Yu Xinchun, Wang Chunfang, Chen Tao, Zhang Wenyi, Yu Huiting, Shu Yuelong, Hu Wenbiao, Wang Xiling
Department of Biostatistics, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, 200231 Xuhui District, Shanghai, China.
Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
BMC Infect Dis. 2017 Dec 7;17(1):756. doi: 10.1186/s12879-017-2863-1.
Disease burden attributable to influenza is substantial in subtropical regions. Our study aims to estimate excess pneumonia and influenza (P&I) mortality associated with influenza by subtypes/lineages in Shanghai, China, 2010-2015.
Quasi-Poisson regression models were fitted to weekly numbers of deaths from causes coded as P&I for Shanghai general and registered population. Three proxies for influenza activity were respectively used as an explanatory variable. Long-term trend, seasonal trend and absolute humidity were adjusted for as confounding factors. The outcome measurements of excess P&I mortality associated with influenza subtypes/lineages were derived by subtracting the baseline mortality from fitted mortality.
Excess P&I mortality associated with influenza were 0.22, 0.30, and 0.23 per 100,000 population for three different proxies in Shanghai general population, lower than those in registered population (0.34, 0.48, and 0.36 per 100,000 population). Influenza B (Victoria) lineage did not contribute to excess P&I mortality (P = 0.206) while influenza B (Yamagata) lineage did (P = 0.044). Influenza-associated P&I mortality was high in the elderly population.
Seasonal influenza A virus had a higher P&I mortality than influenza B virus, while B (Yamagata) lineage is the dominant lineage attributable to P&I mortality.
在亚热带地区，流感所致的疾病负担相当大。我们的研究旨在估算2010 - 2015年中国上海因流感各亚型/谱系导致的额外肺炎和流感（P&I）死亡率。
采用拟泊松回归模型对上海普通人群和登记人口中编码为P&I的死因每周死亡人数进行拟合。分别使用三个流感活动代理指标作为解释变量。将长期趋势、季节趋势和绝对湿度作为混杂因素进行调整。通过从拟合死亡率中减去基线死亡率得出与流感亚型/谱系相关的额外P&I死亡率的结果测量值。
在上海普通人群中，三种不同代理指标对应的与流感相关的额外P&I死亡率分别为每10万人0.22、0.30和0.23，低于登记人口中的水平（每10万人0.34、0.48和0.36）。B（维多利亚）谱系对额外P&I死亡率无贡献（P = 0.206），而B（山形）谱系有贡献（P = 0.044）。与流感相关的P&I死亡率在老年人群中较高。
季节性甲型流感病毒的P&I死亡率高于乙型流感病毒，而B（山形）谱系是导致P&I死亡率的主要谱系。
