Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
PLoS One. 2013 Aug 8;8(8):e69035. doi: 10.1371/journal.pone.0069035. eCollection 2013.
The disease burden of children with laboratory-confirmed influenza in China has not been well described. The aim of this study was to understand the epidemiology and socio-economic burden of influenza in children younger than 5 years in outpatient and emergency department settings.
A prospective study of laboratory-confirmed influenza among children presenting to the outpatient settings in Soochow University Affiliated Children's Hospital with symptoms of influenza-like illness (ILI) was performed from March 2011 to February 2012. Throat swabs were collected for detection of influenza virus by reverse transcription polymerase chain reaction assay. Data were collected using a researcher administered questionnaire, concerning demographics, clinical characteristics, direct and indirect costs, day care absence, parental work loss and similar respiratory illness development in the family.
Among a total of 6,901 children who sought care at internal outpatient settings, 1,726 (25%) fulfilled the criteria of ILI and 1,537 were enrolled. Influenza was documented in 365 (24%) of enrolled 1,537 ILI cases. Among positive patients, 52 (14%) were type A and 313 (86%) were type B. About 52% of influenza outpatients had over-the-counter medications before physician visit and 41% visited hospitals two or more times. Children who attended daycare missed an average of 1.9 days. For each child with influenza-confirmed disease, the parents missed a mean of 1.8 work days. Similar respiratory symptoms were reported in 43% of family contacts of influenza positive children after onset of the child's illness. The mean direct and indirect costs per episode of influenza were $123.4 for outpatient clinics and $134.6 for emergency departments, and $125.9 for influenza A and $127.5 for influenza B.
Influenza is a common cause of influenza-like illness among children and has substantial socio-economic impact on children and their families regarding healthcare seeking and day care/work absence. The direct and indirect costs of childhood influenza impose a heavy financial burden on families. Prevention measures such as influenza vaccine could reduce the occurrence of influenza in children and the economic burden on families.
中国实验室确诊流感患儿的疾病负担尚未得到充分描述。本研究旨在了解门急诊就诊的 5 岁以下流感患儿的流行病学和社会经济负担。
2011 年 3 月至 2012 年 2 月，对苏州大学附属儿童医院门急诊有流感样症状（ILI）的患儿进行了一项前瞻性实验室确诊流感研究。采集咽拭子，通过逆转录聚合酶链反应（RT-PCR）检测流感病毒。使用研究者管理的问卷收集数据，内容包括人口统计学、临床特征、直接和间接费用、日托缺勤、父母工作损失以及家庭中类似呼吸道疾病的发生情况。
在总共 6901 名在内部门诊就诊的儿童中，1726 名（25%）符合 ILI 标准，其中 1537 名符合纳入标准。在纳入的 1537 例 ILI 病例中，有 365 例（24%）确诊为流感。阳性患者中，52 例（14%）为 A 型，313 例（86%）为 B 型。约 52%的流感门诊患者在就诊前服用了非处方药物，41%的患者就诊次数超过 2 次。上日托的儿童平均缺课 1.9 天。每位流感确诊患儿的父母平均误工 1.8 天。在患儿发病后，43%的流感阳性患儿的家庭接触者出现类似呼吸道症状。流感门诊和急诊的每次发作的直接和间接费用分别为 123.4 美元和 134.6 美元，A 型流感为 125.9 美元，B 型流感为 127.5 美元。
流感是儿童 ILI 的常见病因，对儿童及其家庭的医疗保健寻求和日托/工作缺勤造成了重大的社会经济影响。儿童流感的直接和间接费用给家庭带来了沉重的经济负担。预防措施，如流感疫苗，可减少儿童流感的发生和家庭的经济负担。
