Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.
Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand.
J Paediatr Child Health. 2022 Nov;58(11):1980-1989. doi: 10.1111/jpc.16131. Epub 2022 Jul 21.
Aseptic meningitis, including culture negative and viral meningitis, contributes a significant health-care burden, including unnecessary antibiotic use and hospitalisation to treat possible bacterial meningitis. This study analysed aseptic meningitis hospitalisations in New Zealand (NZ) children over 29 years.
In this population-based study, aseptic meningitis hospitalisations in NZ children <15 years old were analysed from 1991 to 2020. Incident rate ratios were calculated using Poisson regression models. Variations in hospitalisations by age, year, sex, ethnicity, geographical region and socio-economic deprivation were analysed.
There were 5142 paediatric aseptic meningitis hospitalisations from 1991 to 2020. Most were unspecified viral meningitis (64%), followed by enterovirus (29%). Hospitalisation rates varied annually with a median of 18.4/100 000 children including a peak in 2001 of 56.4/100 000 (51.7-61.6). From 2002 to 2019, rates increased by 8.4%/year (7.2-9.5%) in infants <90 days old but decreased in all other age groups. In 2020, a reduction in hospitalisations to 9.6/100 000 (7.9-11.8) occurred, and in infants <90 days old were 0.37 times expected. Hospitalisations were 1.50 times (1.49-1.68) higher in males than females; higher in children of Māori (P < 0.001) and Pacific (P < 0.001) versus European ethnicity; and higher for children living in the most (2.44 times, (2.16-2.75)) versus least deprived households; and in northern versus southern NZ.
Aseptic meningitis hospitalisations increased in young infants during 29 years of surveillance, apart from 2020 when admissions reduced during the COVID-19 pandemic. In contrast, hospitalisations decreased in children aged >1 year. Further investigation into reasons for higher admissions by ethnic group, geographical location and increased deprivation are required.
无菌性脑膜炎，包括培养阴性和病毒性脑膜炎，对医疗保健造成了重大负担，包括不必要的抗生素使用和住院治疗可能的细菌性脑膜炎。本研究分析了新西兰（NZ）29 年来儿童无菌性脑膜炎住院情况。
在这项基于人群的研究中，分析了 1991 年至 2020 年期间新西兰<15 岁儿童的无菌性脑膜炎住院情况。使用泊松回归模型计算发病率比值。分析了年龄、年份、性别、种族、地理位置和社会经济贫困程度对住院情况的影响。
1991 年至 2020 年期间，共有 5142 例儿科无菌性脑膜炎住院。大多数为未明确病毒性脑膜炎（64%），其次是肠道病毒（29%）。住院率每年变化，中位数为 18.4/100000 名儿童，2001 年达到峰值 56.4/100000（51.7-61.6）。2002 年至 2019 年，<90 天的婴儿的发病率每年增加 8.4%（7.2-9.5%），但所有其他年龄组的发病率均下降。2020 年，住院率降至 9.6/100000（7.9-11.8），<90 天的婴儿的住院率预计为 0.37 倍。与女性相比，男性的住院率高 1.50 倍（1.49-1.68）；毛利人（P<0.001）和太平洋岛民（P<0.001）高于欧洲裔；生活在最贫困（2.44 倍，（2.16-2.75））和最贫困（2.44 倍，（2.16-2.75））的家庭中的儿童的住院率较高；以及新西兰北部与南部。
在 29 年的监测期间，除了 2020 年 COVID-19 大流行期间住院人数减少外，<90 天的婴儿无菌性脑膜炎住院人数增加。相比之下，1 岁以上儿童的住院人数减少。需要进一步调查为什么某些族裔、地理位置和更高的贫困程度导致住院率较高。
