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Background Influenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings. Methods and findings We aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996–31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle–Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20–64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%–16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000–46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000–9,432,000) LRI hospitalizations occur each year among adults. While adults, In this meta-analysis, Kathryn E. Lafond and colleagues estimate the global hospitalisation burden from influenza infections in adults., Author summary Why was this study done? Every year, millions of people become infected with influenza viruses, which infect the airways and cause symptoms that include a fever, tiredness and weakness, general aches and pains, sore throat, and cough. Most infected individuals recover quickly, but some develop more severe illness such as pneumonia, and may require hospitalization. Influenza vaccination can prevent infections and severe disease, but decisions on how to prioritize risk groups, particularly in limited-resource settings, require a robust evidence base, including global, regional, and local data. What did the researchers do and find? We conducted a systematic review to identify published articles on influenza-associated respiratory disease in hospitalized adults. We then aggregated the data from these articles with data collected by hospital-based influenza surveillance, to calculate a pooled estimate of the proportion of adults hospitalized with respiratory disease who are positive for influenza. Through this approach, we estimated that influenza was associated with 14% of acute respiratory hospitalizations among adults worldwide. This equates to over 5 million influenza-associated hospitalizations per year, with the highest rates among those 65 years and older. What do these findings mean? Estimating the disease burden of influenza allows researchers and policymakers to better understand its global impact across different target groups and allows comparisons with other causes of morbidity and mortality. As global populations age, the importance of vaccinating adults, particularly older adults, is likely to increase.

Made available in DSpace on 2021-06-25T10:53:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-02-01 Alder Hey Children's NHS Foundation Trust The aim of this study was to examine aspects of children's health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The surveys included demographic questions and both closed and open questions focussing on access to and understanding of COVID-19 information. Descriptive statistics and qualitative content analysis procedures were conducted. The findings show that parents are the main source of information for children during the pandemic in most countries (89%, n = 347), except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child's access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children's health literacy needs during a pandemic. Faculty of Health Social Care and Medicine Edge Hill University UQO Departement de Sciences Infirmieres Botucatu Medical School - Unesp - Nursing Department Centre for Education and Research - Nursing and Midwifery Tasmanian Health Service South and University of Tasmania Sant Joan de Deu Research Foundation Department of Nursing Faculty of Medicine Umea University Institute of Health and Care Sciences Centre for Person-Centred Care Sahlgrenska Academy University of Gothenburg Department of Health Sciences Department of Learning The Swedish Red Cross University College Informatics Management and Ethics LIME Karolinska Institutet Keele Medical School Faculty of Medicine and Health Sciences Keele University Botucatu Medical School - Unesp - Nursing Department