{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:14:50Z","timestamp":1788268490090,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,5,27]],"date-time":"2016-05-27T00:00:00Z","timestamp":1464307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["084633"],"award-info":[{"award-number":["084633"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Information on the timing of influenza circulation remains scarce in <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>ropical regions of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We assessed the relationship between influenza activity and several meteorological factors (temperature, specific humidity, precipitation) and characterized the timing of influenza circulation and its implications to vaccination strategies in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed virologically confirmed influenza data for outpatient influenza\u2010like illness (<jats:styled-content style=\"fixed-case\">ILI<\/jats:styled-content>), hospitalized for severe acute respiratory infections (<jats:styled-content style=\"fixed-case\">SARI<\/jats:styled-content>), and cases of severe pneumonia over the period 2007\u20132013. Using logistic and negative binomial regression methods, we assessed the independent association between climatic variables (lagged up to 4 weeks) and influenza activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were multiple influenza epidemics occurring each year and lasting a median duration of 2\u20134 months. On average, there were two epidemics occurring each year in most of the regions in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya, with the first epidemic occurring between the months of <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ebruary and <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>arch and the second one between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>uly and <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ovember. Specific humidity was independently and negatively associated with influenza activity. Combinations of low temperature (&lt;18\u00b0C) and low specific humidity (&lt;11 g\/kg) were significantly associated with increased influenza activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study broadens understanding of the relationships between seasonal influenza activity and meteorological factors in the <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enyan context. While rainfall is frequently thought to be associated with influenza circulation in the tropics, the present findings suggest low humidity is more important in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya. If annual vaccination were a component of a vaccination strategy in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya, the months of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pril to <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>une are proposed as optimal for associated campaigns.<\/jats:p><\/jats:sec>","DOI":"10.1111\/irv.12393","type":"journal-article","created":{"date-parts":[[2016,4,21]],"date-time":"2016-04-21T17:32:27Z","timestamp":1461259947000},"page":"375-385","source":"Crossref","is-referenced-by-count":38,"title":["Influenza activity in <scp>K<\/scp>enya, 2007\u20132013: timing, association with climatic factors, and implications for vaccination campaigns"],"prefix":"10.1111","volume":"10","author":[{"given":"Gideon O.","family":"Emukule","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention \u2013 Kenya Country Office Nairobi Kenya"},{"name":"Department of Primary and Community Care Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Mott","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention \u2013 Kenya Country Office Nairobi Kenya"},{"name":"Influenza Division National Center for Immunization and Respiratory Diseases US Centers for Disease Control and Prevention Atlanta GA USA"},{"name":"US Public Health Service Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Spreeuwenberg","sequence":"additional","affiliation":[{"name":"Netherlands Institute for Health Services research (NIVEL) Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Viboud","sequence":"additional","affiliation":[{"name":"Fogarty International Center National Institutes of Health Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Commanday","sequence":"additional","affiliation":[{"name":"Influenza Division National Center for Immunization and Respiratory Diseases US Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Muthoka","sequence":"additional","affiliation":[{"name":"Ministry of Health Government of Kenya Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick K.","family":"Munywoki","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute Centre for Geographic Medicine Research\u2010Coast Kilifi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Nokes","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute Centre for Geographic Medicine Research\u2010Coast Kilifi Kenya"},{"name":"School of Life Sciences University of Warwick Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koos","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Paget","sequence":"additional","affiliation":[{"name":"Department of Primary and Community Care Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Netherlands Institute for Health Services research (NIVEL) Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61051-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(99)00099-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0001296"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1001.020705"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1003194"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.01680-06"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0100659"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32833cc955"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4269\/ajtmh.2009.81.180","article-title":"Seasonality of influenza in the tropics: a distinct pattern in northeastern Brazil","volume":"81","author":"Moura FE","year":"2009","journal-title":"Am J Trop Med Hyg"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030089"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis530"},{"key":"e_1_2_9_13_1","unstructured":"Wikipedia contributors.Geography of Kenya 2014. 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