tetano
Editor, Senior Moderator
BMC Infect Dis
. 2024 Jan 18;24(1):100.
doi: 10.1186/s12879-023-08685-z. Uncovering the burden of Influenza in children in Portugal, 2008-2018
Alberto Caldas Afonso[SUP] 1 2 3 4 [/SUP], Catarina Gouveia[SUP] 5 6 [/SUP], Gustavo Januário[SUP] 7 8 [/SUP], Mafalda Carmo[SUP] 9 [/SUP], Hugo Lopes[SUP] 10 11 12 [/SUP], Hélène Bricout[SUP] 13 [/SUP], Catarina Gomes[SUP] 14 [/SUP], Filipe Froes[SUP] 15 [/SUP]
Affiliations
Background: Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged < 5 years old. This study aims to cover this gap by estimating the clinical and economic burden of severe influenza in children, in Portugal, during ten consecutive influenza seasons (2008/09-2017/18).
Methods: We reviewed hospitalizations in children aged < 5 years old using anonymized administrative data covering all public hospitals discharges in mainland Portugal. The burden of hospitalization and in-hospital mortality directly coded as due to influenza was supplemented by the indirect burden calculated from excess hospitalization and mortality (influenza-associated), estimated for four groups of diagnoses (pneumonia or influenza, respiratory, respiratory or cardiovascular, and all-cause), through cyclic regression models integrating the incidence of influenza. Means were reported excluding the H1N1pdm09 pandemic (2009/10).
Results: The mean annual number of hospitalizations coded as due to influenza was 189 (41.3 cases per 100,000 children aged < 5 years old). Hospitalization rates decreased with increasing age. Nine-in-ten children were previously healthy, but the presence of comorbidities increased with age. Children stayed, on average, 6.1 days at the hospital. Invasive mechanical ventilation was used in 2.4% of hospitalizations and non-invasive in 3.1%. Influenza-associated excess hospitalizations between 2008 and 2018 were estimated at 1,850 in pneumonia or influenza, 1,760 in respiratory, 1,787 in respiratory or cardiovascular, and 1,879 in all-cause models. A total of 95 influenza-associated excess deaths were estimated in all-cause, 14 in respiratory or cardiovascular, and 9 in respiratory models. Over ten years, influenza hospitalizations were estimated to have cost the National Health Service at least €2.9 million, of which 66.5% from healthy children.
Conclusions: Influenza viruses led to a high number of hospitalizations in children. Most were previously healthy. Results should lead to a reflection on the adequate preventive measures to protect this age group.
Keywords: Burden; Children; Excess; Healthy; Hospitalization; Influenza; Mortality; Portugal.
. 2024 Jan 18;24(1):100.
doi: 10.1186/s12879-023-08685-z. Uncovering the burden of Influenza in children in Portugal, 2008-2018
Alberto Caldas Afonso[SUP] 1 2 3 4 [/SUP], Catarina Gouveia[SUP] 5 6 [/SUP], Gustavo Januário[SUP] 7 8 [/SUP], Mafalda Carmo[SUP] 9 [/SUP], Hugo Lopes[SUP] 10 11 12 [/SUP], Hélène Bricout[SUP] 13 [/SUP], Catarina Gomes[SUP] 14 [/SUP], Filipe Froes[SUP] 15 [/SUP]
Affiliations
- PMID: 38238649
- DOI: 10.1186/s12879-023-08685-z
Background: Despite their higher risk of developing severe disease, little is known about the burden of influenza in Portugal in children aged < 5 years old. This study aims to cover this gap by estimating the clinical and economic burden of severe influenza in children, in Portugal, during ten consecutive influenza seasons (2008/09-2017/18).
Methods: We reviewed hospitalizations in children aged < 5 years old using anonymized administrative data covering all public hospitals discharges in mainland Portugal. The burden of hospitalization and in-hospital mortality directly coded as due to influenza was supplemented by the indirect burden calculated from excess hospitalization and mortality (influenza-associated), estimated for four groups of diagnoses (pneumonia or influenza, respiratory, respiratory or cardiovascular, and all-cause), through cyclic regression models integrating the incidence of influenza. Means were reported excluding the H1N1pdm09 pandemic (2009/10).
Results: The mean annual number of hospitalizations coded as due to influenza was 189 (41.3 cases per 100,000 children aged < 5 years old). Hospitalization rates decreased with increasing age. Nine-in-ten children were previously healthy, but the presence of comorbidities increased with age. Children stayed, on average, 6.1 days at the hospital. Invasive mechanical ventilation was used in 2.4% of hospitalizations and non-invasive in 3.1%. Influenza-associated excess hospitalizations between 2008 and 2018 were estimated at 1,850 in pneumonia or influenza, 1,760 in respiratory, 1,787 in respiratory or cardiovascular, and 1,879 in all-cause models. A total of 95 influenza-associated excess deaths were estimated in all-cause, 14 in respiratory or cardiovascular, and 9 in respiratory models. Over ten years, influenza hospitalizations were estimated to have cost the National Health Service at least €2.9 million, of which 66.5% from healthy children.
Conclusions: Influenza viruses led to a high number of hospitalizations in children. Most were previously healthy. Results should lead to a reflection on the adequate preventive measures to protect this age group.
Keywords: Burden; Children; Excess; Healthy; Hospitalization; Influenza; Mortality; Portugal.