Surveillance for influenza in the context of pandemic H1N1 in an African population with a high burden of HIV, Malaria and Malnutrition. (360G-Wellcome-091947_Z_10_Z)

Sub-Saharan countries such as Malawi have a very high infectious disease burden. Although influenza is likely to be prevalent, there is little or no infrastructure to capture the contribution of influenza to morbidity and mortality or define the potential for pandemic influenza to be more severe in these frequently more immunocompromised populations. In this project we will: 1) Assess the burden of Influenza-like Illness (ILI) and Severe Acute Respiratory Infection (SARI) amongst adults and c hildren presenting to a large Central Hospital in Malawi and to determine the contribution of seasonal (including H3N2 and H1N1) and pandemic H1N1 influenza virus to this disease. 2) Describe the severity and outcome of laboratory proven seasonal and pandemic H1N1 influenza in a population with a high prevalence of HIV, malnutrition and malaria. 3) Determine the influence of HIV on the duration of shedding of seasonal and pandemic H1N1 influenza virus. 4) Document the frequency of secon dary invasive bacterial infections in adults and children with influenza-associated SARI. The findings that arise from this study will provide the detailed understanding of the epidemiology, clinical presentation and outcome of influenza urgently required by public health planners and policy makers in Africa.