Infection is associated with one in five childhood deaths in England and Wales: analysis of national death registrations data, 2013–15

2020 ◽  
Vol 105 (9) ◽  
pp. 857-863 ◽  
Author(s):  
Laura Ferreras-Antolín ◽  
Godwin Oligbu ◽  
Ifeanyichukwu O Okike ◽  
Shamez Ladhani

ObjectiveTo estimate the contribution of infections to childhood deaths in England and Wales over a 3-year period.DesignRetrospective analysis of national electronic death registration data.SettingEngland and Wales.PatientsChildren aged 28 days to 15 years who died during 2013–15.Main outcome measuresThe proportion of children who died of infection compared with total deaths over 3 years; the main pathogens responsible for infection-related deaths in different age groups; comparison with similar data from 2003 to 2005.ResultsThere were 5088 death registrations recorded in children aged 28 days to <15 years in England and Wales during the three calendar years, 2013–2015 (17.6 deaths/100 000 children annually) compared with 6897 (23.9/100 000) during 2003–05 (incidence rate ratios (IRR) 0.74, 95% CI 0.71 to 0.77). During 2013–15, there were 951 (18.7%, 951/5088) infection-related deaths compared with 1368 (19.8%, 1368/6897) during 2003–05, equivalent to an infection-related mortality rate of 3.3/100 000 compared with 4.8/100 000 during the two periods (IRR 0.69, 95% CI 0.64 to 0.75), respectively. An underlying comorbidity was recorded in 55.0% (523/951) of death registrations during 2013–15 and increased with age. Where recorded, respiratory tract infection was the most commonly reported presentation (374/876, 42.7%) during 2013–15. Central nervous system infections accounted for only 4.8% (42/876). Overall, 63.1% (378/599) of infection-related deaths were associated with a bacterial, 34.2% (205/599) with a viral and 2.5% (15/599) with a fungal infection.ConclusionsBeyond the neonatal period, all-cause and infection-related childhood mortality rates have declined by 26% and 31%, respectively, over the past decade. However, infection continues to contribute to one in five childhood deaths.

2012 ◽  
Vol 153 (43) ◽  
pp. 1692-1700
Author(s):  
Viktória Szűcs ◽  
Erzsébet Szabó ◽  
Diána Bánáti

Results of the food consumption surveys are utilized in many areas, such as for example risk assessment, cognition of consumer trends, health education and planning of prevention projects. Standardization of national consumption data for international comparison is an important task. The intention work began in the 1970s. Because of the widespread utilization of food consumption data, many international projects have been done with the aim of their harmonization. The present study shows data collection methods for groups of the food consumption data, their utilization, furthermore, the stations of the international harmonization works in details. The authors underline that for the application of the food consumption data on the international level, it is crucial to harmonize the surveys’ parameters (e.g. time of data collection, method, number of participants, number of the analysed days and the age groups). For this purpose the efforts of the EU menu project, started in 2012, are promising. Orv. Hetil., 2012, 153, 1692–1700.


Author(s):  
Émilie Perez

The role of children in Merovingian society has long been downplayed, and the study of their graves and bones has long been neglected. However, during the past fifteen years, archaeologists have shown growing interest in the place of children in Merovingian society. Nonetheless, this research has not been without challenges linked to the nature of the biological and material remains. Recent analysis of 315 children’s graves from four Merovingian cemeteries in northern Gaul (sixth to seventh centuries) allows us to understand the modalities of burial ritual for children. A new method for classifying children into social age groups shows that the type, quality, quantity, and diversity of grave goods were directly correlated with the age of the deceased. They increased from the age of eight and particularly around the time of puberty. This study discusses the role of age and gender in the construction and expression of social identity during childhood in the Merovingian period.


2021 ◽  
Author(s):  
Sonia Bhala ◽  
Douglas R Stewart ◽  
Victoria Kennerley ◽  
Valentina I Petkov ◽  
Philip S Rosenberg ◽  
...  

