Deaths from pertussis are underestimated in England
Deaths from pertussis are underestimated in England
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DOI：
10.1136/adc.86.5.336
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发表时间：
2002-05-01
影响因子：
5.2
通讯作者：
Miller, E
中科院分区：
文献类型：
--
作者：
Crowcroft, NS;Andrews, N;Miller, E
目标：方法：比较1994 ~ 1999年英国实验室百日咳监测、医院发病统计（HES）和国家统计局（ONS）死亡登记的死亡病例。结果：共发现33例死亡病例，88%为4个月以下婴儿。所有来源之间存在重叠;在强化百日咳监测系统中确定了22例死亡，在ONS死亡率数据中确定了18例，在HES中确定了9例。死于百日咳而死亡证明上没有提到百日咳的儿童比那些提到百日咳的儿童更有可能被验尸官证实（p = 0.0005）。使用捕获-再捕获分析，在五年半的时间内，百日咳死亡的总人数估计为46（95%CI 37至71），或每年约9例死亡。结论：国家死亡率统计显著低于估计死亡百日咳在英格兰和不足以监测国家免疫接种计划。通过加强实验室监测查明的死亡人数最多。死亡登记系统应考虑到现有的微生物信息，以确保准确确定死亡原因。
Aims: To improve estimates of deaths from pertussis in England and to identify reasons for under ascertainment.Methods: Comparison of deaths identified from enhanced laboratory pertussis surveillance, hospital episode statistics (HES), and Office for National Statistics (ONS) death registrations in England, 1994 to 1999.Results: A total of 33 deaths were identified, 88% of infants less than 4 months old. There was overlap between all sources; 22 deaths were identified in the enhanced pertussis surveillance system, 18 in ONS mortality data, and nine in HES. Children who had died from pertussis without mention of pertussis on the death certificate were more likely to have been certified by coroners than those with mention of pertussis (p = 0.0005). Using capture-recapture analysis, the total number of deaths from pertussis in the five and a half year period is estimated to be 46 (95% CI 37 to 71), or around nine deaths per year.Conclusions: National mortality statistics significantly under estimate deaths from pertussis in England and are inadequate for monitoring the national immunisation programme. The largest number of deaths is identified through enhanced laboratory surveillance. Death registration systems should take into account available microbiological information to ensure that cause of death is accurately assigned.