Jin S, Kilgore P E, Holman R C, Clarke M J, Gangarosa E J, Glass R I
Department of International Health, Emory University School of Public Health, Atlanta, GA, USA.
Pediatr Infect Dis J. 1996 May;15(5):397-404. doi: 10.1097/00006454-199605000-00004.
To examine trends in the hospitalizations of children for diarrheal disease in the U.S. and to provide estimates for the burden of disease associated with rotavirus diarrhea.
Data for diarrheal hospitalizations among U.S. children ages 1 month through 4 years were compiled from the National Hospital Discharge Survey for the years 1979 through 1992. Between 1979 and 1992, 12% of all hospitalizations of U.S. children 1 month through 4 years of age had an International Classification of Diseases code for diarrhea listed in one of the top three positions on the discharge diagnosis.
The annual rate of diarrheal hospitalizations, 97 per 10 000 persons (average, 185 742 per year), did not change substantially during the 14-year study period and accounted annually for 724 394 inpatient days (3.9 days per hospitalization). For most diarrheal hospitalizations (75.9%) no causative agent was specified in the National Hospital Discharge Survey records; of the remaining 24.8%, viruses were most commonly reported (19.3%), followed by bacteria (5.1%) and parasites (0.7%). The proportion of hospitalizations associated with viral diarrheas rose from 13% to 27% during the 14-year study period, whereas the proportion of hospitalizations for noninfectious diarrhea declined from 79% to 60%. Every year the number of hospitalizations peaked from November through April, the "winter" months, among children ages 4 through 35 months; this peak began in the West during November and December and reached the Northeast by March.
Diarrhea continues to be a common cause of hospitalization among children in the United States and the winter seasonality estimated to be caused in large part by rotavirus would be expected to decrease if rotavirus vaccines currently being developed were introduced. Our analysis of temporal trends in diarrheal hospitalizations provides a unique surrogate with which to estimate the disease burden associated with rotavirus diarrhea.
研究美国儿童腹泻病住院情况的趋势，并估计轮状病毒腹泻相关疾病负担。
收集1979年至1992年美国国家医院出院调查中1个月至4岁儿童腹泻住院的数据。1979年至1992年期间，美国1个月至4岁儿童所有住院病例中有12%的出院诊断中，国际疾病分类代码显示腹泻位列前三。
腹泻住院年发病率为每万人97例（平均每年185742例），在14年研究期间无显著变化，每年占住院日724394天（每次住院3.9天）。在国家医院出院调查记录中，大多数腹泻住院病例（75.9%）未明确病原体；其余24.8%中，最常报告的是病毒（19.3%），其次是细菌（5.1%）和寄生虫（0.7%）。在14年研究期间，病毒性腹泻相关住院比例从13%升至27%，而非感染性腹泻住院比例从79%降至60%。每年11月至次年4月（“冬季”月份），4至35个月大儿童的住院病例数达到峰值；该峰值11月和12月始于西部，3月到达东北部。
腹泻仍是美国儿童住院的常见原因，如果目前正在研发的轮状病毒疫苗投入使用，预计很大程度上由轮状病毒导致的冬季季节性腹泻将会减少。我们对腹泻住院时间趋势的分析为估计轮状病毒腹泻相关疾病负担提供了一个独特的替代指标。
