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State Influenza Burden and Spatial A...

Czaja, Christopher Albert.

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State Influenza Burden and Spatial Associations with Rurality and Vaccination.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	State Influenza Burden and Spatial Associations with Rurality and Vaccination./
作者:	Czaja, Christopher Albert.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	96 p.
附註:	Source: Dissertations Abstracts International, Volume: 82-06, Section: B.
Contained By:	Dissertations Abstracts International82-06B.
標題:	Public health. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27829161
ISBN:	9798698591146

State Influenza Burden and Spatial Associations with Rurality and Vaccination.
Czaja, Christopher Albert.

State Influenza Burden and Spatial Associations with Rurality and Vaccination. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 96 p.

Source: Dissertations Abstracts International, Volume: 82-06, Section: B.

Thesis (Dr.P.H.)--University of Colorado at Denver, 2020.

This item must not be sold to any third party vendors.

Background. Despite a recommendation that all persons aged ≥6 months receive influenza vaccine, influenza has an enormous annual public health burden. State and local public health agencies can augment existing surveillance with additional estimates of the burden and distribution of influenza disease within states to customize the local public health response.Methods. We conducted three ecologic studies in Colorado using data from the 2007-2008 through 2015-2016 influenza seasons. First, we estimated influenza-associated excess pneumonia and influenza (P&I) and respiratory and circulatory (R&C) hospitalizations and deaths from hospital discharge records, death certificates, and influenza virus surveillance using negative binomial models. Next, we modeled the spatial epidemiology of laboratory-confirmed influenza hospitalizations in rural and urban census tracts statewide, and evaluated the association between rates of adult laboratory-confirmed influenza hospitalization and adult coverage with influenza vaccine in Denver metropolitan area census tracts.Results. Count estimates of influenza excess P&I and R&C hospitalizations and deaths over nine influenza seasons exceeded the number of hospitalizations and deaths documented in hospital discharge and death certificate data by a factor of 2-8, and the number of laboratory-confirmed influenza hospitalizations and linked deaths within 30 days by a factor of 1.2-6.5, depending on outcome. Estimated rates differed by virus type and subtype, age, and season. Laboratory-confirmed influenza hospitalizations in rural Colorado census tracts over eight influenza seasons were inconsistently distributed across seasons. Rural rates were, on average, lower than urban rates. Race, ethnicity, poverty, health insurance coverage, and distance from a hospital accounted for rate differences. Adult vaccine coverage did not account for differences in adult laboratory-confirmed influenza hospitalization rates or clusters in the Denver metropolitan area.Conclusion. State-level estimates of influenza disease burden using methods to address under-detection provide information for prevention planning. Spatial data suggest that one possible intervention would be to target prevention measures to high-rate urban census tracks in order to reduce morbidity and slow the spread of influenza from urban to rural locations. While increasing vaccination coverage in target census tracts is an important goal, public health should evaluate and address other factors that contribute to rate disparities by location.

ISBN: 9798698591146Subjects--Topical Terms:

534748
Public health.
Subjects--Index Terms:

Influenza vaccine

State Influenza Burden and Spatial Associations with Rurality and Vaccination.
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245 1 0 $a State Influenza Burden and Spatial Associations with Rurality and Vaccination.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2020
300 $a 96 p.
500 $a Source: Dissertations Abstracts International, Volume: 82-06, Section: B.
500 $a Advisor: Cockburn, Myles G.;Simoes, Eric A. F.
502 $a Thesis (Dr.P.H.)--University of Colorado at Denver, 2020.
506 $a This item must not be sold to any third party vendors.
506 $a This item must not be added to any third party search indexes.
520 $a Background. Despite a recommendation that all persons aged ≥6 months receive influenza vaccine, influenza has an enormous annual public health burden. State and local public health agencies can augment existing surveillance with additional estimates of the burden and distribution of influenza disease within states to customize the local public health response.Methods. We conducted three ecologic studies in Colorado using data from the 2007-2008 through 2015-2016 influenza seasons. First, we estimated influenza-associated excess pneumonia and influenza (P&I) and respiratory and circulatory (R&C) hospitalizations and deaths from hospital discharge records, death certificates, and influenza virus surveillance using negative binomial models. Next, we modeled the spatial epidemiology of laboratory-confirmed influenza hospitalizations in rural and urban census tracts statewide, and evaluated the association between rates of adult laboratory-confirmed influenza hospitalization and adult coverage with influenza vaccine in Denver metropolitan area census tracts.Results. Count estimates of influenza excess P&I and R&C hospitalizations and deaths over nine influenza seasons exceeded the number of hospitalizations and deaths documented in hospital discharge and death certificate data by a factor of 2-8, and the number of laboratory-confirmed influenza hospitalizations and linked deaths within 30 days by a factor of 1.2-6.5, depending on outcome. Estimated rates differed by virus type and subtype, age, and season. Laboratory-confirmed influenza hospitalizations in rural Colorado census tracts over eight influenza seasons were inconsistently distributed across seasons. Rural rates were, on average, lower than urban rates. Race, ethnicity, poverty, health insurance coverage, and distance from a hospital accounted for rate differences. Adult vaccine coverage did not account for differences in adult laboratory-confirmed influenza hospitalization rates or clusters in the Denver metropolitan area.Conclusion. State-level estimates of influenza disease burden using methods to address under-detection provide information for prevention planning. Spatial data suggest that one possible intervention would be to target prevention measures to high-rate urban census tracks in order to reduce morbidity and slow the spread of influenza from urban to rural locations. While increasing vaccination coverage in target census tracts is an important goal, public health should evaluate and address other factors that contribute to rate disparities by location.
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653 $a Under-detection
653 $a Vaccination coverage
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