SynthesisBMC medicine2022
Regional-based within-year seasonal variations in influenza-related health outcomes across mainland China: a systematic review and spatio-temporal analysis.
Synthesis in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 39 citations in OpenAlex.
- Impact of multifaceted health education on influenza vaccination health literacy in primary school students: a cluster randomized controlled trial.BMC medicine · 2025Trial
- Pre-pandemic contraction, phase-specific rate variation, and site-specific antigenic adaptation shape influenza A(H3N2) evolutionary dynamics in Hubei, China.Journal of virology · 2026Article
- Strain Matching of Seasonal Influenza Vaccines and Emergence of Neuraminidase Inhibitor Resistance in China from 2015 to 2025.Vaccines · 2026Article
- Heat effects on influenza-like illness and heterogeneity factors across regions: based on 333 cities in China.BMC public health · 2026Article
- rTMS for rapid relief of sleep disorders induced by influenza virus infection: a clinical retrospective study.Translational psychiatry · 2026Article
- Generalized additive model integrating multi-source data for short-term influenza forecasting in Shenzhen, China (2023-2025).Frontiers in public health · 2026Article
- Online monitoring and early detection of influenza outbreaks using exponentially weighted spatial lasso: a case study in China during 2014-2020.Journal of applied statistics · 2026Article
- Comparative analysis of influenza epidemiological characteristics in Quzhou, China from 2016 to 2024.Annals of medicine · 2025Article
- Relationships of Upper respiratory tract infections and holistic diets and lifestyles in Northeast China.BMC nutrition · 2025Article
- Epidemiological characteristics and spatio-temporal analysis of influenza in Sichuan Province from 2015 to 2024.BMC infectious diseases · 2025Article
- Social Media as an Emotional Barometer: Bidirectional Encoder Representations From Transformers-Long Short-Term Memory Sentiment Analysis on the Evolution of Public Sentiments During Influenza A on Sina Weibo.Journal of medical Internet research · 2025Article
- Impact of COVID-19 control measures on influenza positivity among patients with acute respiratory infections, 2018-2023: an interrupted time series analysis.BMC infectious diseases · 2025Article
- Knowledge attitude and practice of pregnant women on postnatal depression in Henan Province China.Scientific reports · 2025Article
- Predicting influenza in China from October 1, 2023, to February 5, 2024: A transmission dynamics model based on population migration.Infectious Disease Modelling · 2025Article
- Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020-2024).Frontiers in public health · 2025Article
- Viral etiology of severe acute respiratory infections in hospitalized patients, Shandong, China.PloS one · 2025Observational
- Spatiotemporal patterns of influenza incidence changes in mainland China, 2004-2020.Frontiers in public health · 2025Article
- Molecular epidemiology and phylogenetic analysis of influenza viruses A (H3N2) and B/Victoria during the COVID-19 pandemic in Guangdong, China.Infectious diseases of poverty · 2024Article
- Molecular characterization of influenza virus circulating in Nepal in the year 2019.Scientific reports · 2024Article
- Melatonin improves influenza virus infection-induced acute exacerbation of COPD by suppressing macrophage M1 polarization and apoptosis.Respiratory research · 2024Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundChina experiences large variations in influenza seasonal activity. We aim to update and improve the current understanding of regional-based within-year variations of influenza activity across mainland China to provide evidence for the planning and optimisation of healthcare strategies.
methodsWe conducted a systematic review and spatio-temporal meta-analysis to assess regional-based within-year variations of ILI outpatient consultation rates, influenza test positivity rates amongst both ILI outpatients and SARI inpatients, and influenza-associated excess mortality rates. We searched English and Chinese databases for articles reporting time-series data on the four influenza-related outcomes at the sub-national and sub-annual level. After synthesising the data, we reported on the mean monthly rate, epidemic onset, duration, peak and intensity.
resultsWe included 247 (7.7%) eligible studies in the analysis. We found within-year influenza patterns to vary across mainland China in relation to latitude and geographic location. High-latitude provinces were characterised by having short and intense annual winter epidemics, whilst most mid-latitude and low-latitude provinces experience semi-annual epidemics or year-round activity. Subtype activity varied across the country, with A/H1N1pdm09 and influenza B occurring predominantly in the winter, whereas A/H3N2 activity exhibited a latitudinal divide with high-latitude regions experiencing a winter peak, whilst mid and low-latitude regions experienced a summer epidemic. Epidemic onsets and peaks also varied, occurring first in the north and later in the southeast. We found positive associations between all influenza health outcomes. In addition, seasonal patterns at the prefecture and county-level broadly resembled their wider province.
conclusionsThis is the first systematic review to simultaneously examine the seasonal variation of multiple influenza-related health outcomes at multiple spatial scales across mainland China. The seasonality information provided here has important implications for the planning and optimisation of immunisation programmes and healthcare provision, supporting the need for regional-based approaches to address variations in local epidemiology.
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