1 - Unidade de Nefrologia Pediátrica, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
2 - Centro Hospitalar Universitário Santo António, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
3 - EPIUnit - Instituto de Saúde Pública, Porto, Portugal
4 - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
5 - Hospital D. Estefânia, Centro Hospitalar Lisboa Central, Lisboa, Portugal
6 - Faculdade de Ciências Médicas, Nova Medical School, Lisbon, Portugal
7 - Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
8 - Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
9 - IQVIA, Barcelona, Spain
10 - IQVIA, Lisbon, Portugal
11 - NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
12 - Comprehensive Health Research Center - Universidade NOVA de Lisboa, Lisbon, Portugal
13 - Sanofi, Lyon, France
14 - Sanofi, Lisbon, Portugal
15 - Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Publicação_ BMC Infectious Diseases 24 1 (2024): http://dx.doi.org/10.1186/s12879-023-08685-z.
Resumo:
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.
Palavras Chave: Burden, Children, Excess, Hospitalization, Healthy, Influenza, Mortality, Portugal