Influenza-associated disease burden in mainland China: a systematic review and meta-analysis.
Influenza-associated disease burden in mainland China: a systematic review and meta-analysis.
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中国大陆与流感相关的疾病负担：系统评价和荟萃分析。
DOI：
10.1038/s41598-021-82161-z
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发表时间：
2021-02-03
影响因子：
4.6
通讯作者：
Yu H
中科院分区：
文献类型：
--
作者：
Li J;Chen Y;Wang X;Yu H
流感导致大量发病率和死亡率。已经开展了许多原始研究来估计中国大陆流感的疾病负担，但完整的疾病负担尚未得到系统评价。我们进行了系统回顾和荟萃分析，以评估中国大陆流感相关死亡率、住院治疗和门诊就诊的负担。我们检索了 3 个英文数据库和 4 个中文数据库，其中包含 2005 年至 2019 年发表的研究。分析中纳入了报告季节性流感导致的基于人群的死亡率、住院率或门诊就诊率的研究。固定效应或随机效应模型用于根据异质性程度计算流感相关死亡率的汇总估计值。应用元回归来探索异质性的来源。通过漏斗图和艾格检验评估发表偏倚。我们确定了 30 项符合纳入条件的研究，其中 17 项、8 项、5 项研究分别报告了与流感相关的死亡率、住院情况和门诊就诊情况。所有年龄段和 65 岁以上年龄组的流感相关全因死亡率分别为每 10 万人 14.33 例和 122.79 例。研究在年龄组、死因、统计模型、地理位置和研究时期等方面存在高度异质性，这些因素可以解释流感相关死亡率的60.14%的异质性。流感相关全因死亡率的估计不存在显着的发表偏倚。据观察，年龄 <<5 岁的儿童因流感相关住院和流感样疾病门诊就诊率最高。年龄≥65岁和<5岁的人群是流感死亡和发病负担的主要原因，这需要中国大陆针对老年人和幼儿制定有针对性的疫苗接种政策。
Influenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.
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