Using an online survey of healthcare-seeking behaviour to estimate the magnitude and severity of the 2009 H1N1v influenza epidemic in England.
Using an online survey of healthcare-seeking behaviour to estimate the magnitude and severity of the 2009 H1N1v influenza epidemic in England.
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DOI：
10.1186/1471-2334-11-68
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发表时间：
2011-03-16
影响因子：
3.7
通讯作者：
Eames KT
中科院分区：
文献类型：
--
作者：
Brooks-Pollock E;Tilston N;Edmunds WJ;Eames KT
在2009年H1N1v流感疫情期间，结合流感样疾病咨询、病毒学监测和对求医行为的假设估计了有症状病例的总数。由于科学信息变化、媒体报道和公众焦虑而导致的就医行为变化不包括在病例估计中。这项研究的目的是通过量化在2009年H1N1v流感疫情期间进行的基于互联网的调查来量化寻求医疗保健的行为，以改进对英国H1N1v症状病例数量和病死率(CFR)的估计。我们使用了一项从2009年7月至2010年3月连续进行的在线调查，以估计在2009年H1N1v流感疫情期间寻求医疗保健的ILI病例的比例。我们使用动态的年龄和性别相关的就医行为衡量标准来重新解释咨询数字，并估计2009年症状性ILI病例的真实数量和病死率(CFR)。不同年龄组之间在医疗保健使用方面存在显著差异。从疫情开始到疫情结束，有流感样症状的患者就医的比例从43%下降到32%(p<；0.0001)。相应地调整官方数字，我们估计英国有110万个有症状的病例，比之前估计的多32万例(40%)，秋季的疫情浪潮比之前估计的大45%。将有症状的病例数量与报告的死亡人数相结合，导致CFR估计的总体死亡人数减少，每10万例中有17人死亡，其中成年人的下降幅度最大。可以使用新的数据收集方法实现对就医行为的主动监测，这对于提供对疫情规模和疾病严重程度的准确实时估计至关重要。不同人群之间寻求医疗保健的差异以及随时间的变化对总病例数量和病死率的估计具有重大影响。
During the 2009 H1N1v influenza epidemic, the total number of symptomatic cases was estimated by combining influenza-like illness (ILI) consultations, virological surveillance and assumptions about healthcare-seeking behaviour. Changes in healthcare-seeking behaviour due to changing scientific information, media coverage and public anxiety, were not included in case estimates. The purpose of the study was to improve estimates of the number of symptomatic H1N1v cases and the case fatality rate (CFR) in England by quantifying healthcare-seeking behaviour using an internet-based survey carried out during the course of the 2009 H1N1v influenza epidemic. We used an online survey that ran continuously from July 2009 to March 2010 to estimate the proportion of ILI cases that sought healthcare during the 2009 H1N1v influenza epidemic. We used dynamic age- and gender-dependent measures of healthcare-seeking behaviour to re-interpret consultation numbers and estimate the true number of cases of symptomatic ILI in 2009 and the case fatality rate (CFR). There were significant differences between age groups in healthcare usage. From the start to the end of the epidemic, the percentage of individuals with influenza-like symptoms who sought medical attention decreased from 43% to 32% (p < 0.0001). Adjusting official numbers accordingly, we estimate that there were 1.1 million symptomatic cases in England, over 320,000 (40%) more cases than previously estimated and that the autumn epidemic wave was 45% bigger than previously thought. Combining symptomatic case numbers with reported deaths leads to a reduced overall CFR estimate of 17 deaths per 100,000 cases, with the largest reduction in adults. Active surveillance of healthcare-seeking behaviour, which can be achieved using novel data collection methods, is vital for providing accurate real-time estimates of epidemic size and disease severity. The differences in healthcare-seeking between different population groups and changes over time have significant implications for estimates of total case numbers and the case fatality rate.
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通讯作者：
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