2011-2017年苏州市区5岁以下儿童流感相关门诊就诊率的估计

高君玫; 陈立凌; 田健美; 诸俊; 林玉尊; 王胤; 于佳; 单玮; 邵雪君; 张涛; 张钧; 赵根明

doi:10.13315/j.cnki.cjcep.2019.01.008

2011-2017年苏州市区5岁以下儿童流感相关门诊就诊率的估计

doi: 10.13315/j.cnki.cjcep.2019.01.008

高君玫¹,
陈立凌²,
田健美³,
诸俊³,
林玉尊¹,
王胤¹,
于佳¹,
单玮¹,
邵雪君³,
张涛¹,
张钧²,
赵根明^1, ,

1.
200032 上海, 复旦大学公共卫生学院流行病学教研室
2.
215000 苏州, 苏州市疾病预防控制中心传染病预防控制科
3.
215003 苏州, 苏州大学附属儿童医院

基金项目:

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

详细信息

通讯作者:
赵根明, E-mail: gmzhao@shmu.edu.cn

中图分类号: R181
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出版历程
- 收稿日期: 2018-08-08
- 修回日期: 2018-10-17
- 刊出日期: 2019-01-10

The estimation of influenza-related outpatient rate in children under 5 years in Suzhou from 2011 to 2017

1.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2.
Department of Infectious Disease Control, Suzhou Center for Disease Prevention and Control, Suzhou 215000, China
3.
Soochow University Affiliated Children's Hospital, Suzhou 215003, China

Funds:

China-U.S. Collaborative Program on Emerging and Re-emerging Infectious Diseases 5U2GGH000018

The Fourth Round Three-year Plan of Shanghai Leading Public Health Discipline Project 15GWZK0101

More Information

Corresponding author: ZHAO Gen-ming, E-mail: gmzhao@shmu.edu.cn

摘要

摘要: 目的估计2011-2017年苏州市区5岁以下儿童流感相关流感样病例（influenza-like illness，ILI）就诊率。方法 2011年10月~2017年3月，在苏州大学附属儿童医院门急诊室开展对5岁以下儿童ILI病例的监测。收集咽拭子标本并采用实时定量逆转录-聚合酶链反应进行流感病毒检测。同时基于卫生服务利用数据及人口学数据，估计苏州市区5岁以下儿童流感相关ILI就诊数和就诊率。结果 2011-2017年苏州市区约有45 930例次5岁以下流感相关ILI病例，其中因流感病毒A/H1N1感染就诊的ILI病例7 490例，A/H3N2就诊数为17 843例，B就诊数为20 597例。研究期间，苏州市区5岁以下儿童流感相关ILI病例的就诊率为6.4/100人年，其中2011-2012年流感相关ILI就诊率最高，达20.5/100人年，2012-2013年最低，为2.4/100人年。结论苏州市区5岁以下的儿童流感相关ILI就诊数和就诊率较高，疾病负担较大。
- 儿童 /
- 流感 /
- 阳性率 /
- 就诊率
Abstract: Objective To estimate the outpatient rate of influenza-related influenza-like illness (ILI) for children younger than 5 years in Suzhou municipal districts. Methods From October 2011 to March 2017, we conducted a prospective surveillance program on ILI for children under 5 years in outpatient settings of Soochow University Affiliated Children's Hospital (SCH). The throat swabs were collected and tested for influenza viruses by RT-PCR. Based on the healthcare utilization surveys and population data, the number of visits and the outpatient rate of influenza-related ILI for children younger than 5 years in Suzhou municipal districts were estimated. Results During 2011-2017, in total, there were 45 930 estimated influenza-related ILI cases younger than 5 years in Suzhou municipal districts, which consisted of 7 490 influenza A/H1N1 cases, 17 843 influenza A/H3N2 cases and 20 597 influenza B cases. The estimated outpatient rate of influenza-related ILI was 6.4% in 2011-2017, which was highest in 2011-2012, 20.5%, and the lowest in 2012-2013, 2.4%. Conclusion The number of visits and the outpatient rate of influenza-related ILI in children younger than 5 years was high in Suzhou municipal districts.
- Children /
- Influenza /
- Positive rate /
- Outpatient rate

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表 1 苏州市区5岁以下儿童流感相关ILI就诊率的估计方法及数据来源

Table 1. Estimation methods and data sources of influenza-related ILI outpatient rate in children younger than 5 years in Suzhou municipal districts

估计参数	数据来源
监测诊室记录的门诊就诊数^a	SCH门急诊ILI监测数据
监测诊室记录的服务区域内就诊ILI病例数^b	SCH门急诊ILI监测数据
服务区域内就诊ILI占门诊就诊人数的百分比^c(%)	-
采样送检的ILI病例数^d	SCH门急诊ILI监测数据
流感病毒检测阳性的ILI病例数^e	流感病毒实验室检测
ILI病例中流感病毒阳性者所占百分比^f(%)	-
SCH内科门诊就诊总数^g	SCH信息系统
服务区域内在SCH就诊的ILI总数^h	-
服务区域内在SCH就诊的流感相关ILI病例数^m	-
服务区域内5岁以下平均常住人口数^p	苏州市免疫接种平台
卫生服务利用调查中报告的ILI病例数^q	卫生服务利用调查
报告ILI病例中就诊的病例数^s	卫生服务利用调查
报告ILI病例中到儿童医院就诊的病例数^t	卫生服务利用调查
服务区域内的ILI病例选择SCH就诊的比例^u^[6]	-
服务区域内流感相关ILI就诊数ⁿ	-
服务区域内流感相关ILI就诊率(/100人年)^r	-
注：c=a/b；f=e/d； $\rm h=\sum\limits_{\rm i=1 \text { 月 }}^{12 月} \rm g_{\rm i} * c_{i} ; \rm m=\sum\limits_{\rm i=1 \text { 月 }}^{12 月} \rm h_{\rm j} * \rm f_{\rm j} $ ；u=t/s; n=m/u; r=n/p。

