Faculty of Medicine of Monastir, University of Monastir , Monastir, Tunisia.
Department of Preventive and Community Medicine, University Hospital Fattouma Bourguiba , Monastir, Tunisia.
Libyan J Med. 2020 Dec;15(1):1783048. doi: 10.1080/19932820.2020.1783048.
We aimed to describe the episodes and trends of admissions for community-acquired Respiratory Infections (RI) over a 12-year period and to assess the impact of Haemophilus influenza type b (Hib) vaccine on RI admissions in children aged up to 3 years.
We conducted a twelve-year retrospective observational study on all community-acquired RI admitted to Fattouma Bourguiba Hospital in Monastir Governorate (Tunisia) from 1 January 2002 to 31 December 2013. RI cases were selected from the Regional Registry of Hospital Morbidity. Data were coded according to ICD-10. To assess the impact of the Hib vaccine, three cohorts were defined based on vaccine status (unvaccinated cohort, first vaccinated cohort (VC) by monovalent form and second VC by pentavalent combination).
Admissions for RI represented 17.6% (CI95%: 17.3-18.1) of all communicable diseases hospitalizations (n = 6 061/34 289). The crude incidence rates (CIR) per 100,000 inh were 24.2 for upper RI (URI) and 77.5 and for Lower RI (LRI) (p < 0.0001). Pneumonias represented 53.9% of LRI. Sex-ratio (male/female) was 1.12 for URI and 1.64 for LRI (p < 0.0001). At admission, the median age was 22 years (IQR: 3-52). Admission for Pneumonia increased significantly during study period (slope 'b' = 5.16; p < 0.0001) especially in children up to 5 years old (slope 'b' = 5.53) and in elderly (slope 'b' = 2.13). Among children up to 3 years old, the CIRs per 100,000 for Hib pneumonia admission were 11.6 in Non-Vaccinated Cohort (NVC), 10.6 in Vaccinated Cohort (VC) by protocol 1 (Hib Vaccine monovalent) and 0.80 in VC by protocol 2 (pentavalent vaccine combination).The relative risk reduction was 99% for protocol 2 (p < 0.001).
Admissions for RI in a tertiary level hospital were common with an increasing trend. The Hib immunization program, in particular the pentavalent combination, has had a positive impact on the reduction of related acute diseases.
本研究旨在描述 12 年间社区获得性呼吸道感染（RI）的发病情况和趋势，并评估 Hib 疫苗对 3 岁以下儿童社区获得性 RI 住院的影响。
本研究对 2002 年 1 月 1 日至 2013 年 12 月 31 日期间在莫纳斯提尔省法图玛·布尔吉巴医院（突尼斯）住院的所有社区获得性 RI 患者进行了为期 12 年的回顾性观察性研究。RI 病例从区域住院疾病登记册中选择。数据根据 ICD-10 进行编码。为了评估 Hib 疫苗的影响，根据疫苗接种状态定义了三个队列（未接种疫苗队列、单剂 Hib 疫苗第一接种队列（VC）和五价疫苗联合第二 VC）。
RI 住院占所有传染病住院（n=6061/34289）的 17.6%（95%CI：17.3-18.1）。每 100,000 人发病率（CIR）为 24.2 例上呼吸道感染（URI）、77.5 例下呼吸道感染（LRI）（p<0.0001）。肺炎占 LRI 的 53.9%。URI 的男女比例为 1.12，LRI 为 1.64（p<0.0001）。入院时，中位年龄为 22 岁（IQR：3-52）。研究期间肺炎住院人数显著增加（斜率 'b'=5.16；p<0.0001），尤其是 5 岁以下儿童（斜率 'b'=5.53）和老年人（斜率 'b'=2.13）。3 岁以下儿童 Hib 肺炎入院的每 100,000 人发病率（CIR）在未接种疫苗队列（NVC）中为 11.6，在按方案 1（Hib 疫苗单价）接种疫苗队列（VC）中为 10.6，在按方案 2（五价疫苗联合）接种疫苗队列（VC）中为 0.80。方案 2 的相对风险降低了 99%（p<0.001）。
三级医院 RI 住院较为常见，呈上升趋势。Hib 免疫计划，特别是五价疫苗联合免疫，对减少相关急性疾病具有积极影响。
