Severe acute respiratory infection surveillance in Montenegro, 2014−2017

Abstract

Aim: The study aim was to analyze the epidemiology and clinical characteristics of severe acute respiratory infection (SARI) cases and to compare demographic and clinical characteristics as well as outcomes of influenza-positive SARI cases to those of influenza-negative SARI cases in Montenegro.

Methods: SARI surveillance was established in 2014 in nine healthcare institutions. Retrospective analysis of case-based surveillance data pertaining to all reported SARI cases during three seasons was conducted.

Results: Among the 90 identified SARI cases, 64 (71%) were influenza positive. Death outcome was reported in 25 (28%) of all registered SARI cases. Cardiovascular disease was more prevalent among the patients in the influenza-positive SARI group (36% vs. 12%, p = .021), as was concurrence of two or more chronic medical conditions (57% vs. 30%, p = .042). These patients were also more likely to be immunocompromised (16% vs. 0%, p = .057) and have viral pneumonia (14.4% vs. 20.3%, p = .017), compared to those in the influenza-negative SARI group. Younger age, presence of cardiovascular disease and being immunocompromised were patient characteristics independently associated with SARI related to influenza.

Conclusion: Continued and extended monitoring of SARI is necessary in order to fully assess the burden of flu disease, define risk groups and establish better control measures.

Keywords:

• SARI
• influenza
• surveillance
• Montenegro

Transparency

Declaration of funding

This work was supported by the CDC under Grant [1U51IP000841-01] as a part of South East European Center of Infectious Diseases Surveillance and Control-SECID’s regional project and by the Ministry of Education and Science of the Republic of Serbia (Grant No. 175042).

Author contributions

B.R. and A.G. contributing equally to this work.

Declaration of financial/other relationships

B.R., A.G., G.T., V.P., S.S.G., D.V., S.M., Z.V., O.B. and B.M. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no relevant financial or other relationships to disclose.

Acknowledgements

None reported.