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Published on 29.03.18 in Vol 4, No 1 (2018): EMPHNET Sixth Regional Conference

Preprints (earlier versions) of this paper are available at, first published Mar 29, 2018.

This paper is in the following e-collection/theme issue:


    Severe Acute Respiratory Infections with Influenza and Non-Influenza Respiratory Viruses: Yemen, 2011-2016

    Corresponding Author:

    Mohammed Al Amad


    Background: Sentinel surveillance for severe acute respiratory infections (SARI) is an important tool to monitor influenza circulation and burden of other respiratory pathogens. In Yemen, two sites established at Sana'a and Aden city. Pharyngeal samples are tested for influenza and non- influenza by the Real-Time-PCR assay in NAMRU 3.

    Objective: Describe severity of SARI as indicated by admission to intensive care unit (ICU) and fatality as well as associated influenza and non-influenza viruses among patients in the two sites to provide recommendations for improving SARI surveillance.

    Methods: Data from 2012-2016 of SARI patients who admitted in the two sites based on WHO case definition was obtained from Ministry of Health, It analyzed by Epi info 7 and P<0.05 was the cut point for significance.

    Results: 2,211 patients were admitted in the two sites, 32% in 2013, 62% from Aden, 63% < two years, 20% had chronic diseases and 35% admitted to ICU. Overall SARI fatality was 8% which was significantly higher in Aden than Sana'a (10% vs. 5%, P<0.001), among patients with chronic disease (14% vs. 6.5% P<0.001) and admitted to ICU (10% vs. 7%, P=0.04). Samples of 82% (1,811) patients were tested where influenza viruses (75% Type A) were detected in 5% (89) more in Sana'a than Aden (6% vs. 4%, P=0.04) compared to 36% (655) of non-influenza viruses that included 43% (279) Respiratory Syncytial Virus and 17% (109) Adenovirus. The fatality of confirmed influenza was 9 % compared to 8% for non-influenza viruses.

    Conclusions: Our findings showed that children < 2 years are more affected by SARI. Both influenza and non-influenza viruses lead to mortality and necessitate prompt diagnosis and treatment. Expanding SARI surveillance to involve more hospitals at different governorate is recommended to give more comprehensive picture regarding SARI.

    iproc 2018;4(1):e10599


    Edited by Y Khader; This is a non–peer-reviewed article. submitted 29.03.18; accepted 29.03.18; published 29.03.18

    ©Mohammed Al Amad. Originally published in Iproceedings (, 29.03.2018.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.