Assessing the burden of paediatric influenza in Europe: the European Paediatric Influenza Analysis (EPIA) project.
Assessing the burden of paediatric influenza in Europe: the European Paediatric Influenza Analysis (EPIA) project.
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DOI：
10.1007/s00431-010-1164-0
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发表时间：
2010-08
影响因子：
3.6
通讯作者：
Simonsen, Lone
中科院分区：
文献类型：
--
作者：
Paget, W. John;Balderston, Catherine;Casas, Inmaculada;Donker, Ge;Edelman, Laurel;Fleming, Douglas;Larrauri, Amparo;Meijer, Adam;Puzelli, Simona;Rizzo, Caterina;Simonsen, Lone
欧洲儿科流感分析（EPIA）项目是一个多国项目，旨在收集、分析和提供有关欧洲国家儿科流感负担的数据，目的是提供必要的信息，以便就儿童流感免疫接种建议做出循证决策。最初采取的方法是基于欧洲监测网络现有的每周病毒学和年龄特异性流感样疾病（ILI）数据。我们使用一个多重回归模型的指导下，纵向每周模式的流感病毒属性的每周ILI咨询发病率模式，每种流感（子）类型，同时控制呼吸道合胞病毒（RSV）流行的影响。对2002/2003-2008年期间ILI咨询发生率的建模显示，在英格兰、意大利、荷兰和西班牙，在平均季节，以ILI形式就诊的流感感染影响0-4岁和5-14岁儿童的0.3%至9.8%。除西班牙外，0-4岁儿童的这一比率始终较高。在所分析的六个季节中（根据意大利的数据分析了五个季节），该模型将各国初级保健中47-83%的ILI负担归因于流感病毒感染，其中A（H3 N2）病毒发挥了最重要的作用，其次是流感病毒B和A（H1N1）。来自所研究的四个国家的全国季节平均值表明，0.4%至18%的儿童因ILI而咨询医生，百分比取决于国家和卫生保健系统。流感病毒感染解释了所有国家的大多数儿科ILI咨询。下一步将是将EPIA建模方法应用于严重结局指标（即住院和死亡率数据），以生成儿科流感疫苗接种决策所需的一系列完整的轻度和重度流感负担估计值。
The European Paediatric Influenza Analysis (EPIA) project is a multi-country project that was created to collect, analyse and present data regarding the paediatric influenza burden in European countries, with the purpose of providing the necessary information to make evidence-based decisions regarding influenza immunisation recommendations for children. The initial approach taken is based on existing weekly virological and age-specific influenza-like illness (ILI) data from surveillance networks across Europe. We use a multiple regression model guided by longitudinal weekly patterns of influenza virus to attribute the weekly ILI consultation incidence pattern to each influenza (sub)type, while controlling for the effect of respiratory syncytial virus (RSV) epidemics. Modelling the ILI consultation incidence during 2002/2003–2008 revealed that influenza infections that presented for medical attention as ILI affected between 0.3% and 9.8% of children aged 0–4 and 5–14 years in England, Italy, The Netherlands and Spain in an average season. With the exception of Spain, these rates were always higher in children aged 0–4 years. Across the six seasons analysed (five seasons were analysed from the Italian data), the model attributed 47–83% of the ILI burden in primary care to influenza virus infection in the various countries, with the A(H3N2) virus playing the most important role, followed by influenza viruses B and A(H1N1). National season averages from the four countries studied indicated that between 0.4% and 18% of children consulted a physician for ILI, with the percentage depending on the country and health care system. Influenza virus infections explained the majority of paediatric ILI consultations in all countries. The next step will be to apply the EPIA modelling approach to severe outcomes indicators (i.e. hospitalisations and mortality data) to generate a complete range of mild and severe influenza burden estimates needed for decision making concerning paediatric influenza vaccination.
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