Abstract Background Benign meningiomas are the most frequently reported central nervous system tumors in the United States (US), with increasing incidence in past decades. However, the future trajectory of this neoplasm remains unclear. Methods We analyzed benign meningioma incidence of cases identified by any means (eg, radiographically with or without microscopic confirmation) in US Surveillance Epidemiology and End Results (SEER) cancer registries among 35–84-year-olds during 2004–2017 by sex and race/ethnicity using age-period-cohort (APC) models. We employed APC forecasting models to glean insights regarding the etiology, distribution, and anticipated future (2018–2027) public health impact of this neoplasm. Results In all groups, meningioma incidence overall increased through 2010, then stabilized. Temporal declines were statistically significant overall and in most groups. JoinPoint analysis of cohort rate-ratios identified substantial acceleration in White men born after 1963 (from 1.1% to 3.2% per birth year); cohort rate-ratios were stable or increasing in all groups and all birth cohorts. We forecast that meningioma incidence through 2027 will remain stable or decrease among 55–84-year-olds but remain similar to current levels among 35–54-year-olds. Total meningioma burden in 2027 is expected to be approximately 30,470 cases, similar to the expected case count of 27,830 in 2018. Conclusions Between 2004–2017, overall incidence of benign meningioma increased and then stabilized or declined. For 2018–2027, our forecast is incidence will remain generally stable in younger age groups but decrease in older age groups. Nonetheless, the total future burden will remain similar to current levels because the population is aging.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwang-il Kim ◽  
Eunjeong Ji ◽  
Jung-yeon Choi ◽  
Sun-wook Kim ◽  
Soyeon Ahn ◽  
...  

AbstractWe analyzed the Korean National Health and Nutrition Examination Survey (KNHANES) database to determine the trends of hypertension treatment and control rate in Korea over the past 10 years. In addition, we tried to investigate the effect of chronic medical conditions on hypertension management. We investigated the hypertension prevalence, awareness, treatment, and control rate from 2008 to 2017. KNHANES, which uses a stratified multistage sampling design, is a cross-sectional, nationally representative survey conducted by the Korean government. A total of 59,282 adults (≥ 20 years) were included, which was representative of the total population of around 40 million Koreans per year. The mean age was 50.7 ± 16.4 years and 42.6% were male. The prevalence of hypertension, hypercholesterolemia, diabetes mellitus, and obesity significantly increased over the 10 years. During this period, the hypertension treatment and control rate significantly improved. Hypertension treatment rate was significantly lower in the younger age group compared to the older age group, but the control rate among the treated patients was not significantly different between age groups. The treatment and control rates of hypertension were higher in patients with multimorbidity, which implies that it has a favorable effect on the treatment and control of hypertension. Hypertension treatment and control rate have improved over the past 10 years. The higher treatment and control rate in patients with multimorbidity suggest that the more aggressive surveillance might be associated with the improvement of hypertension treatment and control rate in Korea.


Author(s):  
Alessandro Marcon ◽  
Elena Schievano ◽  
Ugo Fedeli

Mortality from idiopathic pulmonary fibrosis (IPF) is increasing in most European countries, but there are no data for Italy. We analysed the registry data from a region in northeastern Italy to assess the trends in IPF-related mortality during 2008–2019, to compare results of underlying vs. multiple cause of death analyses, and to describe the impact of the COVID-19 epidemic in 2020. We identified IPF (ICD-10 code J84.1) among the causes of death registered in 557,932 certificates in the Veneto region. We assessed time trends in annual age-standardized mortality rates by gender and age (40–74, 75–84, and ≥85 years). IPF was the underlying cause of 1310 deaths in the 2251 certificates mentioning IPF. For all age groups combined, the age-standardized mortality rate from IPF identified as the underlying cause of death was close to the European median (males and females: 3.1 and 1.3 per 100,000/year, respectively). During 2008–2019, mortality rates increased in men aged ≥85 years (annual percent change of 6.5%, 95% CI: 2.0, 11.2%), but not among women or for the younger age groups. A 72% excess of IPF-related deaths was registered in March–April 2020 (mortality ratio 1.72, 95% CI: 1.29, 2.24). IPF mortality was increasing among older men in northeastern Italy. The burden of IPF was heavier than assessed by routine statistics, since less than two out of three IPF-related deaths were directly attributed to this condition. COVID-19 was accompanied by a remarkable increase in IPF-related mortality.


Author(s):  
Iván Area ◽  
Henrique Lorenzo ◽  
Pedro J. Marcos ◽  
Juan J. Nieto

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.


