杭州市儿童流感病例的疾病负担研究(2021—2023年)  

Disease burden of influenza in children in Hangzhou (2021-2023)

作　　者：朱一 李莉[2] 王慎玉 考庆君[1] 孙昼[4] Zhu Yi;Li Li;Wang Shenyu;Kao Qingjun;Sun Zhoua(Office of Public Health Emergency Response,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China;Department of Public Health Hazards Surveillance,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China;Department of Immunization,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Department of AIDS/STDs Control and Prevention,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China)

机构地区：[1]杭州市疾病预防控制中心公共卫生应急办,杭州310021 [2]杭州市疾病预防控制中心健康危害因素监测所,杭州310021 [3]浙江省疾病预防控制中心免疫所,杭州310051 [4]杭州市疾病预防控制中心艾滋病性病防制所,杭州310021

出　　处：《国际流行病学传染病学杂志》2024年第5期300-306,共7页International Journal of Epidemiology and Infectious Disease

基　　金：杭州市医药卫生科技计划(A20200444、ZD20230076)。

摘　　要：目的了解杭州市儿童流感疾病负担情况。方法基于"中国疾病监测信息报告管理系统", 采用分层抽样法, 分别抽取2021年11月至2022年3月、2022年11月至2023年3月报告的现住址为杭州市的3~18岁流感病例作为调查对象, 采用自行设计的调查表, 测算流感病例直接经济负担、间接经济负担和总经济负担以及健康相关生命质量。结果共收集到474例调查对象的有效信息, 年龄为(10.45±4.28)岁, 其中男性248例(52.32%, 248/474), 门诊病例442例(93.25%, 442/474);直接经济负担、间接费用和总经济负担分别为474.08(315.00, 705.86)、0(0, 420.00)和597.25(385.88, 1 145.35)元。6~11岁年龄段直接经济负担为556.76(330.75, 835.64)元, 高于其他年龄段(H=8.248,P=0.016), 住院病例直接经济负担、间接费用和总经济负担分别为2 698.50(1 685.25, 3 976.61)、1 050.00(630.00, 1 921.50)和3 990.00(2 917.50, 5 270.83)元, 均高于门诊病例(Z=-8.492、-7.310和-8.624, 均P<0.001), 门诊就诊次数≥3次者直接经济负担、间接费用和总经济负担分别为705.60(544.36, 1 164.19)、0(0, 945.00)和915.08(599.21, 1 910.87)元, 为组内最高(H=91.447、13.892和73.155, 均P<0.001), 有过敏性鼻炎和鼻窦炎等病史者直接经济负担与总经济负担分别为575.40(363.83, 912.77)和761.75(400.71, 1 714.39)元, 均高于无病史者(Z=-2.708和-2.264, P=0.007和0.024)。流感期间健康效用值为0.78(0.70, 0.87), 低于日常非患病时(Z=-18.283,P<0.001), 住院病例健康效用值为0.53(0.43, 0.71), 低于门诊病例(Z=-5.852,P<0.001)。结论杭州市儿童流感疾病负担较高。建议针对低年龄、有过敏性鼻炎和鼻窦炎病史的儿童, 积极采取开展流感疫苗接种等措施降低流感发病及其疾病负担。Objective:To explore the disease burden of influenza among children in Hangzhou.Methods:Based on National Notifiable Disease Surveillance System,influenza cases aged 3-18 years reported from November 2021 to March 2022 and from November 2022 to March 2023 in Hangzhou,were selected by stratified sampling.A self-designed questionnaire was utilized to assess the direct,indirect and total economic burden,as well as health-related quality of life(HRQoL)of influenza cases.Results:A total of 474 cases was collected,with an average age of(10.45±4.28)years.There were 248(52.32%,248/474)male cases and 442(93.25%,442/474)outpatients.The medians for direct,indirect and total economic burden were 474.08(315.00,705.86),0(0,420.00)and 597.25(385.88,1145.35)yuan,respectively.The direct economic burden for the 6-11 age group was 556.76(330.75,835.64)yuan,which was higher than that of other age groups(H=8.248,P=0.016).For hospitalized cases,the direct,indirect and total economic burden were 2698.50(1685.25,3976.61),1050.00(630.00,1921.50),and 3990.00(2917.50,5270.83)yuan,respectively,which were all significantly higher than those of outpatient cases(Z=-8.492,-7.310,and-8.624,all P<0.001).Among outpatients with three or more visits,the direct,indirect and total economic burden were the highest of 705.60(544.36,1164.19),0(0,945.00),and 915.08(599.21,1910.87)yuan,respectively(H=91.447,13.892 and 73.155,all P<0.001).Cases with a history of allergic rhinitis and sinusitis had higher direct and total economic burden of 575.40(363.83,912.77)and 761.75(400.71,1714.39)yuan,respectively,compared to those without such histories(Z=-2.708 and-2.264,P=0.007 and 0.024).The health utility value during influenza was 0.78(0.70,0.87),which was lower than that during non-ill days(Z=-18.283,P<0.001).Hospitalized cases had lower health utility value of 0.53(0.43,0.71)than outpatients(Z=-5.852,P<0.001).Conclusions:The disease burden of influenza is heavy in children in Hangzhou.It is recommended to actively promote influenza vaccination and other measu

关 键 词：流感 儿童 疾病负担 生命质量 疫苗 

分 类 号：R725.1[医药卫生—儿科]