCED SURVEILLANCE FOR NEW VACCINE PREVENTABLE DISEASES, ENHANCED SURVEILLANCE FOR NEW VACCINE PREVENTABLE DISEASES, ENHANCED SURVEILLANCE FOR NEW VACCINE PREVENTABLE DISEASES
OpenAlex ID: W3211005280