Introduction Social contact patterns significantly influence the transmission dynamics of respiratory pathogens.Previous surveys have quantified human social contact patterns,yielding heterogeneous results across diff...Introduction Social contact patterns significantly influence the transmission dynamics of respiratory pathogens.Previous surveys have quantified human social contact patterns,yielding heterogeneous results across different locations.However,significant gaps remain in understanding social contact patterns in rural areas of China.Methods We conducted a pioneering study to quantify social contact patterns in Anhua County,Hunan Province,China,from June to October 2021,when there were minimal coronavirus disease-related restrictions in the area.Additionally,we simulated the epidemics under different assumptions regarding the relative transmission risks of various contact types(e.g.,indoor versus outdoor,and physical versus non-physical).Results Participants reported an average of 12.0 contacts per day(95%confidence interval:11.3–12.6),with a significantly higher number of indoor contacts compared to outdoor contacts.The number of contacts was associated with various socio-demographic characteristics,including age,education level,income,household size,and travel patterns.Contact patterns were assortative by age and varied based on the type of contact(e.g.,physical versus non-physical).The reproduction number,daily incidence,and infection attack rate of simulated epidemics were remarkably stable.Discussion We found many intergenerational households and contacts that pose challenges in preventing and controlling infections among the elderly in rural China.Our study also underscores the importance of integrating various types of contact pattern data into epidemiological models and provides guidance to public health authorities and other major stakeholders in preparing and responding to infectious disease threats in rural China.展开更多
Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national lev...Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%higher than those found in the accounts review(n=38).Conclusion:The economic burden of influenza-associated outpatient and inpatient visits in China is substantial,particularly for young children,the elderly,and patients with underlying medical conditions.More widespread influenza vaccination would likely alleviate the economic burden of patients.The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.展开更多
基金funded by the Shanghai Municipal Science and Technology Major Project(ZD2021CY001)the National Institute for Health Research(NIHR)(16/137/109)using UK aid from the UK Government to support global health research+2 种基金the Key Program of the National Natural Science Foundation of China(82130093)the National Natural Science Foundation of China(92369118 and 82304202)Shanghai Rising-Star Program(No.22QA1402300).
文摘Introduction Social contact patterns significantly influence the transmission dynamics of respiratory pathogens.Previous surveys have quantified human social contact patterns,yielding heterogeneous results across different locations.However,significant gaps remain in understanding social contact patterns in rural areas of China.Methods We conducted a pioneering study to quantify social contact patterns in Anhua County,Hunan Province,China,from June to October 2021,when there were minimal coronavirus disease-related restrictions in the area.Additionally,we simulated the epidemics under different assumptions regarding the relative transmission risks of various contact types(e.g.,indoor versus outdoor,and physical versus non-physical).Results Participants reported an average of 12.0 contacts per day(95%confidence interval:11.3–12.6),with a significantly higher number of indoor contacts compared to outdoor contacts.The number of contacts was associated with various socio-demographic characteristics,including age,education level,income,household size,and travel patterns.Contact patterns were assortative by age and varied based on the type of contact(e.g.,physical versus non-physical).The reproduction number,daily incidence,and infection attack rate of simulated epidemics were remarkably stable.Discussion We found many intergenerational households and contacts that pose challenges in preventing and controlling infections among the elderly in rural China.Our study also underscores the importance of integrating various types of contact pattern data into epidemiological models and provides guidance to public health authorities and other major stakeholders in preparing and responding to infectious disease threats in rural China.
基金This study was supported by grants from the Ministry of Health-WHO five-year Cooperative Project on Influenza Surveillance in China,the Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences(grant no.U54 GM088558)a commissioned grant from the Health and Medical Research Fund,Food and Health Bureau,Government of the Hong Kong Special Administrative Region(grant no.HKS-15-E05).
文摘Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%higher than those found in the accounts review(n=38).Conclusion:The economic burden of influenza-associated outpatient and inpatient visits in China is substantial,particularly for young children,the elderly,and patients with underlying medical conditions.More widespread influenza vaccination would likely alleviate the economic burden of patients.The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.
