Burden of influenza-associated deaths in the Americas, 2002-2008
Burden of influenza-associated deaths in the Americas, 2002-2008
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DOI：
10.1111/irv.12317
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发表时间：
2015-08-01
影响因子：
4.4
通讯作者：
Widdowson, Marc-Alain
中科院分区：
文献类型：
--
作者：
Cheng, Po-Yung;Palekar, Rakhee;Widdowson, Marc-Alain
背景流感是一种疫苗可预防的致病和致死原因。泛美卫生组织（PAHO）区域已投资于流感疫苗，但几乎没有流感负担的估计值来证明这些投资的合理性。我们估计了2002- 2008年期间35个泛美卫生组织国家的流感相关死亡人数。我们使用来自7个国家的呼吸和循环（R&C）代码，这些国家具有不同的流感季节性和高质量的死亡率数据，以Serfling回归模型或负二项模型按年龄组（0-64，65-74和75岁）估计流感相关死亡率。我们计算了这些国家按年龄组划分的所有R&C死亡中归因于流感的百分比（病因分数），并将其应用于13个国家的年龄特异性死亡率，这些国家的死亡率数据良好，但季节性定义不明确。最后，我们将其余15个国家归入世卫组织死亡率分层，并应用从20个国家计算的流感死亡率的年龄和死亡率分层特异性比率。我们总结了每个国家的估计，得出美洲流感死亡的年平均总数和死亡率。结果对于35个泛美卫生组织国家，我们估计，
Background Influenza disease is a vaccine-preventable cause of morbidity and mortality. The Pan American Health Organization (PAHO) region has invested in influenza vaccines, but few estimates of influenza burden exist to justify these investments. We estimated influenza-associated deaths for 35 PAHO countries during 2002-2008.Methods Annually, PAHO countries report registered deaths. We used respiratory and circulatory (R&C) codes from seven countries with distinct influenza seasonality and high-quality mortality data to estimate influenza-associated mortality rates by age group (0-64, 65-74, and 75years) with a Serfling regression model or a negative binomial model. We calculated the percent of all R&C deaths attributable to influenza by age group in these countries (etiologic fraction) and applied it to the age-specific mortality in 13 countries with good mortality data but poorly defined seasonality. Lastly, we grouped the remaining 15 countries into WHO mortality strata and applied the age and mortality stratum-specific rate of influenza mortality calculated from the 20 countries. We summed each country's estimate to arrive at an average total annual number and rate of influenza deaths in the Americas.Results For the 35 PAHO countries, we estimated an annual mean influenza-associated mortality rate of 21/100000 among