Department of Biostatistics, Faculty of Medicine, Oita University, Yufu, Oita, Japan.
PLoS One. 2012;7(7):e42261. doi: 10.1371/journal.pone.0042261. Epub 2012 Jul 27.
To prevent and control infectious diseases, it is important to understand how sex and age influence morbidity rates, but consistent clear descriptions of differences in the reported incidence of infectious diseases in terms of sex and age are sparse.
Data from the Japanese surveillance system for infectious diseases from 2000 to 2009 were used in the analysis of seven viral and four bacterial infectious diseases with relatively large impact on the Japanese community. The male-to-female morbidity (MFM) ratios in different age groups were estimated to compare incidence rates of symptomatic reported infection between the sexes at different ages. MFM ratios were >1 for five viral infections out of seven in childhood, i.e. male children were more frequently reported as infected than females with pharyngoconjunctival fever, herpangina, hand-foot-and-mouth disease, mumps, and varicella. More males were also reported to be infected with erythema infectiosum and exanthema subitum, but only in children 1 year of age. By contrast, in adulthood the MFM ratios decreased to <1 for all of the viral infections above except varicella, i.e. adult women were more frequently reported to be infected than men. Sex- and age-related differences in reported morbidity were also documented for bacterial infections. Reported morbidity for enterohemorrhagic Escherichia coli infection was higher in adult females and females were reportedly more infected with mycoplasma pneumonia than males in all age groups up to 70 years.
Sex-related differences in reported morbidity for viral and bacterial infections were documented among different age groups. Changes in MFM ratios with age may reflect differences between the sexes in underlying development processes, including those affecting the immune, endocrine, and reproductive systems, or differences in reporting rates.
为了预防和控制传染病，了解性别和年龄如何影响发病率非常重要，但目前对于传染病发病率在性别和年龄方面的差异，仍缺乏一致和明确的描述。
本研究利用了日本 2000 年至 2009 年传染病监测系统的数据，对七种病毒性和四种细菌性传染病进行了分析，这些传染病对日本社会有较大影响。通过估计不同年龄组的男女性发病率（MFM）比值，比较了不同年龄段报告的感染症状的发病率。在儿童时期，七种病毒性传染病中有五种的 MFM 比值大于 1，即男性儿童比女性儿童更常被报告为感染咽结膜炎、疱疹性咽峡炎、手足口病、腮腺炎和水痘。在儿童 1 岁时，也有更多的男性被报告感染传染性红斑和幼儿急疹，但比值均小于 1。相比之下，在成年期，除水痘外，所有上述病毒性传染病的 MFM 比值均下降到小于 1，即成年女性比男性更常被报告为感染。细菌性传染病的发病率也存在性别和年龄相关的差异。肠出血性大肠杆菌感染的报告发病率在成年女性中较高，而肺炎支原体感染在所有年龄组中女性的发病率均高于男性，直至 70 岁。
本研究在不同年龄组中记录了病毒性和细菌性传染病的发病率与性别相关的差异。MFM 比值随年龄的变化可能反映了男女在潜在发育过程中的差异，包括影响免疫系统、内分泌系统和生殖系统的差异，或者报告率的差异。
