Estimation of the National Disease Burden of Influenza-Associated Severe Acute Respiratory Illness in Kenya and Guatemala: A Novel Methodology
Estimation of the National Disease Burden of Influenza-Associated Severe Acute Respiratory Illness in Kenya and Guatemala: A Novel Methodology
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DOI：
10.1371/journal.pone.0056882
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发表时间：
2013-02-27
期刊：
影响因子：
3.7
通讯作者：
Feikin, Daniel R.
中科院分区：
文献类型：
--
作者：
Fuller, James A.;Summers, Aimee;Feikin, Daniel R.
背景：了解低收入国家严重流感的国家疾病负担可以为有关流感治疗和预防的政策决策提供信息。我们提出了一种新的方法，使用本地生成的数据来估计这种负担。方法和发现：该方法首先计算某省5岁儿童住院严重急性呼吸系统疾病（SARI）发病率。然后根据风险因素的流行程度和求医行为对每个省的严重急性呼吸道感染的基本比率进行调整。检测到流感病毒的严重急性呼吸道感染百分比由省级哨点监测确定，并应用于调整后的省级严重急性呼吸道感染住院率。来自医疗保健利用调查的求医数据用于估计非住院流感相关的严重急性呼吸道感染。将住院和非住院流感相关急性呼吸道感染的比率应用于普查数据，以计算全国病例数。利用2009年8月至2011年7月的数据，该方法在肯尼亚进行了实地测试，并在危地马拉进行了验证。在肯尼亚（2009年人口3860万人），每年因流感相关严重急性呼吸道感染住院的5岁儿童病例数为17,129-27,659例（每1,000人0.21-0.24例），具体取决于年份和使用的基本比率。在危地马拉（2011年人口为1 470万人），每年因流感相关肺炎住院的5岁儿童病例数为1 065-2 259例（每1 000人0.5-1.0例），具体取决于年份和所使用的基本比率。在这两个国家，未住院的流感相关病例数比住院病例数倍。结论：流感病毒与肯尼亚和危地马拉大量严重疾病有关。这种方法可以在大多数低收入和中低收入国家实施。
Background: Knowing the national disease burden of severe influenza in low-income countries can inform policy decisions around influenza treatment and prevention. We present a novel methodology using locally generated data for estimating this burden.Methods and Findings: This method begins with calculating the hospitalized severe acute respiratory illness (SARI) incidence for children = 5 years old from population-based surveillance in one province. This base rate of SARI is then adjusted for each province based on the prevalence of risk factors and healthcare-seeking behavior. The percentage of SARI with influenza virus detected is determined from provincial-level sentinel surveillance and applied to the adjusted provincial rates of hospitalized SARI. Healthcare-seeking data from healthcare utilization surveys is used to estimate non-hospitalized influenza-associated SARI. Rates of hospitalized and non-hospitalized influenza-associated SARI are applied to census data to calculate the national number of cases. The method was field-tested in Kenya, and validated in Guatemala, using data from August 2009-July 2011. In Kenya (2009 population 38.6 million persons), the annual number of hospitalized influenza-associated SARI cases ranged from 17,129-27,659 for children = 5 years old (0.21-0.24 per 1,000 persons), depending on year and base rate used. In Guatemala (2011 population 14.7 million persons), the annual number of hospitalized cases of influenza-associated pneumonia ranged from 1,065-2,259 (0.5-1.0 per 1,000 persons) among children = 5 years old, depending on year and base rate used. In both countries, the number of non-hospitalized influenza-associated cases was several-fold higher than the hospitalized cases.Conclusions: Influenza virus was associated with a substantial amount of severe disease in Kenya and Guatemala. This method can be performed in most low and lower-middle income countries.