2015年天津市流感确诊病例流行病学特征分析及疾病负担评估

Analysis on epidemiological characteristics and evaluation on disease burden of confirmed influenza cases in Tianjin in 2015

目的分析天津市流感确诊病例的流行病学分布特征并评估其疾病负担。方法对2015年天津市流感确诊病例进行流行病学调查,统计分析其流行病学特征及疾病负担。结果共调查837例确诊病例,临床症状以发热(100.00%)及咳嗽(80.65%)为主,8.60%的病例出现并发症,4.78%的病例住院治疗,有15.89%的患者有明确接触史,流感门诊病例直接及间接经济负担的中位数分别为350.00元及208.95元。住院病例直接及间接经济负担的中位数分别为8 650.00元及417.90元。住院病例直接和间接经济负担均大于门诊病例(Z=5.939,P=0.000;Z=2.560,P=0.000)。发病与就诊时间间隔与并发症发生率以及疾病直接花费均呈正相关(r_(spearman)=0.404,P=0.000;r_(spearman=)0.128,P=0.000)。结论流感确诊病例除发热外以咳嗽症状为主,主要并发症是肺炎。及时就诊和早期使用抗流感病毒药物,防止并发症发生,减少住院可以有效降低流感的疾病负担。

[Objective]To analyze the epidemiological characteristics of confirmed influenza cases in Tianjin,evaluate the disease burden.[Methods]The confirmed influenza cases in Tianjin in 2015 were investigated to analyze the epidemiological characteristics and disease burden.[Results]Totally 837 influenza cases were investigated,the main clinical symptoms were fever（100.00%）and cough（80.65%）,and 8.60% of the cases had complications. 4.78% were hospitalized and 15.89% had a clear contact history. The median of direct and indirect costs of outpatients were 350.00 Yuan and 208.95 Yuan respectively,while those of inpatients were 8650.00 Yuan and 417.90 Yuan respectively. The direct and indirect costs of inpatients were higher than those of outpatients（Z =5.939,P=0.000;Z=2.560,P =0.000）.The interval between onset and medical care seeking was positively correlated with the incidences of complications（rspearman=0.404,P=0.000）and the direct costs（rspearman=0.128,P=0.000）.[Conclusion]The main clinical symptoms of confirmed influenza cases are ever and cough,and the pneumonia is the main complication. Timely medical care seeking and early use of anti influenza virus drugs,reducing the incidences of complications and hospitalization cases of influenza can drop the disease burden dramatically.