title: Influenza and malaria coinfection among young children in western Kenya, 2009-2011.
abstract: BACKGROUND
  Although children <5 years old in sub-Saharan Africa are vulnerable to both malaria and influenza, little is known about coinfection.
  
  
  METHODS
  This retrospective, cross-sectional study in rural western Kenya examined outpatient visits and hospitalizations associated with febrile acute respiratory illness (ARI) during a 2-year period (July 2009-June 2011) in children <5 years old.
  
  
  RESULTS
  Across sites, 45% (149/331) of influenza-positive patients were coinfected with malaria, whereas only 6% (149/2408) of malaria-positive patients were coinfected with influenza. Depending on age, coinfection was present in 4%-8% of outpatient visits and 1%-3% of inpatient admissions for febrile ARI. Children with influenza were less likely than those without to have malaria (risk ratio [RR], 0.57-0.76 across sites and ages), and children with malaria were less likely than those without to have influenza (RR, 0.36-0.63). Among coinfected children aged 24-59 months, hospital length of stay was 2.7 and 2.8 days longer than influenza-only-infected children at the 2 sites, and 1.3 and 3.1 days longer than those with malaria only (all P < .01).
  
  
  CONCLUSIONS
  Coinfection with malaria and influenza was uncommon but associated with longer hospitalization than single infections among children 24-59 months of age.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. isq8@cdc.gov
authors.forename: Mark G
authors.initials: MG
authors.lastname: Thompson
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Hamel
authors.forename: Meghna
authors.initials: M
authors.lastname: Desai
authors.forename: Gideon
authors.initials: G
authors.lastname: Emukule
authors.forename: Sammy
authors.initials: S
authors.lastname: Khagayi
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
authors.forename: Kathleen
authors.initials: K
authors.lastname: Morales
authors.forename: Simon
authors.initials: S
authors.lastname: Kariuki
authors.forename: Godfrey M
authors.initials: GM
authors.lastname: Bigogo
authors.forename: M Kariuki
authors.initials: MK
authors.lastname: Njenga
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
authors.forename: Frank
authors.initials: F
authors.lastname: Odhiambo
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Kayla F
authors.initials: KF
authors.lastname: Laserson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Katz
mesh_terms: D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology*; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors