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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
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  • Prabda Praphasiri,
  • Manash Shrestha,
  • Jayanton Patumanond,
  • Sutthichai Nakphook,
  • Sutthinan Chawalchitiporn,
  • Darunee Ditsungnoen,
  • Fatimah Dawood,
  • Joshua Mott,
  • Kriengkrai Prasert
Prabda Praphasiri
Thailand MOPH–US CDC Collaboration

Corresponding Author:[email protected]

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Manash Shrestha
Mahidol University
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Jayanton Patumanond
Chiang Mai University
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Sutthichai Nakphook
Institute of Preventive Medicine, Department of Disease Control, Ministry of Public Health
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Sutthinan Chawalchitiporn
Nakhon Phanom Provincial Hospital
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Darunee Ditsungnoen
Thailand Ministry of Public Health – U.S. Centers for Disease Control and Prevention Collaboration
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Fatimah Dawood
Centres for Disease Control and Prevention
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Joshua Mott
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Kriengkrai Prasert
Nakhon Phanom Provincial Hospital
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Background: Adults with cardiopulmonary conditions are at increased risk for complications from influenza and respiratory syncytial virus (RSV) infection, but few data are available from middle-income countries. Methods: Using data from a prospective cohort study of influenza vaccine effectiveness among community-dwelling Thai adults aged ≥65 years, we estimated and compared the incidence of influenza and RSV in those with and without cardiopulmonary conditions. During May 2015-May 2017, older adults in a rural province in Thailand were followed weekly with year-round 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, past healthcare-seeking behavior, weekly influenza activity, and influenza vaccination. Results: Overall, 3,220 adults with a median age of 71 years (IQR 68-76) were enrolled; 1,324 (41.1%) were male; and 313 (9.7%) had ≥1 underlying cardio-pulmonary condition, most commonly chronic obstructive pulmonary disease (131; 41.2%) or asthma (73; 23.3%). Compared to those without, participants with cardiopulmonary conditions had higher incidences of ARI, influenza, and RSV (Adjusted IRR: 1.83, 95% CI 1.63-2.05; 1.84, 95% CI 1.05-3.23; 2.02, 95% CI 1.10-3.72, respectively). Conclusion: Our findings show that older adults in rural Thailand with cardiopulmonary conditions have increased rates of ARI, influenza, and RSV infections, and support efforts to ensure this population has access to influenza vaccines and other respiratory illness prevention measures.
30 Jan 2021Submitted to Influenza and other respiratory viruses
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
05 Feb 2021Reviewer(s) Assigned
20 Feb 2021Review(s) Completed, Editorial Evaluation Pending
22 Feb 2021Editorial Decision: Revise Minor
04 Mar 20211st Revision Received
05 Mar 2021Submission Checks Completed
05 Mar 2021Assigned to Editor
07 Mar 2021Editorial Decision: Accept