新型冠状病毒肺炎防控措施对儿童百日咳就诊趋势的影响

Influence of COVID-19 epidemic on the treatment trend of children with pertussis

目的分析新型冠状病毒肺炎(以下简称新冠肺炎)疫情防控措施实施前后山东大学附属儿童医院儿童百日咳就诊趋势的变化,以了解新冠肺炎防控措施对儿童百日咳就诊趋势的影响。方法基于2018年1月1日-2021年12月31日山东大学附属儿童医院感染性疾病科每月门诊量和上报山东省疾病预防控制中心的儿童百日咳数据资料,以我国2020年2月后采取隔离、戴口罩等新冠肺炎防控措施为基准,分为新冠肺炎防控措施实施前(2018年1月-2020年1月)、实施后(2020年2月-2021年12月)两个时间点,采用断点回归设计对防控措施实施前后儿童百日咳就诊趋势进行分析。结果2018-2021年山东大学附属儿童医院共报告儿童百日咳737例,总报告率为0.334%。防控措施实施前百日咳报告率为0.463%,防控措施实施后百日咳报告率为0.117%。与防控措施实施前相比,防控政策的实施后4岁及以下年龄组儿童就诊构成比下降14.647%,散居儿童就诊构成比下降4.555%,儿童春季就诊构成比下降14.849%,儿童夏季就诊构成比下降23.941%。与防控措施实施前相比,防控措施实施后1月份和3-11月每月儿童百日咳就诊构成比下降,差异均有统计学意义(P<0.001),而在2月份(χ^(2)=0.158,P=0.691)和12月份(χ^(2)=0.002,P=0.960)无统计学意义。断点回归结果提示,百日咳就诊构成比在防控措施实施节点处出现明显向下的跳跃,瞬时降低0.501%(95%CI:-0.971~-0.144),差异具有统计学意义(P=0.016)。结论新冠肺炎防控措施实施后,儿童百日咳报告人数和报告率下降。

Objective To analyze the changes in the trend of childhood pertussis visits in Jinan Children's Hospital before and after the implementation of the Corona Virus Disease 2019(COVID-19)epidemic prevention and control measures,so as to understand the impact of COVID-19prevention and control measures on the trend of childhood pertussis visits.Methods Based on the monthly outpatient volume of Infectious Diseases Department of Jinan Children's Hospital from January 1,2018to December 31,2021and the data of children with pertussis reported to Shandong Center for Disease Control and Prevention,the period of 2018to 2021was divided into 2time points before the implementation of COVID-19 prevention and control policies(January 2018-January 2020)and after the implementation(February 2020-December 2021).After February 2020,the government adopted measures such as quarantine and wearing masks.The regression discontinuity design was used to analyze the clinical trend of children with pertussis before and after the implementation of prevention and control policies.Results From 2018to 2021,a total of 737cases of pertussis were reported in Jinan Children's Hospital,with a total reporting rate of 0.334%,0.463%before and 0.117%after the implementation of the prevention and control measures.Compared with implementing the prevention and control measures,the composition ratio of children aged 4and under who went to the doctor decreased by 14.647%.Before and after implementing the prevention and control measures,the composition ratio of scattered children decreased by 4.555%.After implementing prevention and control measures,the composition ratio of children visiting doctors in spring dropped by 14.849%,and the percentage of children visiting doctors in summer dropped by 23.941%.Compared with before the implementation of the prevention and control measures,the proportion of children who visited pertussis per month in January and from March to November after the implementation of the prevention and control measures decreased significantly,with statistical significance(P<0.001),but there was no statistical significance in February(χ^(2)=0.158,P=0.691)and December(χ^(2)=0.002,P=0.960).Regression discontinuity results suggested that the proportion of patients attending pertussis showed a significant downward jump at the node where the prevention and control measures was implemented,instantly decreasing by 0.501%(95%CI:-0.971,-0.144),and the difference was statistically significant(P=0.016).Conclusion After the implementation of the COVID-19prevention and control measures,the number and rate of children reporting pertussis decreased in Jinan Children's Hospital.