Ho N T, Hoang V M T, Le N N T, Nguyen D T, Tran A, Kaki D, Tran P M, Thompson C N, Ngo M N Q, Truong K H, Nguyen H T, Ha T M, Nguyen C V V, Thwaites G E, Thakur K T, Hesdorffer D, Baker S
Columbia University Medical Center,New York City,New York,USA.
Children's Hospital 2,Ho Chi Minh City,Vietnam.
Epidemiol Infect. 2017 Nov;145(15):3307-3317. doi: 10.1017/S095026881700228X. Epub 2017 Oct 24.
Central nervous system infections (CNSI) are a leading cause of death and long-term disability in children. Using ICD-10 data from 2005 to 2015 from three central hospitals in Ho Chi Minh City (HCMC), Vietnam, we exploited generalized additive mixed models (GAMM) to examine the spatial-temporal distribution and spatial and climatic risk factors of paediatric CNSI, excluding tuberculous meningitis, in this setting. From 2005 to 2015, there were 9469 cases of paediatric CNSI; 33% were ⩽1 year old at admission and were mainly diagnosed with presumed bacterial CNSI (BI) (79%), the remainder were >1 year old and mainly diagnosed with presumed non-bacterial CNSI (non-BI) (59%). The urban districts of HCMC in proximity to the hospitals as well as some outer districts had the highest incidences of BI and non-BI; BI incidence was higher in the dry season. Monthly BI incidence exhibited a significant decreasing trend over the study. Both BI and non-BI were significantly associated with lags in monthly average temperature, rainfall, and river water level. Our findings add new insights into this important group of infections in Vietnam, and highlight where resources for the prevention and control of paediatric CNSI should be allocated.
中枢神经系统感染（CNSI）是儿童死亡和长期残疾的主要原因。利用越南胡志明市（HCMC）三家中心医院2005年至2015年的国际疾病分类第十版（ICD - 10）数据，我们采用广义相加混合模型（GAMM）来研究小儿CNSI（不包括结核性脑膜炎）的时空分布以及空间和气候风险因素。2005年至2015年期间，共有9469例小儿CNSI病例；33%的患儿入院时年龄小于等于1岁，主要诊断为疑似细菌性CNSI（BI）（79%），其余患儿年龄大于1岁，主要诊断为疑似非细菌性CNSI（非BI）（59%）。靠近医院的胡志明市城区以及一些外围地区的BI和非BI发病率最高；BI发病率在旱季更高。在研究期间，每月的BI发病率呈现出显著下降趋势。BI和非BI均与月平均温度、降雨量和河流水位的滞后显著相关。我们的研究结果为越南这一重要感染群体提供了新的见解，并突出了小儿CNSI预防和控制资源应分配的地点。
