Rate-difference method proved satisfactory in estimating the influenza burden in primary care visits

Angelique G S C Jansen, Elisabeth A M Sanders, Jacco Wallinga, Eelke J Groen, Anton M van Loon, Arno W Hoes, Eelko Hak

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    OBJECTIVE: To compare different methods to estimate the disease burden of influenza, using influenza and respiratory syncytial virus-(RSV) associated primary care data as an example.

    STUDY DESIGN AND SETTING: In a retrospective study in the Netherlands over 1997-2003, primary care attended respiratory episodes and national viral surveillance data were used to compare the rate-difference method to other, more complex methods.

    RESULTS: The influenza-associated excess estimated by the different methods varied. The estimates provided by the rate-difference model lay well within this range. According to the rate-difference method, influenza-associated primary care consultations were present for all ages, including low-risk adults. The highest influenza-associated burden was demonstrated for children below the age of 5 years. The RSV-associated primary care burden was highest in the youngest age category and well above that associated with influenza. Significant RSV-associated excess was also recorded among adults, particularly in high-risk adults and the elderly.

    CONCLUSION: The straightforward rate-difference model seemed satisfactory to estimate the influenza-associated burden. Significant influenza-associated excess was demonstrated among persons not yet recommended for influenza vaccination in The Netherlands. The RSV-associated burden was highest for the youngest children, but also significant for adults.

    Original languageEnglish
    Pages (from-to)803-812
    Number of pages10
    JournalJournal of Clinical Epidemiology
    Issue number8
    Publication statusPublished - Aug-2008


    • Adolescent
    • Adult
    • Aged
    • Child
    • Child, Preschool
    • Humans
    • Infant
    • Infant, Newborn
    • Influenza, Human
    • Logistic Models
    • Middle Aged
    • Netherlands
    • Primary Health Care
    • Respiratory Syncytial Virus Infections
    • Respiratory Tract Infections
    • Retrospective Studies

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