| 张婉青,陈立凌,成芳芳,代子瑞,冯爽,张钧,田健美,张涛,赵根明.苏州地区2011-2017年5岁以下儿童流感相关严重急性呼吸道感染临床症状和影响因素研究[J].Chinese journal of Epidemiology,2021,42(6):1044-1049 |
| 苏州地区2011-2017年5岁以下儿童流感相关严重急性呼吸道感染临床症状和影响因素研究 |
| Study on clinical symptoms and influencing factors of influenza-associated severe acute respiratory illness in children younger than 5 years old in Suzhou of China, 2011-2017 |
| Received:August 31, 2020 |
| DOI：10.3760/cma.j.cn112338-20200831-01113 |
| KeyWord: 儿童 流感 住院 影响因素 |
| English Key Word: Children Influenza Hospitalization Influencing factor |
| FundProject:中美新发和再发传染病合作项目（5U2GGH000018）；上海市公共卫生体系建设三年行动计划（2020-2022）重点学科建设（GWV-10.1-XK16） |
| Author Name | Affiliation | E-mail | | Zhang Wanqing | Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China | | | Chen Liling | Department of Infectious Disease Prevention and Control, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China | | | Cheng Fangfang | Department of Infection, Children's Hospital of Soochow University, Suzhou 215003, China | | | Dai Zirui | Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China | | | Feng Shuang | Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China | | | Zhang Jun | Department of Infectious Disease Prevention and Control, Suzhou Center for Disease Control and Prevention, Suzhou 215004, China | | | Tian Jianmei | Department of Infection, Children's Hospital of Soochow University, Suzhou 215003, China | | | Zhang Tao | Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China | | | Zhao Genming | Department of Epidemiology, School of Public Health, Fudan University/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China | gmzhao@shmu.edu.cn |
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| Abstract: |
| 目的 探讨江苏省苏州地区<5岁儿童流感相关严重急性呼吸道感染（SARI）的影响因素，为完善儿童流感防控策略提供证据支持。方法 基于2011年4月至2017年3月在苏州大学附属儿童医院持续开展的前瞻性流感监测的相关数据，χ2检验比较流感相关流感样疾病（ILI）和流感相关SARI之间的临床特征，非条件logistic回归分析流感相关SARI的影响因素。结果 共收集流感相关ILI 786例，流感相关SARI 413例。咳嗽、流涕、气促、哮喘/喘息等临床症状在流感相关SARI中出现的比例显著高于流感相关ILI（P<0.01）。单因素和多因素logistic回归分析结果显示，年龄<6月龄（OR=3.6）、6~23月龄（aOR=2.5）、3个月内呼吸道感染史（aOR=4.5）、慢性肺部疾病史（OR=3.4）、发热热峰39.0~39.9℃（aOR=2.4）、≥40℃（aOR=6.0）、甲型（H1N1）（aOR=2.3）和甲型（H3N2）（aOR=1.9）流感病毒感染是流感相关SARI的影响因素。结论 年龄<2岁、有慢性肺部疾病史、有3个月内呼吸系统感染史以及发热热峰≥39.0℃的儿童应尽早就医，或每年接种流感疫苗，以减少流感相关严重结局的发生。 |
| English Abstract: |
| Objective To study the influencing factors of influenza-associated severe acute respiratory illness (SARI) in children younger than 5 years of old in Suzhou, and to provide evidence to support the improvement of prevention and control strategies for influenza in children.Methods We conducted a prospective influenza surveillance for hospitalized SARI and outpatient influenza-like illness (ILI) at Children's Hospital of Soochow University from April 2011 to March 2017. We compared the clinical and other characteristics of influenza-positive patients with SARI to those with ILI to find the differences and to identify influencing factors of influenza-associated SARI, using χ2test and unconditional logistic regression.Results We found 786 cases of influenza-associated ILI and 413 cases of influenza-associated SARI during the study period. Cough, runny nose, shortness of breath, asthma or wheezing were more common in influenza-associated SARI than in influenza-associated ILI (P<0.01). Univariate and multivariate logistic regression showed that the influencing factors which significantly associated with increased risk of influenza-associated SARI were as follows:younger age (<6 months OR=3.6, 6-23 months aOR=2.5), respiratory infection history within 3 months (aOR=4.5), chronic lung disease history (OR=3.4), fever above 39.0℃ (39.0-39.9℃ aOR=2.4, ≥ 40.0℃ aOR=6.0), and the presence of A/H1N1 (aOR=2.3), A/H3N2 (aOR=1.9). Conclusion Children younger than 2 years old, with a history of chronic lung disease, a history of respiratory infection within 3 months, or with a fever peak above 39.0℃ should seek medical advice as soon as possible or receive annual influenza vaccination to reduce the incidence of influenza-associated serious outcomes. |
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