Using a community based survey of healthcare seeking behavior to estimate the actual magnitude of influenza among adults in Beijing during 2013-2014 season.
Due to a lack of survey of health care seeking behavior for influenza, the actual magnitude of influenza in Beijing of China has not been well described.



During 2013-2014 influenza season, two cross-sectional household surveys were carried out respectively during the epidemic and non-epidemic season of influenza. A structured survey was undertaken with individuals who were ≥18 years selected by a multistage random sampling method in the study. Health care seeking behaviors were then examined to estimate the actual case number of influenza, using a multiplier model.



A total of 14,665 adults were interviewed. 61.9% of ILI cases consulted a physician. The consultation rate during epidemic period is higher than that during non-epidemic period (67.9% vs. 52.3%). Similarly, the proportion of healthcare usage of general hospital during epidemic period is higher than that was during non-epidemic period (27.1% vs. 19.0%, p = 0.008). Lack of insurance and education reduced healthcare seeking significantly in this study. It was estimated that there were 379,767 (90% CI = [281,934, 526,565]) confirmed cases of influenza amongst adults in Beijing, during 2013-2014 influenza season, with an incidence rate of 2.0%.



The surveillance system for ILI and virological data has the potential to provide baseline case number to estimate the actual annual magnitude of influenza. Given the changes in healthcare seeking behavior over time, sentinel surveillance on healthcare seeking behavior are required to be established for better estimate of the true case number of influenza.
Beijing Center for Disease Prevention and Control, 16 Hepingli Middle Street, Beijing, 100013, China.
Xiaoli
X
Wang
Beijing Center for Disease Prevention and Control, 16 Hepingli Middle Street, Beijing, 100013, China.
Shuangsheng
S
Wu
Beijing Center for Disease Prevention and Control, 16 Hepingli Middle Street, Beijing, 100013, China.
Peng
P
Yang
Tongzhou District Center for Disease Prevention and Control, No.1 Luhe Middle School North Street, Tongzhou District, Beijing, 101100, China.
Hongjun
H
Li
Xicheng District Center for Disease Prevention and Control, No.38 Dewai Avenue, Xicheng District, Beijing, 100120, China.
Yanhui
Y
Chu
Changping District Center for Disease Prevention and Control, No.7 Gulou North Street, Changping District, Beijing, 102200, China.
Yaqing
Y
Tang
Haidian District Center for Disease Prevention and Control, No. 5 Xibeiwang Second Street, Haidian District, Beijing, 100094, China.
Weiyu
W
Hua
Dongcheng District Center for Disease Prevention and Control, No. 5 Bingmasi North Lane, Beijing, 10009, China.
Haiyan
H
Zhang
Huairou District Center for Disease Prevention and Control, No.23 Fule North, Huairou District, Beijing, 101400, China.
Chao
C
Li
Beijing Center for Disease Prevention and Control, 16 Hepingli Middle Street, Beijing, 100013, China. bjcdcxm@126.com.
Quanyi
Q
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000068476:Beijing / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D058872:Epidemics; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012621:Seasons; D018571:Sentinel Surveillance; D011795:Surveys and Questionnaires; D055815:Young Adult
Burden; Consultation rate; Healthcare seeking behavior; Influenza