A pluralistic approach to interpreting surveillance data: The likely decline in the occurrence of invasive pneumococcal disease in Japan during the COVID-19 pandemic

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-06-15 DOI:10.1016/j.annepidem.2025.06.008

Reiko Shimbashi , Yuzo Arima , Koji Yahara , Maki Masutani , Ayu Kasamatsu , Munehisa Fukusumi , Toshiki Kajihara , Takeshi Arashiro , Takuri Takahashi , Miyako Otsuka , Yusuke Kobayashi , Katsuhiro Komase , Yuuki Tsuchihashi , Bin Chang , Junko Amemura-Maekawa , Tomimasa Sunagawa , Motoi Suzuki , Yukihiro Akeda

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引用次数: 0

Abstract

Purpose

To systematically investigate whether the decline in invasive pneumococcal disease (IPD; caused by Streptococcus pneumoniae) notifications during the COVID-19 pandemic, based on Japan’s national infectious disease surveillance system, was due to a reduction in incidence.

Methods

Considering potential surveillance biases from changes in healthcare-seeking, testing/diagnosis, or reporting, we compared the following for the 12-month period before vs. after the state of emergency declaration (week 15, 2020): notification rates of IPD, invasive Haemophilus influenzae disease (IHD), and legionellosis (clinically similar bacterial diseases, but unlike IPD/IHD, legionellosis is not transmitted person-to-person and serves as a negative control); surveillance timeliness indicators; notifications restricted to severe cases; and S. pneumoniae detections accounting for test frequency.

Results

Following the declaration, IPD notifications decreased by 60 % (notification rate ratio = 0.39, 95 %CI = 0.37–0.42). While IHD also decreased markedly (0.37, 0.31–0.44), legionellosis declined little (0.83, 0.78–0.88). None of the diseases showed delays in timeliness. Restricted to severe cases, respectively similar trends were observed for IPD, IHD, and legionellosis, with respectively similar death trends in census data. Additionally, decrease in S. pneumoniae detections greatly exceeded that in test counts, substantially decreasing test positivity.

Conclusions

Based on our pluralistic approach, reduced IPD notifications could not be explained by surveillance biases and was likely due to decreased incidence.

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解读监测数据的多元方法：2019冠状病毒病大流行期间日本侵袭性肺炎球菌病发病率可能下降

目的：系统探讨侵袭性肺炎球菌病(IPD；根据日本国家传染病监测系统，在2019冠状病毒病大流行期间，由肺炎链球菌引起的)报告是由于发病率下降。方法：考虑到就诊、检测/诊断或报告的变化可能导致的监测偏差，我们比较了紧急状态宣布前后（2020年第15周）的12个月期间的以下情况：IPD、侵袭性流感嗜血杆菌病（IHD）和军团菌病（临床类似的细菌性疾病，但与IPD/IHD不同，军团菌病不会人与人之间传播，并作为阴性对照）的通报率；监测及时性指标；严重病例通报；肺炎链球菌检测占检测频率。结果：申报后IPD通报率下降60%（通报率比=0.39,95%CI=0.37 ~ 0.42）。军团病下降幅度较小（0.83,0.78-0.88），军团病下降幅度较小（0.37,0.31-0.44）。没有一种疾病显示出时效性的延迟。在严重病例中，IPD、IHD和军团菌病的趋势相似，在人口普查数据中分别有相似的死亡趋势。此外，肺炎链球菌检出率的下降大大超过了检测计数的下降，大大降低了检测阳性。结论：基于我们的多元方法，IPD报告的减少不能用监测偏差来解释，而可能是由于发病率的降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.