Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017

GBD 2017 Influenza Collaborators

Lancet Respir Med 2019; 7: 69-89

Background 背景

Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza.

尽管在针对历史大流行及未来大流行风险的讨论中经常提及流感的疾病负担，但每年仍有大量的下呼吸道感染(LRTIs)及其他呼吸系统疾病（如COPD）因季节性流感引起。2017年全球疾病负担(GBD)研究是一项系统性科学研究，旨在量化一系列疾病及残疾相关的健康影响。本文集中讨论流感引起的LRTIs。

Methods 方法

We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza.

作为GBD 2017研究的一部分，我们对每个国家及部分地区1990年至2017年的年龄及年份数据，建立了流感导致的LRTIs发病率、住院率及死亡率模型。我们使用反事实法首先对LRTI发病率、住院率及死亡率进行评估，然而将其中部分结局与流感相关。

Findings 结果

Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000–200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16·4 deaths per 100 000 [95% UI 11·6–21·9]), and the highest rate among all ages was in eastern Europe (5·2 per 100 000 population [95% UI 3·5–7·2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000–22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000–259 851 000). We estimated that 11·5% (95% UI 10·0–12·9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000–73 864 000) episodes and 8 172 000 severe episodes (5 000 000–13 296 000).

2017年，流感LRTI约导致所有年龄组145 000人 (95% 不确定区间 [UI] 99 000–200 000)死亡。70岁以上成人流感LRTI死亡率最高(每100000人16·4例死亡100 000 [95% UI 11·6–21·9])，东欧所有年龄组死亡率最高(每100000人5·2例死亡[95% UI 3·5–7·2])。我们估计流感LRTIs导致9 459 000人 (95% UI 3 709 000–22 935 000)因 LRTIs 住院及 81 536 000 个住院日(24 330 000–259 851 000)。我们估计11·5% (95% UI 10·0–12·9) 的 LRTI因流感引发，约相当于54 481 000例 (38 465 000–73 864 000)病例及8 172 000重症病例(5 000 000–13 296 000)。

Interpretation 结论

This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are needed.

对于流感LRTIs疾病负担的全面评估表明，每年流感对全球健康产生很大影响。尽管针对可能的大流行进行准备非常重要，但不能忽视季节性流感LRTIs导致的健康影响，应当考虑接种疫苗。需要采取措施改进流感预防。

Funding

Bill & Melinda Gates Foundation.