Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.
J Epidemiol Community Health. 2021 Jan;75(1):76-83. doi: 10.1136/jech-2019-213056. Epub 2020 Sep 3.
Understanding differences in the seasonality of bronchiolitis can help to plan the timing of interventions. We quantified the extent to which seasonality in hospital admissions for bronchiolitis is modified by socioeconomic position.
Using Hospital Episode Statistics, we followed 3 717 329 infants born in English National Health Service hospitals between 2011 and 2016 for 1 year. We calculated the proportion of all infant admissions due to bronchiolitis and the incidence rate of bronchiolitis admissions per 1000 infant-years, according to year, month, age, socioeconomic position and region. We used harmonic Poisson regression analysis to assess whether socioeconomic position modified bronchiolitis seasonality.
The admission rate for bronchiolitis in England increased from 47.4 (95% CI 46.8 to 47.9) to 58.9 per 1000 infant-years (95% CI 58.3 to 59.5) between 2012 and 2016. We identified some variation in the seasonality of admissions by socioeconomic position: increased deprivation was associated with less seasonal variation and a slightly delayed epidemic peak. At week 50, the risk of admission was 38% greater (incidence rate ratios 1.38; 95% CI 1.35 to 1.41) for infants in the most deprived socioeconomic group compared with the least deprived group.
These results do not support the need for differential timing of prophylaxis or vaccination by socioeconomic group but suggest that infants born into socioeconomic deprivation should be considered a priority group for future interventions. Further research is needed to establish if the viral aetiology of bronchiolitis varies by season and socioeconomic group, and to quantify risk factors mediating socioeconomic deprivation and bronchiolitis rates.
了解毛细支气管炎季节性差异有助于规划干预措施的时间。我们量化了社会经济地位对毛细支气管炎住院季节性的影响程度。
我们使用医院病例统计数据，对 2011 年至 2016 年期间在英国国民保健服务医院出生的 3717329 名婴儿进行了为期 1 年的随访。我们根据年份、月份、年龄、社会经济地位和地区计算了所有婴儿因毛细支气管炎住院的比例和每 1000 婴儿年毛细支气管炎住院的发病率。我们使用调和泊松回归分析评估社会经济地位是否改变了毛细支气管炎的季节性。
英格兰毛细支气管炎的入院率从 2012 年至 2016 年期间从 47.4（95%CI 46.8 至 47.9）增加到 58.9 每 1000 婴儿年（95%CI 58.3 至 59.5）。我们发现社会经济地位对入院季节性的一些变化：贫困程度增加与季节性变化减少和流行高峰略有延迟有关。在第 50 周，最贫困的社会经济群体的婴儿入院风险比最不贫困的群体高 38%（发病率比 1.38；95%CI 1.35 至 1.41）。
这些结果不支持根据社会经济地位对预防或疫苗接种进行差异化时间安排的必要性，但表明出生在社会经济贫困家庭的婴儿应被视为未来干预的优先群体。需要进一步研究来确定毛细支气管炎的病毒病因是否随季节和社会经济群体而变化，并量化调节社会经济贫困和毛细支气管炎率的危险因素。
