Influenza-associated mortality in Hong Kong
Influenza-associated mortality in Hong Kong
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DOI：
10.1086/425315
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发表时间：
2004-12-01
影响因子：
11.8
通讯作者：
Peiris, JSM
中科院分区：
文献类型：
--
作者：
Wong, CM;Chan, KP;Peiris, JSM
背景资料。亚热带和热带地区国家流感对死亡率的影响没有得到很好的量化。在气候温暖的地区估计流感相关疾病更加困难，因为病毒传播的季节性不太明确。部分由于这些因素，流感疫苗在热带地区的使用严重不足，即使是对65岁以上的人也是如此。每周的死亡人数以泊松回归为模型，并估计了1996-1999年香港因流感而额外死亡的人数。通过比较流感高发期和流感低发期的每周死亡率，得出流感相关死亡率的替代估计。根据泊松模型得出的估算值表明，在40-65岁的人群中，流感每年导致每100,000人死于心肺疾病的人数为7.3%(95%可信区间，3.1-11.4)，在65岁以上的人群中，每年每100,000人死于心肺疾病的人数为102.0人(95%可信区间，61.2-142.7)。虽然呼吸系统疾病占流感相关死亡的大多数，但流感也占与缺血性心脏病相关死亡的13.8%(95%可信区间，4.8%~22.7%)和5.3%(95%可信区间，1.2%~9.3%)。流感与缺血性心脏病以及呼吸系统疾病造成的死亡有关。在气候温暖的地区，如香港，与流感相关的总体死亡率与温带地区的记录相当。需要重新评估热带地区接种流感疫苗的必要性。
Background. The impact of influenza on mortality in countries in subtropical and tropical regions is poorly quantified. Estimation of influenza-related illness in warm-climate regions is more difficult, because the seasonality of virus circulation is less well-defined. Partly as a result of these factors, influenza vaccine is grossly underutilized in the tropics, even for individuals greater than or equal to 65 years of age.Methods. Weekly numbers of deaths were modeled by Poisson regression, and excess deaths attributable to influenza in Hong Kong were estimated for 1996 - 1999. Comparison of weekly mortality during periods of influenza predominance and periods of low influenza activity was used to derive an alternative estimate of influenza-associated mortality.Results. Estimates derived from the Poisson model indicated that influenza resulted in 7.3 deaths per 100,000 population per year ( 95% confidence interval [CI], 3.1 - 11.4) from cardiorespiratory disease among individuals aged 40 - 65 years and 102.0 deaths per 100,000 per population per year ( 95% CI, 61.2 - 142.7) among individuals aged greater than or equal to 65 years. Although respiratory diseases accounted for the majority of influenza-related deaths, influenza also contributed to 13.8% ( 95% CI, 4.8% - 22.7%) and 5.3% ( 95% CI, 1.2% - 9.3%) of deaths related to ischemic heart disease.Conclusion. Influenza is associated with deaths due to ischemic heart disease as well from respiratory diseases. Overall influenza-associated mortality in a region with a warm climate, such as Hong Kong, is comparable with that documented in temperate regions. The need for influenza vaccination in tropical regions needs to be reassessed.