GIHSN-site s experience & Results of season 21-216 Prague, Czech Republic National Institute of Public Health Hospital Na Bulovce, Dept. of Infectious Diseases jan.kyncl@szu.cz
Study management summary Name of coordinating institution: National Institute of Public Health (Dept. of infectious diseases epidemiology) Number of participating hospitals: 1 No specific demographic features (high proportion of elderly patients, pediatrics, etc.) Specific regions covered: capital Prague and Central Bohemian Region (catchment area of 2. million population) Differences with the core protocol? (specific admission/exclusion criteria, sampling methods?): only patients older 18 years included Study period: from 7/Jan/216 to 28/Apr/216 Site experience and results of season 21-216 Prague, Czech Republic 2
Season 21-216 results summary 3 2 2 1 Number of patients included examinated influenza positive 1 Site experience and results of season 21-216 Prague, Czech Republic 3
Reasons for exclusion (N = 124) 14 no communication no consent 21 no resident 77 6 1 institutionalized hospitalized 3 days doesn t comply ILI criteria Site experience and results of season 21-216 Prague, Czech Republic 4
Included patients N=248 (M 122 F 126) 18.8 9. years Median 7.8 years Examinated patients N=124 (M 66 F 8) 18.8-9. years Median 48 years BMI 17..8 Median 26.9 Influenza positive patients N=42 (M 24 F 18) 21. 81.3 years Median 44.3 years BMI 19.8.8 Median 27.2 Site experience and results of season 21-216 Prague, Czech Republic
Number of patients by calendar week 216 3 included examinated influenza positive 2 2 1 1 1 2 3 4 6 7 8 9 1 11 12 13 14 1 16 17 week Site experience and results of season 21-216 Prague, Czech Republic 6
4 4 3 3 2 2 Chronic diseases occurence by age group Cirrhosis / liver disease Neuromuscular disease Autoimune disease Chronic obstr. pulmonary dis. Rheumatologic disease Renal impairmant Immunodefic. /organ transpl. Asthma Neoplasm Diabetes Cardiovascul. disease 1 1 19-24 2-34 3-44 4-4 -64 6-74 7+ group Site experience and results of season 21-216 Prague, Czech Republic 7
4 Smoking habits 43 4 3 No influenza Influenza A 3 2 28 Influenza B Influenza AB 2 16 1 11 11 1 6 3 Current smoker Past smoker Never smoker Site experience and results of season 21-216 Prague, Czech Republic 8
of patients Number of chronic diseases Female patients 1 9 8 7 6 Number of chronic diseases BMI Hospitalization days 4 3 4 2 3 2 1 1 A B A B A B A B A A B A A B A B A A Influenza type Site experience and results of season 21-216 Prague, Czech Republic 9
of patients Number of chronic diseases 1 9 8 7 6 4 3 2 Autoimune disease Neoplasm Cirrhosis / liver disease Renal impairmant Immunodef. /organ transpl. Diabetes Asthma Cardio- vascul. disease BMI Hospitalization days Lineární (BMI) Lineární (Hospitalization days) Female patients with influenza pregnancy BMI 4 3 2 1 1 Hospitalization A B A B A B A B A A B A A B A B A A Influenza type Site experience and results of season 21-216 Prague, Czech Republic 1
of patients Number of chronic diseases 1 Male patients 9 8 7 6 Number of chronic diseases BMI Hospitalization days 4 3 4 2 3 2 1 1 B B B A A A A A A B B A A A B A B A ABB A A B A Influenza type Site experience and results of season 21-216 Prague, Czech Republic 11
of patients Number of chronic diseases 1 9 8 7 6 Cirrhosis / liver disease Neoplasm Renal impairmant Immunodef. /organ transpl. Diabetes Asthma Cardio- vascul. disease BMI Hospitalization days Lineární (BMI) Lineární (Hospitalization days) Male patients with influenza 4 3 4 BMI 2 3 2 1 1 Days of hospitalization B B B A A A A A A B B A A A B A B A AB B A A B A Site experience and results of season 21-216 Prague, Czech Republic Influenza type 12
BMI / of patients Number of chronic diseases BMI by sex, with dependence on age of patients 1 9 8 7 6 4 3 Autoimun.- female Neoplasm - female Cirrhosis - female Neuromusc.- female Rheuma - female Renal - female Immunodefic.- female Diabetes - female Asthma - female CHOPD - female Cardio - female Autoimun.- male Neoplasm - male Cirrhosis - male Neuromusc.- male Rheuma - male Renal - male Immunodefic.- male Diabetes - male Asthma - male CHOPD - male Cardio - male - female BMI - female - male BMI - male - male - female BMI - male BMI - female 3 28 26 24 22 2 18 16 14 12 1 8 2 6 1 4 2 X X X XYX XYX Y Y Y X X Y Y X X XY X XYX Y XXY Y X Y XXYX X Y Y Y X Y X X - influenza in male population / Y - influenza in female population Site experience and results of season 21-216 Prague, Czech Republic 13
4 4 3 3 Hospitalization length no influenza influenza A influenza B influenza AB 2 2 1 1 1-2 days 3-7 days 8-12 days 13-17 days 18-22 days 23-27 days 28-32 days 33-37 days Site experience and results of season 21-216 Prague, Czech Republic 14
Laboratory results, influenza positive patients (N = 42) 2 22 2 1 1 7 8 2 1 1 1 Influenza type Site experience and results of season 21-216 Prague, Czech Republic
of patients in blue, BMI in red Vaccinated patients (N = 8) 1 9 8 7 chronic diseases number BMI Hospitalisation days 66 7 76 77 8 9 4 6 4 47 2 2 3 3 2 3 2 1 27 2 3 1 19 8 9 1 1 1 3 1 Influenza A Influenza B Influenza B no influenza no influenza no influenza no influenza no influenza 1 Site experience and results of season 21-216 Prague, Czech Republic 16
Key aspects from the season What were the local team expectations for this year? Specific objectives for the season? Were there specific issues in the study implementation? Enrollment of patients improved Difficulty with obtaining of external data (e.g. pneumonia cases in hospital as well as the whole country for Disease burden estimation using SARI sentinel surveillance data ) Epidemiological characteristics of the influenza season (unusual circulation in the country? Unusual timeline?) Relatively high numbers of severe disease this season Site experience and results of season 21-216 Prague, Czech Republic 17
Room for improvement? Challenges To improve communication with patients in hospital (with aim to get higher number of informed consent, e.g. to lower the number of excluded patients) Better cooperation among institutions to obtain data for Diseases burden estimation Strengths and weaknesses Laboratory of good quality Relatively low number of patients but no chance to get another hospital site into the project Site experience and results of season 21-216 Prague, Czech Republic 18
Patient s number with diagnosis pneumonia 2 18 769 18 979 18 16 14 12 1 8 6 4 2 2 91 2 176 278 1 729 1 927 318 Czech Republic Region Prague Central Bohemian region Hospital Bulovka year 214 year 21 Site experience and results of season 21-216 Prague, Czech Republic 19
Thank you for your attention Site experience and results of season 21-216 Prague, Czech Republic