Secular trends in incidence of acute gastroenteritis in general practice, France, 1991 to 2015
Secular trends in incidence of acute gastroenteritis in general practice, France, 1991 to 2015
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DOI：
10.2807/1560-7917.es.2017.22.50.17-00121
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发表时间：
2017-12-14
期刊：
影响因子：
19
通讯作者：
Hanslik, Thomas
中科院分区：
文献类型：
--
作者：
Riviere, Mathieu;Baroux, Noemie;Hanslik, Thomas
我们分析了25年的全科医生（GP）访问急性胃肠炎（AG）监测在法国，GP哨兵网络。我们研究了冬季急性胃肠炎发病率的时间趋势。来自急诊科和药品报销的数据是额外的数据来源。时间序列分析进行了使用广义加法模型的所有数据源的冬季期间。将病毒学数据与三个数据源合并并进行比较。从1991年到2008年，冬季AG的GP访视累积发生率呈上升趋势，达到每10万居民6，466例。2015年，每10万居民中有3,918人死亡。在所有年龄组中均观察到这一下降趋势，并通过广义相加模型得到证实。从2004年起，急诊就诊人数呈下降趋势。药物报销数据分析显示，自2009年数据开始以来呈下降趋势。2012年出现诺如病毒GII.4后，全科医生和急诊科报告的发病率较低（p < 0.0001）。冬季AG发病率似乎遵循长期上升和下降的趋势，这对于通过持续监测进行监测以评估预防策略的影响非常重要，例如未来针对急性病毒性胃肠炎的免疫接种。
We analysed 25 years of general practitioner (GP) visits for acute gastroenteritis (AG) surveillance in France, by the GP Sentinelles network. We searched for time trends of acute gastroenteritis incidence during winter periods. Data from emergency departments and drug reimbursement were additional data sources. A time-series analysis was performed using a generalised additive model for all data sources for the winter period. Virological data were incorporated and compared with the three data sources. The cumulative incidence of GP visits for winter AG exhibited an increasing trend from 1991 until 2008, when it reached 6,466 per 100,000 inhabitants. It decreased thereafter to 3,918 per 100,000 inhabitants in 2015. This decreasing trend was observed for all age groups and confirmed by the generalised additive model. For emergency department visits a decreasing trend was observed from 2004. Drug reimbursement data analyses demonstrated a decreasing trend from when data began in 2009. The incidence reported by GPs and emergency departments was lower following the emergence of norovirus GII.4 2012 (p < 0.0001). Winter AG incidences seem to follow long-term rising and decreasing trends that are important to monitor through continuous surveillance to evaluate the impact of prevention strategies, such as future immunisation against acute viral gastroenteritis.