School of Public Health, Zhejiang University, Hangzhou, People's Republic of China.
Center for Data Science, Zhejiang University, Hangzhou, People's Republic of China.
Infect Dis Poverty. 2021 Oct 21;10(1):127. doi: 10.1186/s40249-021-00911-7.
School closure is a common mitigation strategy during severe influenza epidemics and pandemics. However, the effectiveness of this strategy remains controversial. In this study, we aimed to explore the effectiveness of school closure on seasonal influenza epidemics in provincial-level administrative divisions (PLADs) with varying urbanization rates in China.
This study analyzed influenza surveillance data between 2010 and 2019 provided by the Chinese National Influenza Center. Taking into consideration the climate, this study included a region with 3 adjacent PLADs in Northern China and another region with 4 adjacent PLADs in Southern China. The effect of school closure on influenza transmission was evaluated by the reduction of the effective reproductive number of seasonal influenza during school winter breaks compared with that before school winter breaks. An age-structured Susceptible-Infected-Recovered-Susceptible (SIRS) model was built to model influenza transmission in different levels of urbanization. Parameters were determined using the surveillance data via robust Bayesian method.
Between 2010 and 2019, in the less urbanized provinces: Hebei, Zhejiang, Jiangsu and Anhui, during school winter breaks, the effective reproductive number of seasonal influenza epidemics reduced 14.6% [95% confidential interval (CI): 6.2-22.9%], 9.6% (95% CI: 2.5-16.6%), 7.3% (95% CI: 0.1-14.4%) and 8.2% (95% CI: 1.1-15.3%) respectively. However, in the highly urbanized cities: Beijing, Tianjin and Shanghai, it reduced only 5.2% (95% CI: -0.7-11.2%), 4.1% (95% CI: -0.9-9.1%) and 3.9% (95% CI: -1.6-9.4%) respectively. In China, urbanization is associated with decreased proportion of children and increased social contact. According to the SIRS model, both factors could reduce the impact of school closure on seasonal influenza epidemics, and the proportion of children in the population is thought to be the dominant influencing factor.
Effectiveness of school closure on the epidemics varies with the age structure in the population and social contact patterns. School closure should be recommended in the low urbanized regions in China in the influenza seasons.
学校关闭是严重流感流行和大流行期间的常见缓解策略。然而，这种策略的效果仍存在争议。本研究旨在探讨学校关闭对中国不同城市化率省级行政单位（PLAD）季节性流感的影响。
本研究分析了中国国家流感中心提供的 2010 年至 2019 年的流感监测数据。考虑到气候因素，该研究包括中国北方 3 个相邻 PLAD 地区和南方 4 个相邻 PLAD 地区。通过比较冬季学期前后季节性流感有效繁殖数的减少，评估学校关闭对流感传播的影响。采用年龄结构的易感-感染-恢复-易感（SIRS）模型来模拟不同城市化水平下的流感传播。使用监测数据通过稳健贝叶斯方法确定参数。
2010 年至 2019 年，在欠发达地区（河北、浙江、江苏和安徽），学校寒假期间季节性流感的有效繁殖数分别减少了 14.6%（95%可信区间：6.2-22.9%）、9.6%（95%可信区间：2.5-16.6%）、7.3%（95%可信区间：0.1-14.4%）和 8.2%（95%可信区间：1.1-15.3%）。然而，在高度城市化的城市（北京、天津和上海），仅减少了 5.2%（95%可信区间：-0.7-11.2%）、4.1%（95%可信区间：-0.9-9.1%）和 3.9%（95%可信区间：-1.6-9.4%）。在中国，城市化与儿童比例下降和社会接触增加有关。根据 SIRS 模型，这两个因素都可能降低学校关闭对季节性流感流行的影响，并且认为人口中儿童的比例是主要的影响因素。
学校关闭对疫情的有效性因人群年龄结构和社会接触模式而异。在中国流感季节，应建议在低城市化地区采取学校关闭措施。
Zotero 插件
