title: 2009 A(H1N1) seroconversion rates and risk factors among the general population in Vientiane Capital, Laos.
abstract: OBJECTIVE
  To assess 2009 A(H1N1) seroconversion rates and their determinants within an unvaccinated population in Vientiane Capital, Laos.
  
  
  METHODS
  CoPanFlu Laos, a general population cohort of 807 households and 4,072 participants was established in March 2010. Sociodemographic data, epidemiological data, and capillary blood samples were collected from all the household members in March, and again in October 2010, in order to assess the level of antibodies to 2009 A(H1N1) with the haemagglutination inhibition assay. 2009 A(H1N1) seroconversion was defined as a fourfold or greater increase in titre between inclusion and follow-up. Determinants for pandemic influenza infection were studied using the generalized estimating equations model, taking household clustering into account.
  
  
  RESULTS
  Between March and November 2010, 3,524 paired sera were tested. Prior to the pandemic, our cohort was almost completely vaccine-naive for seasonal influenza. The overall seroconversion rate among nonvaccinated individuals (n = 2,810) was 14.3% (95%CI [13.0, 15.6]), with the highest rate for participants under 20 yo (19.8%, 95%CI [17.4, 22.4]) and the lowest rate for participants over 60 yo (6.5%, 95%CI [3.7, 10.4]). Participants with lower baseline titres had significantly higher infection rates, with a dose-effect relationship. Odds ratios (ORs) ranged from 76.5 (95%CI [27.1, 215.8]), for those with a titre at inclusion of 1∶10, to 8.1 (95%CI [3.3, 20.4]), for those with a titre of 1∶40. Having another household member with a titre ≥1∶80 was associated with a higher likelihood of immunity (OR = 3.3, 95%CI [2.8, 3.9]).
  
  
  CONCLUSIONS
  The determinants and age distribution for seroconversion within a vaccine-naive population were similar to those found in developed countries. This pandemic was characterized by strong epidemiological determinants, regardless of geographical zone and level of development. Moreover, we detected pre-existing cross-reacting antibodies in participants over 60 yo, which could not have originated from former multiple vaccination as has been suggested elsewhere.
authors: UMR 190, Aix-Marseille Université - IRD - EHESP, Marseille, France. alexia.kieffer@gmail.com
authors: Alexia
authors: A
authors: Kieffer
authors: Phimpha
authors: P
authors: Paboriboune
authors: Pascal
authors: P
authors: Crépey
authors: Bruno
authors: B
authors: Flaissier
authors: Vimalay
authors: V
authors: Souvong
authors: Nicolas
authors: N
authors: Steenkeste
authors: Nicolas
authors: N
authors: Salez
authors: François-Xavier
authors: FX
authors: Babin
authors: Christophe
authors: C
authors: Longuet
authors: Fabrice
authors: F
authors: Carrat
authors: Antoine
authors: A
authors: Flahault
authors: Xavier
authors: X
authors: de Lamballerie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology*; D007812:Laos / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D012307:Risk Factors; D012621:Seasons; D016036:Seroepidemiologic Studies; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines
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