Rana Himanshu, Parikh Pathik, Shah Asha N, Gandhi Sanjay
Medicine Dept, GMERS Medical College, Gotri, Vadodara.
J Assoc Physicians India. 2012 Feb;60:95-7.
Epidemiology and clinical outcome of H1N1 in Gujarat from July 2009 to March 2010.
This retrospective descriptive study analyses the month wise distribution of suspected as well as confirmed cases of H1N1 with their outcomes in the state of Gujarat from the month of July 2009 to March 4th 2010. The study included only those who were falling in Category C according to the national guidelines. Besides the government hospitals, the data also have been sought from all the private hospitals suspecting and treating swine flu cases. The patients are classified according to age, gender, location, approach to either government or private hospital, duration of symptoms on admission, associated co morbid conditions, the final outcome, duration of death after symptoms and the district wise distribution of sale of Oseltamivir. The incidence ratio for cases and deaths per 10 lakh population is calculated and compared with other states.
28760 patients attended the swine flu ward and the OPD. Out of 5532 suspected severe (Category C) cases, 1486 cases were confirmed positive with positivity ratio of 26.8%. 28% of all suspected and 37.9% of all positive were seen during the month of January. 64.9% cases were seen amongst the young age group of 13 to 45 years. 55.6% cases were seen in men and maximum cases (336) and deaths (54) were seen in Ahmedabad district. Oseltamivir was started after 5 days in 52% of cases. 297 had expired with an overall Case Fatality Rate of 19.9%. Maximum deaths were seen in young age group (13-45 years) with case fatality rate of 19.6%. 41% patients succumbing to disease were referred from Private to government hospitals and overall 35% cases had expired between 1 and 24 hour of admission. 69% patients did not have history of comorbid illness/condition. Gujarat ranked 5th in Case Incidence Rate per 10 lakh population while ranked second in Death Rate per 10 lakh population.
The incidence and mortality from H1N1 in the state was significantly higher in young, more during the winter months. The case fatality rate in Gujarat is higher than rest of the world, the reason being a selection bias created by the categorization of the patients into category A, B and C as only category C patients were admitted and observed. The sale of Oseltamivir after liberalization of sale of the drug has greatly increased.
2009年7月至2010年3月古吉拉特邦甲型H1N1流感的流行病学及临床结局。
本回顾性描述性研究分析了2009年7月至2010年3月4日古吉拉特邦甲型H1N1流感疑似及确诊病例按月份的分布情况及其结局。该研究仅纳入了根据国家指南属于C类的患者。除了政府医院外，还从所有怀疑并治疗猪流感病例的私立医院收集了数据。患者根据年龄、性别、地点、就诊于政府或私立医院的情况、入院时症状持续时间、相关合并症、最终结局、症状出现后死亡时间以及奥司他韦销售的地区分布进行分类。计算每10万人口的病例和死亡发病率，并与其他邦进行比较。
28760名患者前往猪流感病房和门诊。在5532例疑似重症（C类）病例中，1486例确诊为阳性，阳性率为26.8%。所有疑似病例的28%以及所有阳性病例的37.9%出现在1月份。64.9%的病例出现在13至45岁的年轻人群体中。55.6%的病例为男性，艾哈迈达巴德区的病例（336例）和死亡人数（54例）最多。52%的病例在症状出现5天后开始使用奥司他韦。297例患者死亡，总体病死率为19.9%。死亡人数最多的是年轻人群体（13至45岁），病死率为19.6%。41%因该病死亡的患者是从私立医院转诊至政府医院的，总体35%的病例在入院后1至24小时内死亡。69%的患者没有合并症病史。古吉拉特邦每10万人口的病例发病率排名第5，而每10万人口的死亡率排名第2。
该邦甲型H1N1流感的发病率和死亡率在年轻人中显著更高，在冬季月份更为明显。古吉拉特邦的病死率高于世界其他地区，原因是将患者分为A、B和C类造成了选择偏倚，因为仅C类患者被收治和观察。奥司他韦销售自由化后其销量大幅增加。