1994 ◽  
Vol 1 (4) ◽  
pp. 229-234 ◽  
Author(s):  
A Senthilselvan

OBJECTIVE: To examine the trends in hospitalization rates for atsthma in Saskatchewan from 1970 to 1989 and to investigate the differences in asthma hospitalization rates between rural and urban dwellers.DESIGN: Asthma hospitalization rates were calculated for the age groups O to 4, 5 to 9. 10 to 14, 15 to 24. 25 to 34. 35 to 49 and 50 to 64 years for the period between 1970 and 1989. Only the first admission in each year for each person was included in the analysis. As the classification of asthma changed in 1978. trends in asthma hospitalization rates were investigated separately for the periods 1970 to 1978 and 1979 to 1989. respectively. Rate ratios were obtained for male/female and rural/urban comparisons by fitting Poisson regression models.SETTING: The hospitalization data for respiratory diseases for the province of Saskatchewan were examined by age group, sex and place or residence.RESULT: No significant increases were observed in asthma hospitalization rates lrorn 1970 to 1978. In the period 1979 to 1989. asthma hospitalization rates increased significantly among children under four years from 4.31/1000 in 1979 to 7.04/1000 in 1989. Among children under 14 years. asthma hospitalization rates were greater in boys than in girls . The converse was true for adults aged 15 and above, with women having a higher hospitalization rate for asthma than men . In adults aged 35 and above. rural dwellers had higher hospitalization rates for asthma than urban dwellers throughout the study period. In other age groups, although rural dwellers had higher asthma hospitalization rates than did urban dwellers during 1970 to 1984. the differences disappered duri ng 1985 to 1989.CONCLUSION: Further studies are required to find reasons for the increase in asthma hospitalizations among young children under four years old and for the differences between rural and urban dwellers in the age group 35 years and above.


2021 ◽  
Vol 79 (1) ◽  
pp. 289-300
Author(s):  
Lærke Taudorf ◽  
Ane Nørgaard ◽  
Gunhild Waldemar ◽  
Thomas Munk Laursen

Background: It remains unclear whether the increased focus on improving healthcare and providing appropriate care for people with dementia has affected mortality. Objective: To assess survival and to conduct a time trend analysis of annual mortality rate ratios (MRR) of dementia based on healthcare data from an entire national population. Methods: We assessed survival and annual MRR in all residents of Denmark ≥65 years from 1996–2015 using longitudinal registry data on dementia status and demographics. For comparison, mortality and survival were calculated for acute ischemic heart disease (IHD) and cancer. Results: The population comprised 1,999,366 people (17,541,315 person years). There were 165,716 people (529,629 person years) registered with dementia, 131,321 of whom died. From 1996–2015, the age-adjusted MRR for dementia declined (women: 2.76 to 2.05; men: 3.10 to 1.99) at a similar rate to elderly people without dementia. The sex-, age-, and calendar-year-adjusted MRR was 2.91 (95%CI: 2.90–2.93) for people with dementia. MRR declined significantly more for acute IHD and cancer. In people with dementia, the five-year survival for most age-groups was at a similar level or lower as that for acute IHD and cancer. Conclusion: Although mortality rates declined over the 20-year period, MRR stayed higher for people with dementia, while the MRR gap, compared with elderly people without dementia, remained unchanged. For the comparison, during the same period, the MRR gap narrowed between people with and without acute IHD and cancer. Consequently, initiatives for improving health and decreasing mortality in dementia are still highly relevant.


2004 ◽  
Vol 50 (8) ◽  
pp. 1301-1314 ◽  
Author(s):  
Shawn D Carrigan ◽  
George Scott ◽  
Maryam Tabrizian

Abstract Sepsis in the United States has an estimated annual healthcare cost of $16.7 billion and leads to 120 000 deaths. Insufficient development in both medical diagnosis and treatment of sepsis has led to continued growth in reported cases of sepsis over the past two decades with little improvement in mortality statistics. Efforts over the last decade to improve diagnosis have unsuccessfully sought to identify a “magic bullet” proteic biomarker that provides high sensitivity and specificity for infectious inflammation. More recently, genetic methods have made tracking regulation of the genes responsible for these biomarkers possible, giving current research new direction in the search to understand how host immune response combats infection. Despite the breadth of research, inadequate treatment as a result of delayed diagnosis continues to affect approximately one fourth of septic patients. In this report we review past and present diagnostic methods for sepsis and their respective limitations, and discuss the requirements for more timely diagnosis as the next step in curtailing sepsis-related mortality. We also present a proposal toward revision of the current diagnostic paradigm to include real-time immune monitoring.


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