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. 2021 Sep;15(5):634-640.
doi: 10.1111/irv.12855. Epub 2021 Mar 25.

Underlying cardiopulmonary conditions as a risk factor for influenza and respiratory syncytial virus infection among community-dwelling adults aged ≥ 65 years in Thailand: Findings from a two-year prospective cohort study

Prabda Praphasiri  1 , Manash Shrestha  2 , Jayanton Patumanond  3 , Sutthichai Nakphook  4 , Sutthinan Chawalchitiporn  5 , Darunee Ditsungnoen  1 , Fatimah S Dawood  6 , Joshua A Mott  1   6 , Kriengkrai Prasert  5
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Underlying cardiopulmonary conditions as a risk factor for influenza and respiratory syncytial virus infection among community-dwelling adults aged ≥ 65 years in Thailand: Findings from a two-year prospective cohort study

Prabda Praphasiri et al. Influenza Other Respir Viruses. 2021 Sep.

Abstract

Background: Adults with cardiopulmonary conditions may be at increased risk of influenza and respiratory syncytial virus (RSV) infection, but it is not well-established and few data are available from middle-income countries.

Methods: Using data from a prospective cohort study of influenza vaccine effectiveness, we estimated and compared the incidences of influenza and RSV between community-dwelling Thai adults aged ≥ 65 years with and without cardiopulmonary conditions. During May 2015-May 2017, older adults in a rural province in Thailand were followed-up with weekly surveillance for acute respiratory illness (ARI), defined broadly as new onset or worsening of cough with or without fever, and hospitalized ARI. When ill, nasal self-swabs and/or nasopharyngeal swabs were collected for reverse-transcription polymerase chain reaction testing. We used Poisson regression to calculate incidence rate ratios (IRR), adjusting for age, sex, current smoking, number of hospital visits, weekly influenza activity, and influenza vaccination.

Results: Overall, 3220 adults with a median age of 71 years (IQR 68-76) were enrolled; 1324 (41.1%) were male; and 313 (9.7%) had ≥1 underlying cardiopulmonary condition, most commonly chronic obstructive pulmonary disease (131; 41.2%) or asthma (73; 23.3%). Participants with cardiopulmonary conditions had higher incidences of ARI, influenza, and RSV than those without (Adjusted IRR: 1.84, 95% CI 1.64-2.07; 1.86, 95% CI 1.07-3.26; 2.04, 95% CI 1.11-3.76, respectively).

Conclusion: Older adults in rural Thailand with cardiopulmonary conditions have increased rates of ARI, influenza, and RSV infections. Our findings support efforts to ensure this population has access to influenza vaccines and other respiratory illness prevention measures.

Keywords: Thailand; cardiopulmonary conditions; influenza; older adult; respiratory syncytial virus.

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Conflict of interest statement

The authors declare that they have no personal or financial relationship that could lead to a conflict of interest.

Figures

FIGURE 1
FIGURE 1
Number of laboratory‐confirmed influenza and RSV infection and proportion of positive cases by month among older adults aged ≥ 65 years in population‐based cohort study, Nakhon Phanom province, Thailand, May 2015‐May 2017
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