ArticlePloS one2022
Geospatial epidemiology of hospitalized patients with a positive influenza assay: A nationwide study in Iran, 2016-2018.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Nationwide spatial epidemiological dataset of over 100,000 influenza-like illness notifications in Iran by county (2015-2019).BMC research notes · 2025Article
- National spatiotemporal patterns of influenza-like illness in Iran: A pre-COVID-19 study (2015-2019).PloS one · 2025Article
- Evaluation of the antiviral potential of gemini surfactants against influenza virus H1N1.Archives of microbiology · 2023Article
- Estimation of seasonal influenza disease burden using sentinel site data in Pakistan 2017-2019: A cross-sectional study.Influenza and other respiratory viruses · 2023Article
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Authors and funding
12 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeasonal influenza is a significant public health challenge worldwide. This study aimed to investigate the epidemiological characteristics and spatial patterns of severe hospitalized influenza cases confirmed by polymerase chain reaction (PCR) in Iran.
methodsData were obtained from Iran's Ministry of Health and Medical Education and included all hospitalized lab-confirmed influenza cases from January 1, 2016, to December 30, 2018 (n = 9146). The Getis-Ord Gi* and Local Moran's I statistics were used to explore the hotspot areas and spatial cluster/outlier patterns of influenza. We also built a multivariable logistic regression model to identify covariates associated with patients' mortality.
resultsCumulative incidence and mortality rate were estimated at 11.44 and 0.49 (per 100,000), respectively, and case fatality rate was estimated at 4.35%. The patients' median age was 40 (interquartile range: 22-63), and 55.5% (n = 5073) were female. The hotspot and cluster analyses revealed high-risk areas in northern parts of Iran, especially in cold, humid, and densely populated areas. Moreover, influenza hotspots were more common during the colder months of the year, especially in high-elevated regions. Mortality was significantly associated with older age (adjusted odds ratio [aOR]: 1.01, 95% confidence interval [CI]: 1.01-1.02), infection with virus type-A (aOR: 1.64, 95% CI: 1.27-2.15), male sex (aOR: 1.77, 95% CI: 1.44-2.18), cardiovascular disease (aOR: 1.71, 95% CI: 1.33-2.20), chronic obstructive pulmonary disease (aOR: 1.82, 95% CI: 1.40-2.34), malignancy (aOR: 4.77, 95% CI: 2.87-7.62), and grade-II obesity (aOR: 2.11, 95% CI: 1.09-3.74).
conclusionsWe characterized the spatial and epidemiological heterogeneities of severe hospitalized influenza cases confirmed by PCR in Iran. Detecting influenza hotspot clusters could inform prioritization and geographic specificity of influenza prevention, testing, and mitigation resource management, including vaccination planning in Iran.
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