Influenza-associated paediatric respiratory hospitalizations in China, 1996–2012: a systematic analysis

Abstract

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.

Keywords

• influenza
• pediatric respiratory hospitalizations
• china