ArticleOpen forum infectious diseases2019
The Impact of Influenza and Tuberculosis Interaction on Mortality Among Individuals Aged ≥15 Years Hospitalized With Severe Respiratory Illness in South Africa, 2010-2016.
Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review.African health sciences · 2020Pooled it
- Coinfections in Tuberculosis in Low- and Middle-Income Countries: Epidemiology, Clinical Implications, Diagnostic Challenges, and Management Strategies-A Narrative Review.Journal of clinical medicine · 2025Review
- Unmasking the hidden impact of viruses on tuberculosis risk.Trends in immunology · 2024Review
- Comparing adults with severe SARS-CoV-2 or influenza infection: South Africa, 2016-2021.Southern African journal of infectious diseases · 2024Article
- Burden of influenza A (H1N1)pdm09 infection among tuberculosis patients: a prospective cohort study.BMC infectious diseases · 2023Article
- Review
- Costs of seasonal influenza vaccination in South Africa.Influenza and other respiratory viruses · 2022Review
- The burden of influenza among Kenyan pregnant and postpartum women and their infants, 2015-2020.Influenza and other respiratory viruses · 2022Article
- Sentinel surveillance for influenza A viruses in Lahore District Pakistan in flu season 2015-2016.BMC infectious diseases · 2022Article
- Facility-based surveillance for influenza and respiratory syncytial virus in rural Zambia.BMC infectious diseases · 2021Article
- Respiratory pathogen diversity and co-infections in rural Zambia.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Article
- Immunological Aspects of Diagnosis and Management of Childhood Tuberculosis.Infection and drug resistance · 2021Review
- COVID-19 and Vulnerable Populations in Sub-Saharan Africa.Advances in experimental medicine and biology · 2021Review
- High burden of viral respiratory co-infections in a cohort of children with suspected pulmonary tuberculosis.BMC infectious diseases · 2020Observational
- Prospects for SARS-CoV-2 diagnostics, therapeutics and vaccines in Africa.Nature reviews. Microbiology · 2020Review
- Epidemic and pandemic viral infections: impact on tuberculosis and the lung: A consensus by the World Association for Infectious Diseases and Immunological Disorders (WAidid), Global Tuberculosis Network (GTN), and members of the European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycobacterial Infections (ESGMYC).The European respiratory journal · 2020Review
- Pulmonary mucosal immunity mediated through CpG provides adequate protection against pulmonary Mycobacterium tuberculosis infection in the mouse model. A role for type I interferon.Tuberculosis (Edinburgh, Scotland) · 2020Article
- Influenza disease burden among potential target risk groups for immunization in South Africa, 2013-2015.Vaccine · 2020Article
- HIV and SARS-Coronavirus-2 Epidemics: Possible Interactions and Need for Studies, Especially in Africa.Frontiers in medicine · 2020Article
- Enterovirus D68 and mycobacterial coinfection: case report.Therapeutic advances in infectious diseaseArticle
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Authors and funding
17 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundData on the prevalence and impact of influenza-tuberculosis coinfection on clinical outcomes from high-HIV and -tuberculosis burden settings are limited. We explored the impact of influenza and tuberculosis coinfection on mortality among hospitalized adults with lower respiratory tract infection (LRTI).
methodsWe enrolled patients aged ≥15 years admitted with physician-diagnosed LRTI or suspected tuberculosis at 2 hospitals in South Africa from 2010 to 2016. Combined nasopharyngeal and oropharyngeal swabs were tested for influenza and 8 other respiratory viruses. Tuberculosis testing of sputum included smear microscopy, culture, and/or Xpert MTB/Rif.
resultsAmong 6228 enrolled individuals, 4253 (68%) were tested for both influenza and tuberculosis. Of these, the detection rate was 6% (239/4253) for influenza, 26% (1092/4253) for tuberculosis, and 77% (3113/4053) for HIV. One percent (42/4253) tested positive for both influenza and tuberculosis. On multivariable analysis, among tuberculosis-positive patients, factors independently associated with death were age group ≥65 years compared with 15-24 years (adjusted odds ratio [aOR], 3.6; 95% confidence interval [CI], 1.2-11.0) and influenza coinfection (aOR, 2.3; 95% CI, 1.02-5.2). Among influenza-positive patients, laboratory-confirmed tuberculosis was associated with an increased risk of death (aOR, 4.5; 95% CI, 1.5-13.3). Coinfection with other respiratory viruses was not associated with increased mortality in patients positive for tuberculosis (OR, 0.7; 95% CI, 0.4-1.1) or influenza (OR, 1.6; 95% CI, 0.4-5.6).
conclusionsTuberculosis coinfection is associated with increased mortality in individuals with influenza, and influenza coinfection is associated with increased mortality in individuals with tuberculosis. These data may inform prioritization of influenza vaccines or antivirals for tuberculosis patients and inform tuberculosis testing guidelines for patients with influenza.
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