法国百日咳住院（2008-2020年）：基于法国国家卫生数据系统的发病率和成本的现实世界回顾性分析

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-05-05 DOI:10.1016/j.jiph.2025.102801

Juan C. Vargas-Zambrano , Mickael Arnaud , Ana Antunes , Khalil Karzazi , Johanna Despres , Regis Verdier , Florence Boisnard , Jerome Jund , Cecile Janssen , Didier Pinquier , Denis Macina

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引用次数: 0

摘要

背景：在法国评估百日咳负担和2013年疫苗接种计划更新（3 + 1至2 + 1计划）的影响因非强制性报告而受阻。我们的目的是估计2008年至2020年间法国百日咳的累积发病率和住院费用。方法本观察性回顾性队列研究使用法国国家健康数据系统（SNDS）（2008年1月至2020年12月）的索赔数据进行。分析百日咳累积发病率-住院率、累积发病率比和经济负担。累积发病率估计为每年记录的法国人口因SNDS而住院的百日咳总人数，并以每10万居民表示。累积发病率采用经百日咳疾病循环模式调整的负二项回归估计。结果全年百日咳住院10893例，重症36.7 % [n = 3997]；百日咳博德泰拉病：93.3 % [n = 10,158])。2009年（n = 1276）、2012-2013年（n = 2762）和2017-2018年（n = 1727）报告了疫情。病例比例最高的年龄组为2-5个月（34.7 %），其次为0-1个月（18.0 %）和≥65岁（13.6 %）。2月龄和2 ~ 5月龄婴儿因百日咳杆菌病累积住院的发生率相似(累积发病率比[CIR]=0.96 [0.90 ~ 1.02]；比较者：2个月)，且≥1岁患儿较低（CIR≤0.01）。成人中，CIR随年龄增长而增加，在≥65岁时达到峰值(CIR=2.95 [2.57-3.38]；比较对象：18-25岁)。CIR降低后计划变化(CIR=0.61 [0.43-0.84]；比较国：3 + 1)和强制疫苗接种政策实施后(CIR=0.68 [0.43-1.08]；比较指标：在强制疫苗接种政策出台之前)。总体费用中位数为3259欧元（所有病例），重症病例费用较高，2个月大的婴儿费用最高（4880欧元）。结论：结果再次强调百日咳持续存在的公共卫生挑战，特别是0-5个月的婴儿。研究结果可能指导欧洲未来的疫苗接种政策。

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Pertussis hospitalizations in France (2008–2020): A real-world retrospective analysis of incidence and costs based on the French National Health Data System

Background

Assessing pertussis burden and the impact of the 2013 vaccination schedule update (3 + 1 to 2 + 1 schedule) in France is hindered by non-mandatory reporting. We aimed to estimate the cumulative incidence and hospitalization costs due to pertussis in France between 2008 and 2020.

Methods

This observational retrospective cohort study was conducted using claims data from the French National Health Data System (SNDS) (January 2008–December 2020). Cumulative incidence of pertussis-hospitalizations, cumulative incidence ratios, and economic burden were analyzed. Cumulative incidences were estimated as the total pertussis-hospitalizations recorded annually from SNDS with respect to the French population, and expressed per 100,000 inhabitants. Cumulative incidence ratios were estimated using a negative binomial regression adjusted on the cyclical pattern of pertussis disease.

Results

Overall, 10,893 patients were hospitalized for pertussis (severe cases: 36.7 % [n = 3997]; Bordetella pertussis disease: 93.3 % [n = 10,158]). Outbreaks were reported in 2009 (n = 1276), 2012–2013 (n = 2762), and 2017–2018 (n = 1727). The age group with the highest proportion of cases was 2–5 months (34.7 %), followed by 0–1 month (18.0 %) and ≥65 years (13.6 %). Cumulative incidence of hospitalization due to Bordetella pertussis disease was similar among infants aged <2 and 2–5 months (cumulative incidence ratio [CIR]=0.96 [0.90–1.02]; comparator: <2 months) and quite low in children aged ≥1 year (CIR≤0.01). Among adults, CIRs increased with age and peaked at ≥65 years (CIR=2.95 [2.57–3.38]; comparator: 18–25 years). CIRs decreased post schedule change (CIR=0.61 [0.43–0.84]; comparator: 3 + 1) and post-implementation of mandatory vaccination policy (CIR=0.68 [0.43–1.08]; comparator: before mandatory vaccination policy) across all age groups. Median overall costs were €3259 (all cases), with higher costs for severe cases and highest costs (€4880) for infants aged <2 months.

Conclusion

Results reemphasized the persistent public health challenge of pertussis, especially in infants aged 0–5 months. Findings may guide future vaccination policies in Europe.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.