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Influenza-associated paediatric respiratory hospitalizations in China, 1996-2012: a systematic analysis
Mei Shang1,2, Kathryn E Lafond2, Jeffrey McFarland1,2
1China-US Collaborative Program on Emerging and Reemerging Infectious Diseases, Centers for Disease Control and Prevention, Beijing, China.
Insights
Influenza significantly contributes to pediatric respiratory hospitalizations in China. Vaccinating school-aged children could prevent many severe influenza cases and hospitalizations.
Area of Science:
- Pediatric Infectious Diseases
- Public Health Surveillance
- Epidemiology
Background:
- The World Health Organization (WHO) recommends influenza vaccination for children aged 6 months and older.
- Limited national data exist on the burden of severe influenza-associated outcomes in Chinese children.
- Understanding influenza's impact is crucial for informing vaccination policies.
Purpose of the Study:
- To systematically review and quantify the burden of laboratory-confirmed influenza-associated pediatric respiratory hospitalizations in China.
- To analyze trends and variations in influenza positivity rates based on age, methodology, and geography.
Main Methods:
- A systematic review of studies published between 1996 and 2012 was conducted.
- Data on laboratory-confirmed influenza-associated pediatric respiratory hospitalizations were extracted.
- Pooled influenza positivity percentages were estimated using a random-effects regression model, stratified by age, case definition, testing methods, and location.
Main Results:
- Influenza was linked to 8.8% of respiratory hospitalizations in children under 18 years.
- Positivity rates varied by age group, with 7.0% for <2 years and 8.9% for <5 years.
- Higher influenza positivity was observed in Northern China compared to Southern China and in studies including older children.
Conclusions:
- Influenza represents a significant cause of pediatric respiratory hospitalizations in China.
- Targeted influenza vaccination programs, particularly for school-aged children, could substantially reduce illness and hospitalizations.
- Further research and enhanced surveillance are needed to refine vaccination strategies.
Background:
The World Health Organization recommends that children aged ≥ 6 months be vaccinated against influenza. Influenza vaccination policies depend on the evidence of the burden of influenza, yet few national data on influenza-associated severe outcomes among children exist in China.
Methods:
We conducted a systematic review of articles published from 1996 to 2012 on laboratory-confirmed, influenza-associated paediatric respiratory hospitalizations in China. We extracted data and stratified the percentage of samples testing positive for influenza by age group (< 2, < 5 and < 18 years old); case definition; test methods; and geographic location. The pooled percentage of samples testing positive for influenza was estimated with a random effects regression model.
Results:
Influenza was associated with 8.8% of respiratory hospitalizations among children aged < 18 years, ranging from 7.0% (95% confidence interval: 4.2-9.8%) in children aged < 2 years to 8.9% (95% confidence interval: 6.8-11%) in children aged < 5 years. The percentage of samples testing positive for influenza was consistently higher among studies with data from children aged < 5 years and < 18 years than those restricted only to children aged < 2 years; the percentages were higher in Northern China than Southern China.
Discussion:
Influenza is an important cause of paediatric respiratory hospitalizations in China. Influenza vaccination of school-aged children could prevent substantial influenza-associated illness, including hospitalizations, in China.
