PDF(Pubmed)
Abstract：
BACKGROUND: We describe how rates of two frequently occurring notifiable diseases-diphtheria and scarlet fever-varied between regions of The Netherlands in the early twentieth century, and identify potential factors underlying this variation.
METHODS: Digitized weekly mandatory notification data for 1905-1925, municipality level, were aggregated into 27 \'spatial units\' defined by unique combinations of province and population density category (high: more than 4500; mid : 1250-4500; low: less than 1250 inhabitants km-2). Generalized additive regression models were fitted to estimate the associations between notification rates and population density, infant mortality rate and household income, while adjusting for temporal trends per spatial unit.
RESULTS: Annual per capita notification rates for both diphtheria and scarlet fever tended to rise from the beginning of the period 1905-1925 until peaking around 1918/1919. Adjusted diphtheria notification rates were higher for high- and mid- compared with low-density municipalities (by 71.6 cases per 100 000, 95% confidence interval (CI) : 52.7-90.5; 39.0/100 k, 95% CI : 24.7-53.3, respectively). Scarlet fever showed similar associations with population density (35.7 cases per 100 000, 95% CI : 9.4-62.0; 21.4/100 k, 95% CI: 1.5-41.3).
CONCLUSIONS: There was considerable spatial variation in notification rates for both diseases in early twentieth century Netherlands, which could partly be explained by factors capturing variation in living conditions and socio-economic circumstances. These findings aid understanding of contemporary respiratory infection transmission.
METHODS: Digitized weekly mandatory notification data for 1905-1925, municipality level, were aggregated into 27 \'spatial units\' defined by unique combinations of province and population density category (high: more than 4500; mid : 1250-4500; low: less than 1250 inhabitants km-2). Generalized additive regression models were fitted to estimate the associations between notification rates and population density, infant mortality rate and household income, while adjusting for temporal trends per spatial unit.
RESULTS: Annual per capita notification rates for both diphtheria and scarlet fever tended to rise from the beginning of the period 1905-1925 until peaking around 1918/1919. Adjusted diphtheria notification rates were higher for high- and mid- compared with low-density municipalities (by 71.6 cases per 100 000, 95% confidence interval (CI) : 52.7-90.5; 39.0/100 k, 95% CI : 24.7-53.3, respectively). Scarlet fever showed similar associations with population density (35.7 cases per 100 000, 95% CI : 9.4-62.0; 21.4/100 k, 95% CI: 1.5-41.3).
CONCLUSIONS: There was considerable spatial variation in notification rates for both diseases in early twentieth century Netherlands, which could partly be explained by factors capturing variation in living conditions and socio-economic circumstances. These findings aid understanding of contemporary respiratory infection transmission.
摘要：
背景：我们描述了二十世纪初荷兰地区之间两种常见的应报告疾病白喉和猩红热的发生率如何变化，并确定这种变化背后的潜在因素。
方法：1905-1925年的数字化每周强制性通知数据，汇总为27个“空间单位”，由省份和人口密度类别的独特组合定义（高：4500以上；中：1250-4500；低：少于1250居民km-2）。拟合了广义加性回归模型来估计通知率和人口密度之间的关联，婴儿死亡率和家庭收入，同时调整每个空间单位的时间趋势。
结果：从1905-1925年开始，白喉和猩红热的年人均通报率趋于上升，直到1918/1919年左右达到峰值。与低密度城市相比，高，中，调整后的白喉通知率更高（每100000例71.6例，95％置信区间（CI）：52.7-90.5；39.0/100k，95%CI：分别为24.7-53.3）。猩红热与人口密度相似（每100000例35.7例，95％CI：9.4-62.0;21.4/100k，95%CI：1.5-41.3）。
结论：在20世纪早期荷兰，这两种疾病的通报率存在相当大的空间差异，这可以部分解释为捕捉生活条件和社会经济环境变化的因素。这些发现有助于理解当代呼吸道感染的传播。
方法：1905-1925年的数字化每周强制性通知数据，汇总为27个“空间单位”，由省份和人口密度类别的独特组合定义（高：4500以上；中：1250-4500；低：少于1250居民km-2）。拟合了广义加性回归模型来估计通知率和人口密度之间的关联，婴儿死亡率和家庭收入，同时调整每个空间单位的时间趋势。
结果：从1905-1925年开始，白喉和猩红热的年人均通报率趋于上升，直到1918/1919年左右达到峰值。与低密度城市相比，高，中，调整后的白喉通知率更高（每100000例71.6例，95％置信区间（CI）：52.7-90.5；39.0/100k，95%CI：分别为24.7-53.3）。猩红热与人口密度相似（每100000例35.7例，95％CI：9.4-62.0;21.4/100k，95%CI：1.5-41.3）。
结论：在20世纪早期荷兰，这两种疾病的通报率存在相当大的空间差异，这可以部分解释为捕捉生活条件和社会经济环境变化的因素。这些发现有助于理解当代呼吸道感染的传播。
