Impact and longevity of measles-associated immune suppression: a matched cohort study using data from the THIN general practice database in the UK.
Impact and longevity of measles-associated immune suppression: a matched cohort study using data from the THIN general practice database in the UK.
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DOI：
10.1136/bmjopen-2017-021465
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发表时间：
2018-11-08
期刊：
影响因子：
2.9
通讯作者：
de Swart RL
中科院分区：
文献类型：
--
作者：
Gadroen K;Dodd CN;Masclee GMC;de Ridder MAJ;Weibel D;Mina MJ;Grenfell BT;Sturkenboom MCJM;van de Vijver DAMC;de Swart RL
检验麻疹感染在较长时间内会增加非麻疹传染病发病率的假设。一项基于人群的匹配队列研究。本研究调查了英国健康改善网络全科医疗记录数据库中1-15岁的儿童。参与者包括1990年至2014年期间诊断为麻疹的2228名患者，这些患者在年龄，性别，全科医生实践和日历年与19930名未患麻疹的儿童相匹配。所有对照组均接受过至少一次麻疹疫苗接种。排除有免疫损害病史或免疫抑制治疗的儿童。使用多变量分析调整混杂变量，在预定时期内麻疹后感染、抗感染处方和全因住院的发病率比（IRR）。在麻疹患儿中，非麻疹传染病的发病率在麻疹后5年内的每个评估时间段内均显著增加：第一个月为43（IRR：1.43; 95% CI 1.22 - 1.68），第1个月至第1年为22%（IRR：1.22; 95% CI 1.14 - 1.31），第1 - 2.5年为10%（IRR：1.10; 95% CI 1.02 - 1.19），第2.5 - 5年随访为15%（IRR：1.15; 95% CI 1.06 - 1.25）。患有麻疹的儿童在第一个月接受抗感染处方的可能性是三倍多，在第一个月和5年之间的可能性增加了15%-24%。麻疹儿童的住院率仅在诊断后一个月内增加，但此后没有增加（IRR：2.83; 95% CI 1.72至4.67）。麻疹后，儿童确诊感染率增加，需要增加抗菌治疗处方。这项基于人群的匹配队列研究支持麻疹对宿主对非麻疹传染病的抵抗力具有长期影响的假设。
To test the hypothesis that measles infection increases the incidence of non-measles infectious diseases over a prolonged period of time. A population-based matched cohort study. This study examined children aged 1–15 years in The Health Improvement Network UK general practice medical records database. Participants included 2228 patients diagnosed with measles between 1990 and 2014, which were matched on age, sex, general practitioner practice and calendar year with 19 930 children without measles. All controls had received at least one measles vaccination. Children with a history of immune-compromising conditions or with immune-suppressive treatment were excluded. Incidence rate ratio (IRR) of infections, anti-infective prescriptions and all-cause hospitalisations following measles in predetermined periods using multivariate analysis to adjust for confounding variables. In children with measles, the incidence rate for non-measles infectious disease was significantly increased in each time period assessed up to 5 years postmeasles: 43% in the first month (IRR: 1.43; 95% CI 1.22 to 1.68), 22% from month one to the first year (IRR: 1.22; 95% CI 1.14 to 1.31), 10% from year 1 to 2.5 years (IRR: 1.10; 95% CI 1.02 to 1.19) and 15% (IRR: 1.15; 95% CI 1.06 to 1.25) in years 2.5 to 5 years of follow-up. Children with measles were more than three times as likely to receive an anti-infective prescription in the first month and 15%–24% more likely between the first month and 5 years. The rate of hospitalisation in children with measles was increased only in the month following diagnosis but not thereafter (IRR: 2.83; 95% CI 1.72 to 4.67). Following measles, children had increased rates of diagnosed infections, requiring increased prescribing of antimicrobial therapies. This population-based matched cohort study supports the hypothesis that measles has a prolonged impact on host resistance to non-measles infectious diseases.
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影响因子：
8.7
作者：
Griffin DE
通讯作者：
Griffin DE
影响因子：
28.2
作者：
AABY, P;BUKH, J;SMITS, AJ
通讯作者：
SMITS, AJ
DOI：
10.3390/v8080210
发表时间：
2016-07-28
期刊：
Viruses
影响因子：
--
作者：
Laksono BM;de Vries RD;McQuaid S;Duprex WP;de Swart RL
通讯作者：
de Swart RL
影响因子：
81.5
作者：
Rota, Paul A.;Moss, William J.;Goodson, James L.
通讯作者：
Goodson, James L.
影响因子：
6.4
作者：
Sanders, Raymond;Dabbagh, Alya;Featherstone, David
通讯作者：
Featherstone, David