| 于佳,张涛,王胤,高君玫,华军,田健美,丁云芳,张钧,陈立凌,李健琴,赵根明.苏州市2011-2017年5岁以下儿童流感门诊病例临床特征及疾病负担[J].Chinese journal of Epidemiology,2018,39(6):847-851 |
| 苏州市2011-2017年5岁以下儿童流感门诊病例临床特征及疾病负担 |
| Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 |
| Received:October 09, 2017 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.06.029 |
| KeyWord: 流行性感冒 儿童 临床症状 疾病负担 |
| English Key Word: Influenza Children Clinical characteristics Economic burden |
| FundProject:中美新发和再发传染病合作项目（5U2GGH000018）；第四轮公共卫生三年行动计划重点学科建设项目（15GWZK0101）；苏州市临床重点病种诊疗技术专项项目；苏州市重点学科；江苏省临床重点专科 |
| Author Name | Affiliation | E-mail | | Yu Jia | School of Public Health, Fudan University, Shanghai 200032, China | | | Zhang Tao | School of Public Health, Fudan University, Shanghai 200032, China | | | Wang Yin | School of Public Health, Fudan University, Shanghai 200032, China | | | Gao Junmei | School of Public Health, Fudan University, Shanghai 200032, China | | | Hua Jun | Soochow University Affiliated Children's Hospital, Suzhou 215003, China | | | Tian Jianmei | Soochow University Affiliated Children's Hospital, Suzhou 215003, China | | | Ding Yunfang | Soochow University Affiliated Children's Hospital, Suzhou 215003, China | | | Zhang Jun | Suzhou Center for Disease Control and Prevention, Suzhou 215000, China | | | Chen Liling | Suzhou Center for Disease Control and Prevention, Suzhou 215000, China | | | Li Jianqin | Soochow University Affiliated Children's Hospital, Suzhou 215003, China | | | Zhao Genming | School of Public Health, Fudan University, Shanghai 200032, China | gmzhao@shmu.edu.cn |
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| Abstract: |
| 目的 了解2011-2017年苏州大学附属儿童医院<5岁儿童流感样病例（ILI）临床特征及疾病负担。方法 2011年3月至2017年2月于苏州市儿童医院监测因流感样疾病就诊的<5岁门诊病例，通过问卷调查和电话随访收集人口学信息、临床信息、疾病史及与医疗有关的直接和间接费用，比较ILI及不同流感亚型确诊病例的临床特征和社会经济负担。结果 共纳入6 310例，其中791例（12.9%）流感病毒检测阳性，其中A/H1N1阳性88例（11.1%），A/H3N2阳性288例（36.4%），B型415例（52.5%）。流感阳性儿童发生咳嗽、流涕、喘息、呕吐、抽搐的比例皆高；A/H1N1、A/H3N2、B型感染导致临床特征的主要差异为咳嗽（χ2=9.227，P=0.010）、喘息（χ2=7.273，P=0.026）和呕吐（χ2=8.163，P=0.017）。流感病毒阴性者治疗平均费用688.4（95%CI：630.1~746.7）元，流感病毒阳性者为768.0（95%CI：686.8~849.3）元。A/H1N1阳性者治疗总费用明显高于A/H3N2阳性和B型阳性者（χ2=7.237，P=0.028）。结论 儿童感染流感病毒更易发生咳嗽、流涕、喘息、呕吐、抽搐等临床症状，并造成严重的疾病负担，其中A/H1N1亚型感染造成的疾病负担高于其他2种亚型。 |
| English Abstract: |
| Objective To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017.Methods From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI.Results We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415 (52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ2=9.227, P=0.010), wheezing (χ2=7.273, P=0.026) and vomiting (χ2=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95% CI:630.1-746.7) for influenza-negative children; 768.0 Yuan (95% CI:686.8-849.3) for influenza-positive children and 738.3 Yuan (95% CI:655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ2=7.237, P=0.028).Conclusion Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes. |
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