2016—2018年杭州市农村地区学校和幼托机构流感疾病负担研究

Disease burden of influenza in schools and child care settings in rural areas of Hangzhou, 2016-2018

目的分析杭州市农村地区学校和幼托机构流感疾病负担情况。方法采用系统抽样法,选择杭州市淳安县2016—2018年基于流感病例监测系统报告的医院就诊的3~17岁病例作为调查对象,共294例。采用自行设计的调查表,获取调查对象基本情况、门诊及住院治疗情况、生病期间亲属陪护情况、患病期间生命质量等情况。计算直接经济负担、间接经济负担和失能情况等相关指标,比较不同特征对象上述指标差异。结果调查对象的年龄为(8.88±3.92)岁,其中男性为143例(48.64%),门诊病例为283例(96.26%)。总经济负担为124 743.95元人民币,人均总经济负担为424.30元人民币,人均直接和间接经济负担分别为361.33和62.97元人民币。不同年龄病例人均直接、间接、总经济负担之间的差异均有统计学意义(P值均<0.001),3~5岁组最高,M分别为276.34、50.98和321.26元人民币,12~17岁组最低,分别为175.30、26.54和201.79元人民币。调查对象损失的伤残调整生命年为1.18人年,负担强度M为3.21人年/千人,不同年龄病例间的负担强度差异有统计学意义(P<0.001),12~17岁组最大,为4.25人年/千人,3~5岁组最小,为2.60人年/千人。结论杭州市农村地区学校和幼托机构流感疾病负担较重,3~5岁儿童经济负担较重,12~17岁儿童负担强度较大。

Objective The objective of this study was to analyze the disease burden of influenza in schools and child care settings in rural areas of Hangzhou. Methods Hospital visit influenza cases aged 3-17 years in hospitals that reported based on influenza surveillance system from 2016 to 2018 in Chun′an county, Hangzhou city were selected as study subjects and a total of 294 confirmed cases of influenza were selected using system sampling method. Questionnaires were designed to investigate the basic information and data on inpatients and outpatients among, health care and life quality, etc.. Direct and indirect economic burden and disability adjusted life year (DALY) were analyzed and compared among different age groups. Results The mean age of investigated subjects was (8.88±3.92) years. A total of 143 (48.64%) investigated cases were male. In total of 283 (96.26%) cases were outpatients. The total economic burden was 124 743.95 CNY. The mean economic burden was 424.30 CNY per person. The mean direct and indirect economic burden was 361.33 and 62.97 CNY per person respectively. The difference of the mean direct, indirect and total economic burden per person between different age group was statistically significant (P<0.001). The 3-5 years age group showed the highest economic burden with the median value of direct, indirect and total economic burden per person being 276.24, 50.98 and 321.26 CNY, respectively, while the 12-17 years age group showed the lowest values with 175.30, 26.54, 201.79 CNY, respectively. The DALY of 294 influenza cases was 1.18, and the median of burden strength was 3.21 DALY/thousand. The difference of the burden of strength between different age group influenza case was statistically significant (P<0.001), of which the 12-17 years age group showed the highest value with 4.25 DALYs/thousand while the 3-5 years age group showed the lowest value with 2.60 DALY/thousand. Conclusion The disease burden of influenza was heavy in schools and kindergartens in rural areas of Hangzhou city, with the cases aged from 3 to 5 years showing higher economic burden and cases aged from 12 to 17 years showing greater burden strength.