National trends in Haemophilus influenzae meningitis mortality and hospitalization among children, 1980 through 1991.
National trends in Haemophilus influenzae meningitis mortality and hospitalization among children, 1980 through 1991.
复制标题
1980 年至 1991 年全国儿童流感嗜血杆菌脑膜炎死亡率和住院治疗趋势。
作者：
K. Schoendorf;W. Adams;Kiely Jl;J. Wenger
目的
B型流感嗜血杆菌（HiB）结合疫苗于1987年12月在美国获得常规使用许可。我们比较了Hib结合疫苗许可前后5岁以下儿童中流感嗜血杆菌脑膜炎死亡和住院的全国趋势。
方法
流感嗜血杆菌脑膜炎死亡率的计算使用的数据从1980年至1991年的计算机化国家死亡率档案。使用1980年至1991年全国医院出院调查的数据计算流感嗜血杆菌脑膜炎的住院率。将1980年至1887年流感嗜血杆菌死亡率和住院率的趋势与1988年至1991年的趋势进行了比较。还检查了肺炎链球菌和脑膜炎奈瑟菌脑膜炎的趋势。
结果
从1980年到1987年，流感嗜血杆菌脑膜炎的死亡率平均每年下降8.5%，而从1988年到1991年每年下降48%（趋势差异P <0.001）。从1980年到1987年，流感嗜血杆菌脑膜炎的住院率每年增加1%，从1988年到1991年，平均每年下降34%。在这两个时期，肺炎链球菌或脑膜炎奈瑟菌脑膜炎的死亡率或住院趋势没有显著差异。在婴儿中，流感嗜血杆菌脑膜炎死亡率从1980年到1987年平均每年下降8%，从1988年到1991年平均每年下降43%。一至四岁儿童的平均年下降率相似，这两个时期分别为8%和58%。尽管在绝对死亡率方面存在地区差异，但全国所有地区的脑膜炎死亡率趋势相似。
结论
在美国< 5岁的儿童中，我们发现在Hib结合疫苗许可后的几年里，流感嗜血杆菌脑膜炎的死亡和住院率大幅下降，但肺炎链球菌或脑膜炎奈瑟菌脑膜炎的死亡和住院率没有下降。这些结果表明，流感嗜血杆菌脑膜炎的下降主要是由于使用了Hib结合疫苗。
OBJECTIVE
Haemophilus influenzae type b (Hib) conjugate vaccines were licensed for routine use in the United States in December 1987. We compared national trends in deaths and hospitalization from H influenzae meningitis among children < 5 years old before and after Hib conjugate vaccine licensure.
METHODS
H influenzae meningitis mortality rates were calculated using data from the 1980 through 1991 computerized national mortality files. Hospitalization rates from H influenzae meningitis were calculated using data from the 1980 through 1991 National Hospital Discharge Surveys. Trends in H influenzae mortality and hospitalization from 1980 through 1887 were compared with trends from 1988 through 1991. Trends for Streptococcus pneumoniae and Neisseria meningitidis meningitis were also examined.
RESULTS
From 1980 through 1987, mortality from H influenzae meningitis decreased an average of 8.5% each year, compared with a 48% annual decrease from 1988 through 1991 (P < .001 for difference in trends). H influenzae meningitis hospitalization rates increased 1% each year from 1980 through 1987, and decreased an average of 34% each year from 1988 through 1991. There was no significant difference in mortality or hospitalization trends for S pneumoniae or N meningitidis meningitis during the two periods. Among infants, H influenzae meningitis mortality decreased an average of 8% per year from 1980 through 1987 and 43% per year from 1988 through 1991. One- to four-year-old children had similar average annual declines, 8% and 58% for the two periods. Although there were regional differences in the absolute mortality rates, all regions of the country had similar trends in meningitis mortality.
CONCLUSIONS
Among US children < 5 years old, we found substantial decreases in deaths and hospitalization from H influenzae meningitis, but not S pneumoniae or N meningitidis meningitis, in the years after Hib conjugate vaccine licensure. These results suggest that the declines in H influenzae meningitis were due primarily to the use of Hib conjugate vaccines.