Pan American Health Organization/World Health Organization, Washington, DC, United States of America.
Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
PLoS One. 2019 Sep 6;14(9):e0221479. doi: 10.1371/journal.pone.0221479. eCollection 2019.
Despite having influenza vaccination policies and programs, countries in the Americas underutilize seasonal influenza vaccine, in part because of insufficient evidence about severe influenza burden. We aimed to estimate the annual burden of influenza-associated respiratory hospitalizations in the Americas.
Thirty-five countries in the Americas with national influenza surveillance were invited to provide monthly laboratory data and hospital discharges for respiratory illness (International Classification of Diseases 10th edition J codes 0-99) during 2010-2015. In three age-strata (<5, 5-64, and ≥65 years), we estimated the influenza-associated hospitalizations rate by multiplying the monthly number of respiratory hospitalizations by the monthly proportion of influenza-positive samples and dividing by the census population. We used random effects meta-analyses to pool age-group specific rates and extrapolated to countries that did not contribute data, using pooled rates stratified by age group and country characteristics found to be associated with rates.
Sixteen of 35 countries (46%) contributed primary data to the analyses, representing 79% of the America's population. The average pooled rate of influenza-associated respiratory hospitalization was 90/100,000 population (95% confidence interval 61-132) among children aged <5 years, 21/100,000 population (13-32) among persons aged 5-64 years, and 141/100,000 population (95-211) among persons aged ≥65 years. We estimated the average annual number of influenza-associated respiratory hospitalizations in the Americas to be 772,000 (95% credible interval 716,000-829,000).
Influenza-associated respiratory hospitalizations impose a heavy burden on health systems in the Americas. Countries in the Americas should use this information to justify investments in seasonal influenza vaccination-especially among young children and the elderly.
尽管有流感疫苗接种政策和计划，美洲国家仍未能充分利用季节性流感疫苗，部分原因是缺乏关于严重流感负担的充分证据。我们旨在估计美洲地区与流感相关的呼吸道住院的年度负担。
邀请 35 个具有国家流感监测的美洲国家提供 2010-2015 年期间每月的呼吸道疾病（国际疾病分类第 10 版 J 编码 0-99）的实验室数据和住院数据。在三个年龄组（<5 岁、5-64 岁和≥65 岁）中，我们通过将每月呼吸道住院人数乘以每月流感阳性样本比例并除以人口普查人口来估计与流感相关的住院率。我们使用随机效应荟萃分析来汇总年龄组特异性比率，并使用按年龄组和与比率相关的国家特征分层的汇总比率来推断未提供数据的国家。
35 个国家中的 16 个（46%）国家为分析提供了主要数据，占美洲人口的 79%。平均汇总比率为<5 岁儿童的 90/100,000 人（95%置信区间 61-132），5-64 岁人群的 21/100,000 人（13-32），≥65 岁人群的 141/100,000 人（95-211）。我们估计，美洲地区与流感相关的呼吸道住院的平均年人数为 772,000 人（95%可信区间 716,000-829,000）。
与流感相关的呼吸道住院给美洲的卫生系统带来了沉重负担。美洲国家应利用这一信息为季节性流感疫苗接种投资提供依据-特别是在儿童和老年人中。
