Research Article: Epidemiology of respiratory infections among adults in Qatar (2012-2017)

Date Published: June 13, 2019

Publisher: Public Library of Science

Author(s): Hamad Eid Al-Romaihi, Maria K. Smatti, Nandakumar Ganesan, Shazia Nadeem, Elmoubasher Farag, Peter V. Coyle, Joanne Daghfal Nader, Hebah A. Al-Khatib, Emad B. Elmagboul, Said Al Dhahry, Salih A. Al-Marri, Asmaa A. Al Thani, Abdullatif Al Khal, Muna A. Al Maslamani, Hadi M. Yassine, Ronald Dijkman.


Limited data is available about the etiology of influenza like illnesses (ILIs) in Qatar.

This study aimed at providing preliminary estimates of influenza and other respiratory infections circulating among adults in Qatar.

We retrospectively collected data of about 44,000 patients who visited Hamad General Hospital clinics, sentinel sites, and all primary healthcare centers in Qatar between 2012 and 2017. All samples were tested for influenza viruses, whereas about 38,000 samples were tested for influenza and a panel of respiratory viruses using Fast Track Diagnostics (FTD) RT-PCR kit.

Among all ILIs cases, 20,278 (46.5%) tested positive for at least one respiratory pathogen. Influenza virus was predominating (22.6%), followed by human rhinoviruses (HRVs) (9.5%), and human coronaviruses (HCoVs) (5%). A detection rate of 2–3% was recorded for mycoplasma pneumonia, adenoviruses, human parainfluenza viruses (HPIVs), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ILIs cases were reported throughout the year, however, influenza, RSV, and HMPV exhibited strong seasonal peaks in the winter, while HRVs circulated more during fall and spring. Elderly (>50 years) had the lowest rates of influenza A (13.9%) and B (4.2%), while presenting the highest rates of RSV (3.4%) and HMPV (3.3%). While males had higher rates of HRVs (11.9%), enteroviruses (1.1%) and MERS CoV (0.2%), females had higher proportions of influenza (26.3%), HPIVs (3.2%) and RSV (3.6%) infections.

This report provides a comprehensive insight about the epidemiology of ILIs among adults in the Qatar, as a representative of Gulf States. These results would help in improvement and optimization of diagnostic procedures, as well as control and prevention of the respiratory infections.

Partial Text

Acute respiratory infections (ARIs) lead to significant rate of mortality and morbidity worldwide. According to the World Health Organization (WHO), approximately 290,000 to 650,000 deaths annually are caused by influenza virus infection alone [1]. Several other respiratory pathogens including human rhinoviruses (HRVs), respiratory syncytial virus (RSV), human parainfluenza viruses (HPIVs), human metapneumovirus (HMPV), adenoviruses, enteroviruses, and human coronaviruses (HCoVs) are associated with the development of ARIs [2]. Nevertheless, due to the similarity in the clinical presentation of these infections, the particular underlying cause is usually difficult to be identified unless with laboratory testing; and generally, ARI patients are subjected to presumptive treatment [3].

Qatar is a small country on the eastern coast of the Arabian Peninsula and it is characterized by dry, subtropical desert climate with minimal annual rainfall and extremely hot and humid summers. The weather in Qatar can be broadly grouped into two seasons: hot season between May and October, and cool season between December and February. Additionally, Qatar is a multinational country, where >85% of its population are expats arriving from several countries in MENA region and South East Asia. Furthermore, Qatar is located within the hot zone of MERS-virus circulation. MERS-CoV shedding was evidenced in 59% of dromedary camels at the central slaughterhouse in Qatar, in which five different MERS strains were co-circulating [14]. The high proportion of MERS shedding and the circulation of multiple variants emphasizes on the potential human health risk in a diverse and dynamic environment like Qatar. These are all factors that make it essential to study the epidemiology of communicable diseases, especially when considering the country’s preparation for the Football World Cup 2022. Here we report on the epidemiological and demographic characteristics of ILIs among adult patients in Qatar during the period between 2012–2017.