Crespo Inma, Soldevila Núria, Muñoz Pilar, Godoy Pere, Carmona Gloria, Domínguez Angela
CIBER de Epidemiología y Salud Pública (CIBERESP), Casanova 143, 3rd floor, Public Health Department, 08036 Barcelona, Spain.
BMC Public Health. 2014 Mar 20;14:268. doi: 10.1186/1471-2458-14-268.
Whooping cough is a communicable disease whose incidence has increased in recent years in some countries with vaccination. Since 1981, in Catalonia (Spain), cases must be reported to the Public Health Department. In 1997, surveillance changed from aggregated counts to individual report and the surveillance system was improved after 2002. Catalan public health is universal with equal coverage geographically. The aim of this study was to determine whether there are differences in whooping cough incidence in rural and urban counties.
Cases in 1990-2010 were classified as rural or urban. Incidences and risk ratios (RR) between urban and rural counties and 95% CI were calculated. Associations between rural and urban counties and structural changes during the study period were analysed.
Twelve years of the whole study period showed differences in incidence between rural and urban counties. The incidence was higher in urban counties in seven years and rural counties in five years. There was a positive association of whooping cough incidence in rural and urban counties in four-week periods. Structural changes were detected in the following four-week periods: 4th in 1993, 7th in 1996 and 3rd 2005 in rural counties and 5th 1993, 9th in 1996 and 8th in 2007 in urban counties.
Differences in whooping cough between rural and urban counties were found. In most years, the incidence was higher in urban than in rural counties. Rural and urban counties show similar cyclic behaviour when four-week periods were considered.
百日咳是一种传染病，近年来在一些已实施疫苗接种的国家发病率有所上升。自1981年以来，在加泰罗尼亚（西班牙），病例必须向公共卫生部报告。1997年，监测从汇总计数改为个体报告，2002年后监测系统得到改进。加泰罗尼亚的公共卫生是全民性的，地理覆盖范围均等。本研究的目的是确定农村和城市县的百日咳发病率是否存在差异。
将1990 - 2010年的病例分为农村或城市病例。计算农村和城市县之间的发病率和风险比（RR）以及95%置信区间。分析农村和城市县之间的关联以及研究期间的结构变化。
整个研究期间的12年显示农村和城市县的发病率存在差异。城市县发病率较高的年份有7年，农村县发病率较高的年份有5年。在四周时间段内，农村和城市县的百日咳发病率呈正相关。在以下四周时间段检测到结构变化：农村县在1993年第4周、1996年第7周和2005年第3周，城市县在1993年第5周、1996年第9周和2007年第8周。
发现农村和城市县的百日咳存在差异。在大多数年份，城市的发病率高于农村。当考虑四周时间段时，农村和城市县表现出相似的周期性行为。
