Is socioeconomic position associated with bronchiolitis seasonality? A cohort study
Is socioeconomic position associated with bronchiolitis seasonality? A cohort study
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DOI：
10.1136/jech-2019-213056
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发表时间：
2021-01-01
影响因子：
6.3
通讯作者：
Hardelid, Pia
中科院分区：
文献类型：
--
作者：
Lewis, Kate;De Stavola, Bianca;Hardelid, Pia
背景了解细支气管炎的季节性差异有助于规划干预时间。我们量化了因细支气管炎入院的季节性因社会经济地位而变化的程度。方法使用医院事件统计数据，我们对 2011 年至 2016 年间在英国国家卫生服务医院出生的 3 717 329 名婴儿进行了为期一年的跟踪。我们根据年、月、年龄、社会经济地位和地区，计算了因细支气管炎入院的所有婴儿的比例以及每千名婴儿年细支气管炎入院的发病率。我们使用调和泊松回归分析来评估社会经济地位是否改变了细支气管炎的季节性。结果 2012 年至 2016 年间，英国细支气管炎的入院率从每 1000 名婴儿年 47.4 例（95% CI 46.8 至 47.9）增加到 58.9 例（95% CI 58.3 至 59.5）。我们发现入院季节性存在一些变化按社会经济地位：贫困的增加与季节性变化较小和流行病高峰期略有延迟有关。第 50 周时，与最贫困群体相比，最贫困社会经济群体的婴儿入院风险高出 38%（发病率比为 1.38；95% CI 1.35 至 1.41）。结论这些结果并不支持按社会经济群体区分预防或疫苗接种时间的必要性，但表明出生于社会经济贫困的婴儿应被视为未来干预的优先群体。需要进一步研究以确定细支气管炎的病毒病因是否因季节和社会经济群体而异，并量化介导社会经济剥夺和细支气管炎发病率的危险因素。
BackgroundUnderstanding differences in the seasonality of bronchiolitis can help to plan the timing of interventions. We quantified the extent to which seasonality in hospital admissions for bronchiolitis is modified by socioeconomic position.MethodsUsing Hospital Episode Statistics, we followed 3 717 329 infants born in English National Health Service hospitals between 2011 and 2016 for 1 year. We calculated the proportion of all infant admissions due to bronchiolitis and the incidence rate of bronchiolitis admissions per 1000 infant-years, according to year, month, age, socioeconomic position and region. We used harmonic Poisson regression analysis to assess whether socioeconomic position modified bronchiolitis seasonality.ResultsThe admission rate for bronchiolitis in England increased from 47.4 (95% CI 46.8 to 47.9) to 58.9 per 1000 infant-years (95% CI 58.3 to 59.5) between 2012 and 2016. We identified some variation in the seasonality of admissions by socioeconomic position: increased deprivation was associated with less seasonal variation and a slightly delayed epidemic peak. At week 50, the risk of admission was 38% greater (incidence rate ratios 1.38; 95% CI 1.35 to 1.41) for infants in the most deprived socioeconomic group compared with the least deprived group.ConclusionThese results do not support the need for differential timing of prophylaxis or vaccination by socioeconomic group but suggest that infants born into socioeconomic deprivation should be considered a priority group for future interventions. Further research is needed to establish if the viral aetiology of bronchiolitis varies by season and socioeconomic group, and to quantify risk factors mediating socioeconomic deprivation and bronchiolitis rates.