Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis
Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus: a systematic analysis
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DOI：
10.1016/s2214-109x(19)30264-5
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发表时间：
2019-08-01
影响因子：
34.3
通讯作者：
Rosen, Brian
中科院分区：
文献类型：
--
作者：
Li, You;Reeves, Rachel M.;Rosen, Brian
流感病毒、呼吸道合胞病毒、副流感病毒和偏肺病毒是与幼儿（≥ 65岁）急性下呼吸道感染相关的最常见病毒。这些病毒的每月活动的全球报告是必要的，以告知公共卫生战略和计划，以控制theirs.Methods在这个系统性的分析，我们汇编的数据从2000年1月1日和2017年12月31日之间发表的研究的系统性文献综述;在线数据集;和未发表的研究数据。如果研究报告了至少连续12个月的实验室确认的流感病毒、呼吸道合胞病毒、副流感病毒或偏肺病毒或这些病毒组合的人类感染发生率数据，则有资格入选（或52周当量）;报告的所有年份的稳定检测实践;明确界定的地理位置的居民中的病毒结果;以及至少每月一次的病毒聚集结果。通过三个阶段的过程提取数据，从中我们计算出每月的年平均百分比（AAP）作为病毒活动的相对强度。我们将流行持续时间定义为占年度阳性样本的75%的最少月份数，每个组成月份定义为流行月份。此外，我们模拟了流感病毒和呼吸道合胞病毒的月AAP使用特定地点的温度和相对湿度预测当地的平均流行月份。我们还预测了流感病毒和呼吸道合胞病毒在5度乘5度网格上的全球流行月份。本研究的系统评价在PROSPERO注册，编号CRD 42018091628。在排除重复后剩余的21065项研究中，对1081篇全文文章进行了合格性评估，其中185篇被确定为合格。我们纳入了流感病毒的246个位点，呼吸道合胞病毒的183个位点，副流感病毒的83个位点和偏肺病毒的65个位点。在大多数温带地区，流感病毒在冬季有明显的季节性流行，但随着离赤道距离的减小，流行的时间变化更大，季节性更小。与流感病毒不同，呼吸道合胞病毒在温带和热带地区都有明显的季节性流行，从每个半球的热带地区的夏末月份开始，在冬季月份到达大多数温带地区。在大多数温带地区，流感病毒流行晚于呼吸道合胞病毒（0.3个月[95% CI -0.3至0.9]），而在热带地区未观察到明确的时间顺序。副流感病毒流行主要发生在每个半球的春季和初夏。偏肺病毒流行病发生在冬末和春季在大多数温带地区，但流行病的时间是更多样化的热带地区。流感病毒流行在温带地区持续时间较短（3.8个月[3.6至4.0]），在热带地区持续时间较长（5.2个月[4.9至5.5]）。所有研究中心的呼吸道合胞病毒（4.6个月[4.3 - 4.8]）和偏肺病毒（4.8个月[4.4 - 5.1]）的流行持续时间相似。相比之下，副流感病毒的流行持续时间更长（6.3个月[6.0至6.7]）。该模型对流感病毒在温带地区和呼吸道合胞病毒在温带和热带地区的平均流行月份具有较好的预测性。通过留一法交叉验证，疫情发生的总体预测误差在1个月以内（流感病毒-0.2个月[-0.6至0.1];呼吸道合胞病毒0.1个月[-0.2至0.4]）。解释这项研究是第一个提供流感病毒、呼吸道合胞病毒、副流感病毒、和偏肺病毒。我们的模型有助于预测流感病毒和呼吸道合胞病毒流行的当地发病月份。季节性信息对卫生服务规划、呼吸道合胞病毒被动预防的时机、流感病毒和未来呼吸道合胞病毒疫苗接种的策略具有重要意义。版权所有（C）2019作者。爱思唯尔有限公司出版
Background Influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus are the most common viruses associated with acute lower respiratory infections in young children (= 65 years). A global report of the monthly activity of these viruses is needed to inform public health strategies and programmes for their control.Methods In this systematic analysis, we compiled data from a systematic literature review of studies published between Jan 1, 2000, and Dec 31, 2017; online datasets; and unpublished research data. Studies were eligible for inclusion if they reported laboratory-confirmed incidence data of human infection of influenza virus, respiratory syncytial virus, parainfluenza virus, or metapneumovirus, or a combination of these, for at least 12 consecutive months (or 52 weeks equivalent); stable testing practice throughout all years reported; virus results among residents in well-defined geographical locations; and aggregated virus results at least on a monthly basis. Data were extracted through a three-stage process, from which we calculated monthly annual average percentage (AAP) as the relative strength of virus activity. We defined duration of epidemics as the minimum number of months to account for 75% of annual positive samples, with each component month defined as an epidemic month. Furthermore, we modelled monthly AAP of influenza virus and respiratory syncytial virus using site-specific temperature and relative humidity for the prediction of local average epidemic months. We also predicted global epidemic months of influenza virus and respiratory syncytial virus on a 5 degrees by 5 degrees grid. The systematic review in this study is registered with PROSPERO, number CRD42018091628.Findings We initally identified 37 335 eligible studies. Of 21 065 studies remaining after exclusion of duplicates, 1081 full-text articles were assessed for eligibility, of which 185 were identified as eligible. We included 246 sites for influenza virus, 183 sites for respiratory syncytial virus, 83 sites for parainfluenza virus, and 65 sites for metapneumovirus. Influenza virus had clear seasonal epidemics in winter months in most temperate sites but timing of epidemics was more variable and less seasonal with decreasing distance from the equator. Unlike influenza virus, respiratory syncytial virus had clear seasonal epidemics in both temperate and tropical regions, starting in late summer months in the tropics of each hemisphere, reaching most temperate sites in winter months. In most temperate sites, influenza virus epidemics occurred later than respiratory syncytial virus (by 0.3 months [95% CI -0.3 to 0.9]) while no clear temporal order was observed in the tropics. Parainfluenza virus epidemics were found mostly in spring and early summer months in each hemisphere. Metapneumovirus epidemics occurred in late winter and spring in most temperate sites but the timing of epidemics was more diverse in the tropics. Influenza virus epidemics had shorter duration (3.8 months [3.6 to 4.0]) in temperate sites and longer duration (5.2 months [4.9 to 5.5]) in the tropics. Duration of epidemics was similar across all sites for respiratory syncytial virus (4.6 months [4.3 to 4.8]), as it was for metapneumovirus (4.8 months [4.4 to 5.1]). By comparison, parainfluenza virus had longer duration of epidemics (6.3 months [6.0 to 6.7]). Our model had good predictability in the average epidemic months of influenza virus in temperate regions and respiratory syncytial virus in both temperate and tropical regions. Through leave-one-out cross validation, the overall prediction error in the onset of epidemics was within 1 month (influenza virus -0.2 months [-0.6 to 0.1]; respiratory syncytial virus 0.1 months [-0.2 to 0.4]).Interpretation This study is the first to provide global representations of month-by-month activity of influenza virus, respiratory syncytial virus, parainfluenza virus, and metapneumovirus. Our model is helpful in predicting the local onset month of influenza virus and respiratory syncytial virus epidemics. The seasonality information has important implications for health services planning, the timing of respiratory syncytial virus passive prophylaxis, and the strategy of influenza virus and future respiratory syncytial virus vaccination. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.