The viral aetiology of influenza-like illnesses in Kampala and Entebbe, Uganda, 2008

Balinandi, Stephen; Bakamutumaho, Barnabas; Kayiwa, John T.; Ongus, Juliette; Oundo, Joseph; Awor, Anna C.; Lutwama, Julius J.

Globally, influenza-like illnesses (ILI), also known as acute respiratory illnesses, are common causes of morbidity and mortality in both developed and developing countries. 1, 2 In temperate climates, ILI is reported throughout the year amongst hospital patients with a marked increase in cases recorded during winter periods. There is also evidence of sporadic background activity of ILI transmission throughout the year amongst communities in tropical climates, with a slight increase in cases during the rainy season. 3, 4, 5 However, little is known about the aetiologic agents of ILI in some developing countries, making it a challenge to plan and implement effective patient management and disease prevention and control efforts. 6, 7 As surveillance and monitoring programmes for ILI scale up in many countries, primarily triggered by the increased threat of zoonosis and the emergence of pandemic-prone respiratory viruses, there is a need to identify and document the incidence of endemic and circulating pathogens. This information is important for differential diagnosis, outbreak investigations, trend analysis, early recognition of emerging and re-emerging viruses and implementation of specific public health interventions such as mass vaccination campaigns. In Uganda, a tropical country lying along the equator, surveillance for influenza was started in July 2007. By June 2008, influenza viruses were confirmed in only 12% of patients presenting with ILI at health facilities, implying that the aetiologies in the remaining 88% were unknown. 8 There are a few studies in Uganda that have identified influenza viruses, respiratory syncytial viruses, parainfluenza viruses, coxsackieviruses and echoviruses as being causative agents of ILI -but these studies were conducted during the 1970s. 9, 10, 11 More recent results from other countries including Senegal, Cote d'Ivoire, Kenya and Madagascar have shown that these viruses are in circulation together with newly-discovered viruses such as coronaviruses, bocaviruses and polyomaviruses. 12, 13, 14, 15, 16 In the current study, we identify the respiratory viruses that are associated with ILI patients seeking healthcare in Kampala city and Entebbe town, both located in the central region of Uganda.