Weary Taylor E, Tusiime Patrick, Tuhaise Shamilah, Mandujano Reyes Juan Francisco, Ross Elizabeth, Gern James E, Goldberg Tony L
Department of Pathobiological Sciences, University of Wisconsin School of Veterinary Medicine, Madison, WI, United States.
The Kasiisi Project, Fort Portal, Uganda.
Front Pediatr. 2024 Apr 8;12:1336009. doi: 10.3389/fped.2024.1336009. eCollection 2024.
Respiratory disease is a major cause of morbidity and mortality in the developing world, but prospective studies of temporal patterns and risk factors are rare.
We studied people in rural Western Uganda, where respiratory disease is pervasive. We followed 30 adults (ages 22-51 years; 534 observations) and 234 children (ages 3-11 years; 1,513 observations) between May 2019 and July 2022 and collected monthly data on their respiratory symptoms, for a total of 2,047 case records. We examined associations between demographic and temporal factors and respiratory symptoms severity.
The timing of our study (before, during, and after the emergence of COVID-19) allowed us to document the effects of public health measures instituted in the region. Incidence rates of respiratory symptoms before COVID-19 lockdown were 568.4 cases per 1,000 person-months in children and 254.2 cases per 1,000 person-months in adults. These rates were 2.6 times higher than the 2019 global average for children but comparable for adults. Younger children (ages 3-6 years) had the highest frequencies and severities of respiratory symptoms. Study participants were most likely to experience symptoms in February, which is a seasonal pattern not previously documented. Incidence and severity of symptoms in children decreased markedly during COVID-19 lockdown, illustrating the broad effects of public health measures on the incidence of respiratory disease.
Our results demonstrate that patterns of respiratory disease in settings such as Western Uganda resemble patterns in developed economies in some ways (age-related factors) but not in others (increased incidence in children and seasonal pattern). Factors such as indoor air quality, health care access, timing of school trimesters, and seasonal effects (rainy/dry seasons) likely contribute to the differences observed.
在发展中世界，呼吸道疾病是发病和死亡的主要原因，但关于时间模式和风险因素的前瞻性研究很少。
我们对乌干达西部农村地区的人群进行了研究，该地区呼吸道疾病普遍存在。在2019年5月至2022年7月期间，我们跟踪了30名成年人（年龄在22至51岁之间；534次观察）和234名儿童（年龄在3至11岁之间；1513次观察），并每月收集他们的呼吸道症状数据，共获得2047份病例记录。我们研究了人口统计学和时间因素与呼吸道症状严重程度之间的关联。
我们的研究时间（新冠疫情出现之前、期间和之后）使我们能够记录该地区实施的公共卫生措施的效果。新冠疫情封锁前，儿童呼吸道症状的发病率为每1000人月568.4例，成人为每1000人月254.2例。这些发病率是2019年全球儿童平均发病率的2.6倍，但与成人的全球平均发病率相当。年龄较小的儿童（3至6岁）呼吸道症状的发生频率和严重程度最高。研究参与者最有可能在2月出现症状，这是一种此前未记录的季节性模式。在新冠疫情封锁期间，儿童症状的发病率和严重程度显著下降，这说明了公共卫生措施对呼吸道疾病发病率的广泛影响。
我们的结果表明，在乌干达西部这样的环境中，呼吸道疾病模式在某些方面（与年龄相关的因素）与发达经济体相似，但在其他方面（儿童发病率增加和季节性模式）则不同。室内空气质量、医疗保健可及性、学校学期时间以及季节影响（雨季/旱季）等因素可能导致了观察到的差异。