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表 2 2011-2017年SCH筛选的ILI病例流感病毒阳性率及亚型分布[n (%)]

Table 2. The influenza positive rate and virus distribution of ILI cases screened in SCH from 2011 to 2017[n (%)]

特征	检测数	阳性例数	阳性率(%)	A/H1N1	A/H3N2	B	χ²值	P值
年龄组(月)							37.0	<0.001
0~	278	36	12.9	1(2.8)	16(44.4)	19(52.8)
6~	2 346	253	10.8	27(10.7)	109(43.1)	117(46.2)
24~	790	132	16.7	14(10.6)	44(33.3)	74(56.1)
36~59	1 286	223	17.3	27(12.1)	70(31.4)	126(56.5)
年度							257.7	<0.001
2011-2012	1 808	427	23.6	14(3.3)	149(34.9)	264(61.8)
2012-2013	817	39	4.8	14(35.9)	6(15.4)	19(48.7)
2013-2014	726	78	10.7	12(15.4)	61(78.2)	5(6.4)
2014-2015	582	41	7.0	2(4.9)	10(24.4)	29(70.7)
2015-2016	546	42	7.7	27(64.3)	0(0.0)	15(35.7)
2016-2017	221	17	7.7	0(0.0)	13(76.5)	4(23.5)
性别							0.3	0.590
男	2 647	369	13.9	41(11.1)	137(37.1)	191(51.8)
女	2 053	275	13.4	28(10.2)	102(37.1)	145(52.7)
合计	4 700	644	13.7	69(10.7)	239(37.1)	336(52.2)

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表 3 2011-2017年苏州市区5岁以下儿童不同年龄组及不同亚型流感相关ILI就诊数

Table 3. The number of influenza-related ILI visits for children under 5 years in Suzhou municipal districts by age group and virus subtype from 2011 to 2017

年度	合计	年龄组(月)				病毒分型
年度	合计	0~	6~	24~	36~59	A/H1N1	A/H3N2	B
2011-2012	19 160	1 081	7 835	4 384	5 860	628	6 686	11 846
2012-2013	2 871	141	1 379	245	1 106	1 031	442	1 398
2013-2014	9 286	467	4 465	2 021	2 333	1 429	7 262	595
2014-2015	5 366	546	1 667	1 099	2 054	261	1 309	3 796
2015-2016	6 443	151	2 115	1 607	2 570	4 141	-	2 302
2016-2017	2 804	174	1 202	337	1 091	-	2 144	660
2011-2017	4 5930	2 560	18 663	9 693	15 014	7 490	17 843	20 597

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表 4 2011-2017年苏州市区5岁以下儿童各年龄组及各病毒亚型流感相关ILI就诊率[/100人年(95% CI)]

Table 4. The outpatient rate of influenza-related ILI for children under 5 years in Suzhou municipal districts by age group and virus subtype from 2011 to 2017[/100 person-year(95% CI)]

年度	合计	年龄组(月)				病毒分型
年度	合计	0~	6~	24~	36~59	A/H1N1	A/H3N2	B
2011-2012	20.5(18.0~23.2)	9.3(5.7~13.2)	25.0(20.6~29.8)	24.4(19.2~29.9)	7.9(6.6~9.3)	0.7(0.6~0.8)	7.2(6.3~8.1)	12.7(11.1~14.4)
2012-2013	2.4(1.5~3.3)	1.1(-0.4~2.8)	3.5(1.8~5.4)	0.9(-0.1~2.1)	2.5(1.2~3.9)	0.9(0.6~1.2)	0.4(0.2~0.5)	1.2(0.8~1.6)
2013-2014	7.9(5.8~10.2)	4.2(0.3~8.7)	10.1(6.6~14.1)	7.6(3.9~11.6)	4.8(2.5~7.2)	1.2(0.9~1.6)	6.2(4.5~8.0)	0.5(0.4~0.7)
2014-2015	3.7(2.4~5.2)	4.1(0.3~8.5)	3.8(1.6~6.4)	3.4(1.1~6.1)	3.7(1.8~6.0)	0.2(0.1~0.3)	1.0(0.6~1.3)	2.8(1.8~3.9)
2015-2016	4.3(2.9~6.0)	1.1(-0.9~3.5)	4.8(2.2~7.9)	5.4(2.3~9.1)	4.1(2.1~6.3)	2.7(1.8~3.7)	-	1.5(1.0~2.0)
2016-2017	1.6(0.7~2.7)	1.2(-0.9~3.8)	2.4(0.6~4.6)	0.8(-0.2~2.0)	1.6(0.3~3.2)	-	1.3(0.6~2.2)	0.4(0.2~0.7)

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