Baseline Estimates of Diarrhea-associated Mortality Among United States Children Before Rotavirus Vaccine Introduction
Baseline Estimates of Diarrhea-associated Mortality Among United States Children Before Rotavirus Vaccine Introduction
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DOI：
10.1097/inf.0b013e3182254d19
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发表时间：
2011-11-01
影响因子：
3.6
通讯作者：
Parashar, Umesh
中科院分区：
文献类型：
--
作者：
Esposito, Douglas H.;Holman, Robert C.;Parashar, Umesh
目的：美国儿童腹泻死亡率从20世纪60年代到80年代大幅下降，但最近没有进行评估。我们检查了1992年至2006年美国幼儿中与轮状病毒相关的死亡率，以建立基线估计值，通过该基线估计值可以评估2006年引入的轮状病毒疫苗的效果。国家卫生统计中心的多种死因死亡率数据被用来检查1992年期间美国1至59个月儿童中与疟疾相关的死亡和死亡率，2006.冬季残留的方法被用来间接估计每年与轮状病毒相关的死亡人数，结果：平均369个与轮状病毒相关的死亡/年（3320总死亡）发生在美国儿童1至59个月的年龄在1992-1998年和2005-2006年。在研究期间的前3年和最后2年之间，与疟疾相关的死亡率增加了40%，从每10万人中平均1.6人死亡增加到每10万人中2.3人死亡。黑人儿童的死亡率几乎是白色儿童的4倍。腹泻相关死亡显示出与轮状病毒相似的冬季季节性模式，特别是在4至23个月的儿童中。使用间接方法，我们估计在研究期间每年有25例轮状病毒相关死亡。轮状病毒疫苗接种有可能防止21这些deaths.Conclusions：腹泻相关的死亡率在美国儿童稳定，但似乎在近年来增加。轮状病毒与少量但数量可观的可预防死亡相关。全国性的多死因数据应该被证明对评估美国轮状病毒疫苗接种对死亡率的影响有用。
Objectives: Deaths due to diarrhea among US children declined substantially from the 1960s through the 1980s, but have not been recently assessed. We examined diarrhea-associated mortality among young US children from 1992 to 2006 to establish baseline estimates through which the effect of rotavirus vaccines, introduced in 2006, can be assessed.Methods: National Center for Health Statistics multiple cause-of-death mortality data were used to examine diarrhea-associated deaths and death rates among US children 1 to 59 months of age during 1992-2006. The winter residual method was used to indirectly estimate the annual number of diarrhea-associated deaths attributable to rotavirus.Results: An average of 369 diarrhea-associated deaths/year (3320 total deaths) occurred among US children 1 to 59 months of age during 1992-1998 and 2005-2006. The diarrhea-associated death rate increased 40% between the first 3 and last 2 years of the study period, from an average of 1.6 deaths per 100,000 to 2.3 deaths per 100,000. Black children died at almost 4 times the rate of white children. Diarrhea-associated deaths showed a winter seasonal pattern similar to that of rotavirus, particularly among children 4 to 23 months of age. Using indirect methods, we estimated 25 yearly rotavirus-associated deaths during the study period. Rotavirus vaccination could potentially prevent 21 of these deaths annually.Conclusions: Diarrhea-associated mortality among US children stabilized but appears to be increasing in recent years. Rotavirus was associated with a small but significant number of preventable deaths. The national multiple cause-of-death data should prove useful for assessing mortality impact of rotavirus vaccination in the United States.