Uppala Rattapon, Sitthikarnkha Phanthila, Niamsanit Sirapoom, Sutra Sumitr, Thepsuthammarat Kaewjai, Techasatian Leelawadee, Anantasit Nattachai, Teeratakulpisarn Jamaree
Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang, Khon Kaen 40002, Thailand.
Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Trop Med Infect Dis. 2022 Jul 28;7(8):151. doi: 10.3390/tropicalmed7080151.
Background: The COVID-19 outbreak emerged in January 2020 and remains present in 2022. During this period, nonpharmaceutical interventions (NPIs) have been used to reduce the spread of COVID-19 infection. Nationwide data analysis should be pushed as the new standard to demonstrate the impact of COVID-19 infection on other respiratory illnesses and the reliability of NPIs during treatment. Objective: This study aims to identify and compare the incidence of lower respiratory tract infections (LRTIs) among children in Thailand before and after the emergence of COVID-19. Methods: A retrospective study was carried out in hospitalized children under the age of 18 in Thailand from October 2015 to September 2020. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification, was used to identify patient diagnoses (ICD-10-TM). The data were extracted from the Universal Coverage Health Security Scheme Database. Results: A total of 1,610,160 admissions were attributed to LRTIs. The most common diagnosis was pneumonia (61.9%). Compared to the 2019 fiscal year, the number of hospitalizations due to LRTIs decreased by 33.9% in the 2020 fiscal year (COVID-19 period) (282,590 vs. 186,651). The incidence of all three diagnostic groupings was substantially lower in the pre- and post-COVID-19 eras, with a decrease of 28% in the pneumonia group (incidence rate ratio (IRR) = 0.72; 95% confidence interval (CI): 0.71 to 0.72), 44% in the bronchiolitis group (IRR = 0.56; 95% CI: 0.55 to 0.57), and 34% in the bronchitis group (IRR = 0.66; 95% CI: 0.65 to 0.67). Between fiscal years 2019 and 2020, the overall monthly cost of all hospitalizations for LRTIs decreased considerably (p value < 0.001). Conclusions: NPIs may decrease the number of pediatric hospitalizations related to LRTIs. All policies designed to prevent the spread of COVID-19 must be continually utilized to maintain the prevention of LRTIs.
2019冠状病毒病（COVID-19）疫情于2020年1月出现，并在2022年仍有发生。在此期间，非药物干预措施（NPIs）已被用于减少COVID-19感染的传播。应推动全国性数据分析作为新标准，以证明COVID-19感染对其他呼吸道疾病的影响以及NPIs在治疗期间的可靠性。目的：本研究旨在确定并比较COVID-19出现前后泰国儿童下呼吸道感染（LRTIs）的发病率。方法：对2015年10月至2020年9月在泰国住院的18岁以下儿童进行回顾性研究。使用《国际疾病和相关健康问题统计分类》第十次修订版泰国修改版来确定患者诊断（ICD-10-TM）。数据从全民覆盖健康保障计划数据库中提取。结果：共有1,610,160例住院归因于LRTIs。最常见的诊断是肺炎（61.9%）。与2019财年相比，2020财年（COVID-19期间）因LRTIs住院的人数减少了33.9%（282,590例对186,651例）。在COVID-19之前和之后的时期，所有三个诊断组的发病率均大幅降低，肺炎组降低了28%（发病率比（IRR）=0.72；95%置信区间（CI）：0.71至0.72），细支气管炎组降低了44%（IRR = 0.56；95%CI：0.55至0.57），支气管炎组降低了34%（IRR = 0.66；95%CI：0.65至0.67）。在2019财年和2020财年之间，所有LRTIs住院的总体每月费用大幅下降（p值<0.001）。结论：NPIs可能会减少与LRTIs相关的儿科住院人数。所有旨在预防COVID-19传播的政策必须持续使用，以维持对LRTIs的预防。
