Soudani Samira, Mafi Alireza, Al Mayahi Zayid, Al Balushi Sultan, Dbaibo Ghassan, Al Awaidy Salah, Amiche Amine
Sanofi Pasteur, OneJLT 3rd floor, Dubai, UAE.
Sanofi Pasteur, Istanbul, Turkey.
Infect Dis Ther. 2022 Feb;11(1):15-52. doi: 10.1007/s40121-021-00534-3. Epub 2022 Jan 8.
Seasonal influenza represents a huge health burden, resulting in significant mortality and morbidity. Following the 2009 H1N1 pandemic, focus has been directed on the burden of influenza globally. Country and regional disease burden estimates play important roles in helping inform decisions on national influenza intervention programmes. Despite improvements in influenza surveillance following the 2009 pandemic, many opportunities remain unexplored in the Eastern Mediterranean and North African (EMNA) region, which has a high prevalence of patients with chronic disease and thus a population at high risk of influenza complications. We conducted a systematic literature review of Embase, Medline, Scopus and the Cochrane Database of Systematic Reviews from 1 January 1998 to 31 January 2020 covering the EMNA region with the aim to describe the epidemiology of influenza in the region and assess the influenza epidemiological surveillance research landscape. Relevant data on study characteristics, population, clinical/virology characteristics and epidemiology were extracted and summarised descriptively. Of the 112 studies identified for inclusion, 90 were conducted in the Eastern Mediterranean region, 19 in North Africa and three across the EMNA region. Data were reported on 314,058 laboratory-confirmed influenza cases, 96 of which were derived from surveillance systems. Amongst the surveillance studies, the percentage of positive cases reported ranged from 1% to 100%. The predominantly identified influenza strain was strain A; H1N1 was the most prominent circulating subtype. Typing was performed in approximately 75% and subtyping in 50% of studies, respectively. Data on those considered most at risk for influenza complications were collected in 21% of studies, highlighting a regional gap for these data. Our review reveals existing gaps in regional estimates of influenza health and economic burden, hospitalisation rates and duration, and highlights the need for robust and high-quality epidemiology data to help inform public health interventions.
季节性流感造成了巨大的健康负担，导致大量死亡和发病。2009年甲型H1N1流感大流行之后，全球流感负担成为关注焦点。国家和地区疾病负担估计对于为国家流感干预计划提供决策依据发挥着重要作用。尽管2009年大流行后流感监测有所改善，但东地中海和北非（EMNA）地区仍有许多机会未被探索，该地区慢性病患者患病率高，因此是流感并发症的高危人群。我们对1998年1月1日至2020年1月31日期间Embase、Medline、Scopus和Cochrane系统评价数据库进行了系统文献综述，涵盖EMNA地区，旨在描述该地区流感流行病学情况，并评估流感流行病学监测研究状况。提取了有关研究特征、人群、临床/病毒学特征和流行病学的相关数据，并进行描述性总结。在确定纳入的112项研究中，90项在东地中海地区进行，19项在北非进行，3项在整个EMNA地区进行。报告了314,058例实验室确诊流感病例的数据，其中96例来自监测系统。在监测研究中，报告的阳性病例百分比从1%到100%不等。主要鉴定出的流感毒株为甲型；H1N1是最主要的流行亚型。分别在约75%的研究中进行了分型，在50%的研究中进行了亚型分型。21%的研究收集了有关那些被认为流感并发症风险最高人群的数据，凸显了这些数据方面的地区差距。我们的综述揭示了在流感健康和经济负担、住院率和住院时长的地区估计方面存在的差距，并强调需要可靠和高质量的流行病学数据来为公共卫生干预提供依据。
