Establishing influenza epidemic thresholds and intensity levels in Türkiye using the moving epidemic method and assessing concordance with WHO transmission zones: A sentinel surveillance analysis of ten seasons, 2013-2025
EPIDEMIOLOGY & INFECTION, cilt.154, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 154
- Basım Tarihi: 2026
- Doi Numarası: 10.1017/s095026882610209x
- Dergi Adı: EPIDEMIOLOGY & INFECTION
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, Educational research abstracts (ERA), EMBASE, Environment Index, Hospitality & Tourism Complete, Hospitality & Tourism Index, MEDLINE, Directory of Open Access Journals, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest)
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Ankara Üniversitesi Adresli: Evet
Özet
The Moving Epidemic Method (MEM) is the ECDC/WHO-Europe-endorsed approach for establishing influenza epidemic thresholds and intensity levels, yet no positivity-based MEM analysis exists for T & uuml;rkiye or any country in the WHO Western Asia transmission zone. Weekly influenza positivity rates from FluNet sentinel surveillance were analysed for ten of twelve seasons (2013/2014-2024/2025, excluding two COVID-19 pandemic seasons) using the mem R package with cross-validated optimized slope parameter, and T & uuml;rkiye's average epidemic curve and thresholds were compared with the Western Asia (excluding T & uuml;rkiye) and South West Europe zones using Lin's concordance correlation coefficient (CCC), root mean square deviation (RMSD) and complementary correlation metrics. The epidemic threshold was 10.59% positivity, with intensity thresholds at 42.56% (medium), 60.92% (high), and 71.38% (very high); cross-validated sensitivity was 0.77, specificity 0.88, and Matthews correlation coefficient 0.65. T & uuml;rkiye's average curve showed higher concordance with Western Asia (CCC=0.890; RMSD=4.22 percentage points) than South West Europe (CCC=0.672; RMSD=12.48) despite similar Pearson correlations (0.922 vs. 0.939), and the Western Asia epidemic threshold (11.50%) closely matched T & uuml;rkiye's. These first operational MEM thresholds for T & uuml;rkiye and the first positivity-based thresholds for the Western Asia zone confirm alignment with the current WHO transmission zone classification and support integration into routine surveillance.