Hospitalisations due to pertussis in New Zealand in the pre-immunisation and mass immunisation eras
Hospitalisations due to pertussis in New Zealand in the pre-immunisation and mass immunisation eras
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DOI：
10.1111/j.1440-1754.2007.01034.x
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发表时间：
2007-03-01
影响因子：
1.7
通讯作者：
Thomas, Mark G.
中科院分区：
文献类型：
--
作者：
Somerville, Rebecca L.;Grant, Cameron C.;Thomas, Mark G.
目的：与其他发达国家相比，新西兰近几十年来的百日咳疾病负担一直很大。然而，由于百日咳的流行周期较长，这些比较使用的数据相对较短。为了更好地了解目前的疾病负担，本研究探讨了百日咳住院数据在新西兰的预免疫接种和大规模免疫接种eras.Methods：医院出院数据和人口数据，从1873年至2004年，估计平均百日咳出院率每十年。使用相对危险度和95%置信区间（CI）进行比较率。结果：平均每年每10万人百日咳住院率从1873年至1919年低于2，在20世纪40年代增加到12，在20世纪60年代减少到不到4，并从那时起增加，在本十年的率为5.8。与1960年代（每10万人3.8人）相比，1980年代（RR = 1.11，95% CI 1.03，1.21）、1990年代（RR = 1.33，95% CI 1.23，1.44）和2000年代（RR = 1.55，95% CI 1.42，1.68）的年平均发病率明显更高。自1960年以来，1岁以下、1至4岁和5岁及以上儿童的住院率有所增加。婴儿的增加最为显著（RR 2000与1960年代= 2.87，95% CI 2.59，3.18）。结论：在大规模免疫接种后，新西兰百日咳住院率最初下降，随后稳步上升。为了减少百日咳疾病负担，需要提高免疫覆盖率和及时性，并考虑在更广泛的年龄范围内推广百日咳疫苗接种计划。
Aim: Pertussis disease burden in New Zealand in recent decades has been large compared with other developed countries. However, these comparisons use data from relatively short time periods given the long epidemic cycle of pertussis. To better understand the current disease burden, this study examined pertussis hospitalisation data in New Zealand in both the pre-immunisation and mass immunisation eras.Methods: Hospital discharge data and population data from 1873 to 2004 were used to estimate average pertussis hospital discharge rates per decade. Rates were compared using relative risks and 95% confidence intervals (CI).Results: Average annual pertussis hospitalisation rates per 100 000 were less than two from 1873 to 1919, increased to 12 in the 1940s, decreased to less than four in the 1960s and have increased since then with the rate in the current decade being 5.8. Compared with the 1960s (3.8 per 100 000) the average annual rate has been significantly greater in the 1980s (RR = 1.11, 95% CI 1.03, 1.21), 1990s (RR = 1.33, 95% CI 1.23, 1.44) and 2000s (RR = 1.55, 95% CI 1.42, 1.68). Since 1960 hospitalisation rates have increased for those less than one year old, one to four years old and five years and older. The increases have been most marked for infants (RR 2000s vs. 1960s = 2.87, 95% CI 2.59, 3.18).Conclusion: After an initial decline following mass immunisation, pertussis hospitalisation rates in New Zealand have subsequently increased steadily. To reduce pertussis disease burden improved immunisation coverage and timeliness is required and consideration given to spreading the pertussis vaccine schedule over a wider age range.