背景:中耳炎(OM)是儿童中普遍存在的呼吸道疾病,由于其对儿童健康和经济负担的影响,因此构成了重大的公共卫生挑战。然而,没有在日本进行的全国性流行病学研究。本研究调查了日本OM的流行病学趋势,考虑到7价肺炎球菌结合疫苗(PCV7)引入的影响。
方法:本研究为回顾性队列研究,使用全国纵向出生队列的次要数据。这项调查是在2001年(PCV前时代)和2010年(PCV后时代)出生的两个队列,直到9岁。每年,父母接受了关于他们孩子健康状况的调查,包括OM的出现。在这项研究中评估了OM的年度患病率和累积发病率。并使用改良的Poisson回归模型调整了环境因素,以2001年队列为参考,对两个队列进行了比较。
结果:该研究包括来自2001年队列的47,015名儿童和来自2010年队列的38,554名儿童。OM的峰值年流行率因时代而异。按1.5岁计算,2001年队列的累积发病率为13.8%,2010年队列的累积发病率为18.5%,分别为28.9%和33.3%。分别,到3.5岁。特别是,从第四次调查开始,涵盖2.5-3.5岁,观察到OM风险从增加转变为降低.
结论:这项全国性的纵向研究强调了整个日本的OM流行病学随时间的变化,变化可能受到PCV7的引入的影响。在这项研究中,由于缺乏个人PCV7疫苗接种数据,PCV7的效果是根据人群水平的疫苗接种率估算的.结果表明,后期OM的发病率显着下降,与PCV7的摄取增加一致。
BACKGROUND: Otitis media (OM) is a prevalent respiratory disease in children and poses significant public health challenges due to its impact on child health and economic burdens. However, there have no nationwide epidemiological studies conducted in Japan. This
study investigates the epidemiological trends of OM in Japan, taking into account the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) introduction.
METHODS: This
study was retrospective cohort
study using secondary data on the nationwide longitudinal birth cohort. This survey followed two cohorts born in 2001 (pre-PCV era) and 2010 (post-PCV era) until the age of 9. Every year, parents were surveyed about their children\'s health status, including occurrences of OM. The annual period prevalence and cumulative incidence of OM were assessed in this
study, and the two cohorts were compared using a modified Poisson regression model adjusted environmental factors with the 2001 cohort as reference.
RESULTS: The
study included 47,015 children from the 2001 cohort and 38,554 from the 2010 cohort. Peak annual period prevalence of OM varied by era. Cumulative incidence was 13.8 % for the 2001 cohort and 18.5 % for the 2010 cohort by 1.5 years of age and 28.9 % and 33.3 %, respectively, by 3.5 years of age. In particular, from the fourth survey onward, covering ages 2.5-3.5 years, a shift was observed from an increased risk to a decreased risk of OM.
CONCLUSIONS: This nationwide longitudinal study emphasizes variations in OM epidemiology across Japan over time, with changes potentially influenced by the introduction of PCV7. In this
study, due to the absence of individual PCV7 vaccination data, the effect of PCV7 was estimated based on the vaccination rate at the population level. The results suggest a notable decrease in the incidence of OM in later years, aligning with the increased uptake of PCV7.