Does the economic recession influence the incidence of pertussis in a cosmopolitan European city?
Por:
Brugueras, S, Rius, C, Millet, JP, Casals, M, Cayla, JA, Simon, P, de Andres, A, Clos, R, Ricart, M, Ros, M, Santoma, MJ, Gorrindo, P, Palau, P, Cunille, M, Masdeu, E, Avellanes, I, Rodrigo, JA, Codina, G, Martin, MT, Gonzalez, JJ, Brio, S, Del Carpio, J, Otero, A, Diaz, A, Lopez, N, Vaque, M, Sala, P, Calsina, M, Meije, Y, Guasch, E, Pascual, MR, Palasi, C, Moro, AL, Enrubia, M, Monso, G, Sole, JM, Rodriguez, P, Pallares, H, Salva, A, Ferrandez, A, Hostalot, AM, Munoz, MC
Publicada:
4 feb 2019
Resumen:
BackgroundIn the last few years, pertussis has re-emerged worldwide. The aim of this article is to study how the incidence of the disease has evolved in Barcelona city over a 16-year period, and determine which factors are associated with the evolution of the disease. We discuss the causes of the observed changes considering different possibilities such as vaccination coverage, vaccine effectiveness, increased surveillance or the effect of the current economic recession.MethodsWe performed a cross-sectional, observational, population-based descriptive study using data for the 2000-2015 period from the notifiable diseases register maintained by Barcelona Public Health Agency. We used Poisson regression to compute adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (CI).ResultsA total of 1791 cases were registered. The incidence of the disease increased throughout the city from 2011 onwards. While children under 1year of age had the highest-incidence and were the most at risk (aOR=27.18, CI:23.51-31.44), we found that the age of affected children was higher in the last years. Incidence proportion (PRR) was lower among foreign-born children than native children (PRR=0.43 CI:0.32-0.58). In the whole-cell vaccine period (2000-2004), the percentage of cases under 1year of age who received the vaccine was lower than in 2005-2015 when the acellular vaccine was used (p=0.01), suggesting a lower efficacy of the acellular vaccine. However, vaccination coverage in children under 6years remained high (90%), and there were no significant year-to-year variations (p=0.757). Moreover, there did not appear to be any significant restrictions in medical care. According to the index of disposable household income (DHI), pertussis incidence increased from 2011 onwards in all neighbourhoods and remained higher in those with lower DHI.ConclusionsThe noteworthy increase in pertussis incidence does not seem to be due to the economic recession, but to other factors here described.
Filiaciones:
Brugueras, S:
Agencia Salut Publ Barcelona, Serv Epidemiol, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBF, Barcelona, Spain
Univ Autonoma Barcelona, Fac Med, Dept Pediat Obstet & Ginecol & Med Prevent, Barcelona, Spain
Rius, C:
Agencia Salut Publ Barcelona, Serv Epidemiol, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBF, Barcelona, Spain
Univ Autonoma Barcelona, Fac Med, Dept Pediat Obstet & Ginecol & Med Prevent, Barcelona, Spain
Millet, JP:
Agencia Salut Publ Barcelona, Serv Epidemiol, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ CIBF, Barcelona, Spain
TB Res Unit Fdn FuiTB, Barcelona, Spain
Casals, M:
Univ Vic Cent Univ Catalonia UVic UCC, Sport & Phys Activ Studies Ctr CEEAF, Barcelona, Spain
Cayla, JA:
Agencia Salut Publ Barcelona, Serv Epidemiol, Barcelona, Spain
TB Res Unit Fdn FuiTB, Barcelona, Spain
Simon, P:
Agencia Salut Publ Barcelona, Barcelona, Spain
de Andres, A:
Agencia Salut Publ Barcelona, Barcelona, Spain
Clos, R:
Agencia Salut Publ Barcelona, Barcelona, Spain
Ricart, M:
Agencia Salut Publ Barcelona, Barcelona, Spain
Ros, M:
Agencia Salut Publ Barcelona, Barcelona, Spain
Santoma, MJ:
Agencia Salut Publ Barcelona, Barcelona, Spain
Gorrindo, P:
Agencia Salut Publ Barcelona, Barcelona, Spain
Palau, P:
Agencia Salut Publ Barcelona, Barcelona, Spain
Cunille, M:
Agencia Salut Publ Barcelona, Barcelona, Spain
Masdeu, E:
Agencia Salut Publ Barcelona, Barcelona, Spain
Avellanes, I:
Agencia Salut Publ Barcelona, Barcelona, Spain
Rodrigo, JA:
Hosp Univ Vall Hebron, Barcelona, Spain
Codina, G:
Hosp Univ Vall Hebron, Barcelona, Spain
Martin, MT:
Hosp Univ Vall Hebron, Barcelona, Spain
Gonzalez, JJ:
Hosp Univ Vall Hebron, Barcelona, Spain
Brio, S:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Del Carpio, J:
Hosp Univ Dexeus, Barcelona, Spain
Otero, A:
Hosp Univ Dexeus, Barcelona, Spain
Diaz, A:
Hosp Nens Barcelona, Barcelona, Spain
Lopez, N:
Hosp Mar, Barcelona, Spain
Vaque, M:
Hosp Barcelona, Barcelona, Spain
Sala, P:
Hosp Barcelona, Barcelona, Spain
Calsina, M:
Hosp Barcelona, Barcelona, Spain
Meije, Y:
Hosp Barcelona, Barcelona, Spain
Guasch, E:
Ctr Atencio Primaria Via Barcino, Barcelona, Spain
Pascual, MR:
Ctr Atencio Primaria Via Barcino, Barcelona, Spain
Palasi, C:
Ctr Atencio Primaria Sardenya Barcelona, Barcelona, Spain
Moro, AL:
Ctr Atencio Primaria Larrard, Barcelona, Spain
Enrubia, M:
Ctr Atencio Pediat Integral Barcelona Esquerra, Barcelona, Spain
Monso, G:
Ctr Atencio Primaria Rio Janeiro, Barcelona, Spain
Sole, JM:
Ctr Atencio Primaria St Andreu, Barcelona, Spain
Rodriguez, P:
Consorci Atencio Primaria Salut Barcelona Esquer, Barcelona, Spain
Pallares, H:
Consorci Atencio Primaria Salut Barcelona Esquer, Barcelona, Spain
Salva, A:
Consorci Atencio Primaria Salut Barcelona Esquer, Barcelona, Spain
Ferrandez, A:
Ctr Atencio Primaria Ciutat Meridiana, Barcelona, Spain
Hostalot, AM:
Ctr Atencio Primaria Pare Claret, Barcelona, Spain
Munoz, MC:
Hosp St Joan Deu, Barcelona, Spain
Gold, Green Published
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