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阿根廷疫苗接种前和接种后时期流感所致死亡率:一项生态学研究(2002 - 2016年) 阿根廷疫苗接种前和接种后时期归因于流感的死亡率:生态学研究(2002 - 2016年)

[Mortality attributable to influenza in pre-vaccination and post-vaccination periods in Argentina: an ecological study (2002-2016)Mortalidade atribuível à gripe no período pré-vacinal e pós-vacinal na Argentina: estudo ecológico (2002-2016)].

作者信息

Sarrouf Elena B, Souza-Santos Reinaldo, Cruz Oswaldo Gonçalves

机构信息

Departamento de Estadísticas de Salud de los Servicios, Dirección de Epidemiología, Ministerio de Salud Pública de la provincia de Tucumán, Argentina.

Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Rev Panam Salud Publica. 2019 Feb 13;43:e15. doi: 10.26633/RPSP.2019.15. eCollection 2019.

Abstract

OBJECTIVES

Compare mortality from severe acute respiratory infection (SARI) attributable to influenza between pre-vaccination (pre-V) and post-vaccination (post-V) periods, to determine the historical evolution and seasonality of time series between 2002 and 2016, and to estimate the risk of death in children between 6 and 23 months of age, using a statistical model.

METHODS

Time-series study using official mortality data from the official statistical database on deaths. ICD-10 codes between J09-18.9 and J22X were considered to represent SARI. Crude rates and age-adjusted rates (AAR) were calculated, and pre-V (2002-2009) and post-V (2010-2016) periods were compared using the chi-squared (2) test. The best statistical model was the one that compared deaths from SARI in children during 2002 with other years. The data were analyzed with R programming ( <0.05).

RESULTS

4.6% of deaths (301,747) were from SARI, with a median age of 82 years. The percentage of deaths under age 2 declined in the post-V period (from 2.34% to 0.99%, < 0.05). Marked seasonality was observed in winter. The AAR in persons over age 64 rose from 259.8 per 100,000 population (pre-V) to 328.6 (post-V) ( < 0.05). In children, the crude rate dropped significantly. Compared with the year 2002, there was a significantly lower estimated risk of dying from SARI during the three years post-V.

CONCLUSIONS

The reduction in mortality from influenza in Argentina was more pronounced in children, with an estimated 3.5 fewer child deaths from SARI per month.

摘要

目的

比较接种疫苗前(V前)和接种疫苗后(V后)时期因流感导致的严重急性呼吸道感染(SARI)死亡率,确定2002年至2016年时间序列的历史演变和季节性,并使用统计模型估计6至23个月龄儿童的死亡风险。

方法

采用官方死亡统计数据库中的官方死亡率数据进行时间序列研究。将J09 - 18.9和J22X之间的国际疾病分类第十版(ICD - 10)编码视为代表SARI。计算粗率和年龄调整率(AAR),并使用卡方(χ²)检验比较V前(2002 - 2009年)和V后(2010 - 2016年)时期。最佳统计模型是将2002年儿童SARI死亡情况与其他年份进行比较的模型。使用R编程对数据进行分析(P < 0.05)。

结果

4.6%的死亡(301,747例)由SARI导致,中位年龄为82岁。V后时期2岁以下儿童的死亡百分比下降(从2.34%降至0.99%,P < 0.05)。在冬季观察到明显的季节性。64岁以上人群的AAR从每10万人口259.8(V前)升至328.6(V后)(P < 0.05)。在儿童中,粗率显著下降。与2002年相比,V后三年因SARI死亡的估计风险显著降低。

结论

阿根廷流感死亡率的降低在儿童中更为明显,估计每月因SARI导致的儿童死亡减少3.5例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2332/6398302/f4d633de5729/rpsp-43-e15-g001.jpg

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