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Background <p>Little is known about the global impact of co-circulation and co-infection of COVID-19 and influenza in Democratic Republic of the Congo (DRC). This study aims at analyzing data on SARS-CoV-2, influenza and other respiratory viruses collected during an outbreak response in the rural Province of Panzi to advocate for the strengthening of respiratory virus surveillance systems.</p> Methods <p>Routinely collected surveillance data were analyzed following a health alert of increases in acute respiratory infection (ARI) cases and deaths. Oropharyngeal and nasopharyngeal swabs were systematically collected and tested for influenza, SARS-CoV-2, and respiratory pathogens using multiplex RT-PCR. Statistical analysis included descriptive statistics and comparative tests (chi-square/Fisher’s exact test and t-test or Welch test).</p> Results <p>Routine surveillance data yielded a total of 5,781 suspected cases, including 108 deaths. Incidence rates peaked in 2025 for ARI (209 per 100,000 people) and for Influenza-Like Illness (approximately 250 per 100,000 people). Children under one year of age remained the most affected throughout the entire duration of the epidemic. A total of 115 biological samples (approximately 2% of suspected cases) were tested and 55 (47.8%) were positive for at least one respiratory pathogen. Influenza was detected in 30 cases (54.5%), SARS-CoV-2 in 15 cases (27.3%). Median patient age was 5 years (range 0.4–75 years), with 36.4% 1-&lt;5 years. Eleven co-infections, meaning at least 2 virus detected in the same individual, were identified. Among them, co-infection of influenza with SARS-CoV-2 occurred in 2 cases (6.7%), with rhinovirus in 2 cases (6.7%), with parainfluenza type1/2 in 1 case (3.3%), with Bocavirus in 1 case (3.3%), and with adenovirus in 1 case (3.3%). Influenza A (H1N1) pdm09 was the sole circulating influenza subtype.</p> Conclusion <p>This study documents the co-circulation and co-infection of respiratory viruses, particularly influenza and SARS-CoV-2, despite a small sampling size. These findings emphasize the need to strengthen routine surveillance of respiratory viruses to assess a robust knowledge of co-circulation of respiratory infections and also the clinical impact of the co-infections in DRC.</p>

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SARS-COv-2, influenza and other respiratory virus co-circulation during an outbreak in a rural health zone in Democratic Republic of Congo, 2024–2025

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Eric Bokabo,
  • Hippolyte Situakibanza,
  • Serge Mazamay,
  • Roger Vumilia Kizungu,
  • Mathias Mossoko,
  • Edith Nkwembe,
  • Hélène Broutin

摘要

Background

Little is known about the global impact of co-circulation and co-infection of COVID-19 and influenza in Democratic Republic of the Congo (DRC). This study aims at analyzing data on SARS-CoV-2, influenza and other respiratory viruses collected during an outbreak response in the rural Province of Panzi to advocate for the strengthening of respiratory virus surveillance systems.

Methods

Routinely collected surveillance data were analyzed following a health alert of increases in acute respiratory infection (ARI) cases and deaths. Oropharyngeal and nasopharyngeal swabs were systematically collected and tested for influenza, SARS-CoV-2, and respiratory pathogens using multiplex RT-PCR. Statistical analysis included descriptive statistics and comparative tests (chi-square/Fisher’s exact test and t-test or Welch test).

Results

Routine surveillance data yielded a total of 5,781 suspected cases, including 108 deaths. Incidence rates peaked in 2025 for ARI (209 per 100,000 people) and for Influenza-Like Illness (approximately 250 per 100,000 people). Children under one year of age remained the most affected throughout the entire duration of the epidemic. A total of 115 biological samples (approximately 2% of suspected cases) were tested and 55 (47.8%) were positive for at least one respiratory pathogen. Influenza was detected in 30 cases (54.5%), SARS-CoV-2 in 15 cases (27.3%). Median patient age was 5 years (range 0.4–75 years), with 36.4% 1-<5 years. Eleven co-infections, meaning at least 2 virus detected in the same individual, were identified. Among them, co-infection of influenza with SARS-CoV-2 occurred in 2 cases (6.7%), with rhinovirus in 2 cases (6.7%), with parainfluenza type1/2 in 1 case (3.3%), with Bocavirus in 1 case (3.3%), and with adenovirus in 1 case (3.3%). Influenza A (H1N1) pdm09 was the sole circulating influenza subtype.

Conclusion

This study documents the co-circulation and co-infection of respiratory viruses, particularly influenza and SARS-CoV-2, despite a small sampling size. These findings emphasize the need to strengthen routine surveillance of respiratory viruses to assess a robust knowledge of co-circulation of respiratory infections and also the clinical impact of the co-infections in DRC.