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首页> 外文期刊>BMC Medical Informatics and Decision Making >Relationship between the population incidence of pertussis in children in New South Wales, Australia and emergency department visits with cough: a time series analysis
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Relationship between the population incidence of pertussis in children in New South Wales, Australia and emergency department visits with cough: a time series analysis

机译：澳大利亚新南威尔士州儿童百日咳的人群发病率与急诊科咳嗽的关系：时间序列分析

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Background Little is known about the potential of syndromic surveillance to provide early warning of pertussis outbreaks. We conducted a time series analysis to assess whether an emergency department (ED) cough syndrome would respond to changes in the incidence of pertussis in children aged under 10?years in New South Wales (NSW), Australia, and to evaluate the timing of any association. A further aim was to assess the lag between the onset of pertussis symptoms and case notification in the infectious diseases surveillance system in NSW. Methods Using routinely collected data, we prepared a daily count time series of visits to NSW EDs assigned a provisional diagnosis of cough. Separate daily series were prepared for three independent variables: notifications of cases of pertussis and influenza and ED visits with bronchiolitis (a proxy measure of respiratory syncytial virus (RSV) infection). The study period was 1/1/2007-31/12/2010. A negative binomial multivariate model was used to assess associations between the outcome and independent variables. We also evaluated the median delay in days between the estimated onset of a case of pertussis and the date the local public health authority was notified of that case. Results When notified pertussis increased by 10 cases in one day, ED visits with cough increased by 5.2% (95% confidence interval (CI): 0.5%-10.0%) seven days later. Daily increases in the other independent variables had a smaller impact on cough visits. When notified influenza increased by 10 cases in one day, ED visits with cough increased by 0.8% (95% CI: 0%-1.7%) seven days later. When ED visits with bronchiolitis increased by 10 visits in one day, ED visits with cough increased by 4.8% (95% CI: 1.2%-8.6%) one day earlier. The median interval between estimated onset of pertussis and case notification was seven days. Conclusions Pertussis appears to be an important driver of ED visits with cough in children aged under 10?years. However, the median delay in notification of cases of pertussis was similar to the lag in the pertussis-associated short-term increases in ED visits with cough. Elevations in RSV and influenza activity may also explain increases in the ED cough syndrome. Real time monitoring of ED visits with cough in children is therefore unlikely to consistently detect a potential outbreak of pertussis before passive surveillance.
机译：背景鲜为人知的是，症状监测对百日咳暴发提供预警的潜力。我们进行了时间序列分析，以评估澳大利亚新南威尔士州（NSW）急诊科（ED）咳嗽综合征是否会对百岁以下儿童百日咳的发生率产生反应，并评估任何时间协会。另一个目的是评估新南威尔士州传染病监视系统中百日咳症状发作与病例通报之间的时间差。方法使用常规收集的数据，我们准备了对新南威尔士州急诊科就诊的咳嗽临时诊治的每日计数时间序列。为三个独立变量准备了单独的每日系列：百日咳和流感病例的通知以及细支气管炎的急诊就诊（呼吸道合胞病毒（RSV）感染的替代指标）。研究期为1/1 / 2007-31 / 12/2010。负二项式多元模型用于评估结果与独立变量之间的关联。我们还评估了百日咳病例的估计发病与当地公共卫生当局通知该病例之间的延迟天数。结果当通报百日咳一天内增加10例时，七天后有咳嗽的ED就诊增加了5.2％（95％置信区间（CI）：0.5％-10.0％）。其他自变量的每日增加对咳嗽的影响较小。如果一天之内通知的流感病例增加10例，则7天后咳嗽的ED就诊次数增加了0.8％（95％CI：0％-1.7％）。当ED毛细支气管炎的访视在一天中增加10次时，咳嗽ED的访视在一天前增加了4.8％（95％CI：1.2％-8.6％）。估计百日咳发作与病例通报之间的中位间隔为7天。结论百日咳似乎是10岁以下儿童咳嗽急诊就诊的重要驱动因素。但是，百日咳病例的中位通知延迟与因咳嗽而急诊就诊的百日咳相关短期增加的滞后时间相似。 RSV和流感活动的升高也可能解释了ED咳嗽综合征的增加。因此，在被动监测之前，对儿童咳嗽急诊就诊的实时监测不可能始终如一地发现百日咳的潜在爆发。

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