This analysis used national sentinel surveillance data collected at nine hospital-based SARI sentinel sites across Cambodia between 2020 and 2024. The design was a retrospective, cross-sectional analysis of routinely collected hospital surveillance records to describe epidemiological patterns, temporal trends of influenza and SARS-CoV-2, and determinants of laboratory-confirmed SARI positivity.
A total of 16,739 hospitalised patients met the SARI case definition and were included in the analysis. The median age of participants was 16 years (IQR = 59). Overall, 54.6% of included patients were male. Across the study period, 13.5% of SARI cases were laboratory-confirmed as either influenza or SARS-CoV-2; this combined positivity was the primary outcome measure reported.
The surveillance captured a dynamic pattern of viral circulation over the five-year period with year-to-year changes in dominant subtypes and the appearance of new detections:
In late 2023, surveillance identified sporadic A(H5N1) cases among SARI patients.
The source notes a high mortality rate in 2021, coinciding with substantial SARS-CoV-2 activity. No detailed mortality counts, rates by year, or breakdown by age or diagnosis were provided in the source text. Additional outcome details and cause-specific mortality were not reported in the provided summary.
The investigators performed descriptive and bivariate analyses followed by multivariable logistic regression to identify factors independently associated with SARI-confirmed positivity (influenza or SARS-CoV-2). Key adjusted associations reported in the source include:
The source did not report other covariates, interaction terms, model fit statistics, or the full list of variables included in the multivariable model in the summary text.
Findings indicate an overall increase in SARI trends over the surveillance period and annual shifts in the dominant influenza subtypes, with periods of intense SARS-CoV-2 circulation overlapping. The high mortality observed in 2021 highlights the severe clinical impact during peak SARS-CoV-2 activity in Cambodia. The analysis identified age group, region, year, and season as significant factors associated with SARI-confirmed positivity. Based on these results, the authors recommend prioritising targeted interventions and preventive measures for identified high-risk groups and settings.
Several details were not reported in the supplied summary and therefore cannot be asserted here. Specifically, the source summary did not include numeric year-by-year counts of infections or deaths, detailed age-stratified incidence rates, denominators for site-specific positivity, vaccination status of patients, the p-value associated with the Phnom Penh regional comparison, or the complete list of covariates entered into the multivariable model. The surveillance design is hospital-based and sentinel in scope; representativeness for the entire country was not detailed in the provided text.
Overall, the sentinel surveillance dataset from nine hospitals over 2020–2024 documented shifting patterns of influenza and SARS-CoV-2 among hospitalised SARI patients and identified specific demographic, seasonal, and geographic correlates of laboratory-confirmed respiratory virus detection, supporting targeted public health action.