Invasive meningococcal disease in England: assessing disease burden through linkage of multiple national data sources
Invasive meningococcal disease in England: assessing disease burden through linkage of multiple national data sources
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DOI：
10.1186/s12879-015-1247-7
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发表时间：
2015-12-01
影响因子：
3.7
通讯作者：
Ramsay, Mary E.
中科院分区：
文献类型：
--
作者：
Ladhani, Shamez N.;Waight, Pauline A.;Ramsay, Mary E.
背景：在英格兰，英格兰公共卫生部门加强了对侵袭性脑膜炎球菌病 (IMD) 的监测。报告的 IMD 病例持续下降引起了人们的担忧，即 MRU 可能低估了真实的 IMD 发病率。方法：我们连接了五个国家数据集来估计五年内的疾病负担，包括 PHE 脑膜炎球菌参考单位 (MRU) 确认、医院事件统计数据 (HES)、国家卫生服务 (NHS) 医院重大感染的电子报告、死亡登记和私人实验室报告。结果：2007-11 年间，MRU 确认了 5115 例 IMD 病例， 4275 例 (84%) 与 HES 匹配，其中 3935 例 (92%) 具有 A39*（脑膜炎球菌病），340 例 (8%) 具有 G00*（细菌性脑膜脑炎）ICD-10 代码。 HES 中还发现了 2792 例具有 A39* 代码的住院病例。其中，1465 例 (52%) 与 MRU 检测的 IMD PCR 阴性样本之一相匹配，其余 1327 例住院 A39* 病例中只有 73 例在当地或由私人实验室确诊。未经实验室确诊的住院病例的特征与PCR阴性的IMD病例相比，与PCR阳性的IMD病例相似。结论：除了MRU确诊病例之外，对多个国家数据源的询问发现很少有实验室确诊病例。 HES 中存在大量未经确诊和 PCR 阴性病例，表明临床医生对疑似 IMD 患者住院的门槛较低，意识有所提高。
Background: In England, Public Health England conducts enhanced surveillance of invasive meningococcal disease (IMD). The continuing decline in reported IMD cases has raised concerns that the MRU may be underestimating true IMD incidence.Methods: We linked five national datasets to estimate disease burden over five years, including PHE Meningococcal Reference Unit (MRU) confirmations, hospital episode statistics (HES), electronic reports of significant infections by National Health Service (NHS) Hospitals, death registrations and private laboratory reports.Results: During 2007-11, MRU confirmed 5115 IMD cases and 4275 (84 %) matched to HES, including 3935 (92 %) with A39* (meningococcal disease) and 340 (8 %) with G00* (bacterial meningo-encephalitis) ICD-10 codes. An additional 2792 hospitalised cases with an A39* code were identified in HES. Of these, 1465 (52 %) matched to one of 53,806 samples tested PCR-negative for IMD by MRU and only 73 of the remaining 1327 hospitalised A39* cases were confirmed locally or by a private laboratory. The characteristics of hospitalised cases without laboratory confirmation were similar to PCR-negative than PCR-positive IMD cases.Conclusions: Interrogation of multiple national data sources identified very few laboratory confirmations in addition to the MRU-confirmed cases. The large number of unconfirmed and PCR-negative cases in HES suggests increased awareness among clinicians with low thresholds for hospitalising patients with suspected IMD.