WHO Collaborating Centre for Infectious Disease Epidemiology and Control,School of Public Health,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong Special Administrative Region,China.
Center for Communicable Disease Dynamics,Department of Epidemiology,Harvard TH Chan School of Public Health,Boston, MA,USA.
Epidemiol Infect. 2019 Jan;147:e217. doi: 10.1017/S0950268819001067.
Statistical models are commonly employed in the estimation of influenza-associated excess mortality that, due to various reasons, is often underestimated by laboratory-confirmed influenza deaths reported by healthcare facilities. However, methodology for timely and reliable estimation of that impact remains limited because of the delay in mortality data reporting. We explored real-time estimation of influenza-associated excess mortality by types/subtypes in each year between 2012 and 2018 in Hong Kong using linear regression models fitted to historical mortality and influenza surveillance data. We could predict that during the winter of 2017/2018, there were ~634 (95% confidence interval (CI): (190, 1033)) influenza-associated excess all-cause deaths in Hong Kong in population ⩾18 years, compared to 259 reported laboratory-confirmed deaths. We estimated that influenza was associated with substantial excess deaths in older adults, suggesting the implementation of control measures, such as administration of antivirals and vaccination, in that age group. The approach that we developed appears to provide robust real-time estimates of the impact of influenza circulation and complement surveillance data on laboratory-confirmed deaths. These results improve our understanding of the impact of influenza epidemics and provide a practical approach for a timely estimation of the mortality burden of influenza circulation during an ongoing epidemic.
统计模型常用于估计流感相关超额死亡率，由于各种原因，医疗机构报告的实验室确诊流感死亡人数往往低估了这一数字。然而，由于死亡率数据报告的延迟，及时可靠地估计这种影响的方法仍然有限。我们使用历史死亡率和流感监测数据拟合的线性回归模型，探索了 2012 年至 2018 年期间香港每年按类型/亚型实时估计流感相关超额死亡率的方法。我们可以预测，在 2017/2018 年冬季，香港 18 岁及以上人群中与流感相关的全因超额死亡人数约为 634 人（95%置信区间（CI）：（190，1033）），而报告的实验室确诊死亡人数为 259 人。我们估计流感与老年人的大量超额死亡有关，这表明应在该年龄组实施控制措施，如使用抗病毒药物和接种疫苗。我们开发的方法似乎提供了流感流行对死亡率影响的可靠实时估计，并补充了对实验室确诊死亡人数的监测数据。这些结果提高了我们对流感流行影响的理解，并为在当前流行期间及时估计流感流行的死亡率负担提供了一种实用方法。
