Abstract
BackgroundRespiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. However, data on trends of respiratory diseases over long period of time is limited. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children’s teaching hospitals in China between 2009 and 2018.MethodsA retrospective study based on routine administrative data was designed and implemented according to the RECORD statement. Demographic details and diagnoses of the outpatients < 18 years visiting the respiratory department of the hospital were extracted from the Hospital Information System. Age- and gender-specific trends were illustrated by calculating average annual growth rate (AAGR) for ROVs and comparing change of proportion for different RODs over time.ResultsThere were 698,054 ROVs from 285,574 children (40.4% female). AAGR of ROVs was 15.2%. Children aged 4 to < 7 years had a faster increase than other age groups. Bronchitis (27.6%), pneumonia (18.5%), pneumonia affecting other systems (18.4%), asthma and status asthmaticus (10.7%), and vasomotor and allergic rhinitis (9.2%) accounted for 84.4% of all RODs. The proportion of bronchitis decreased across years, with the concomitant increasing trend in the proportion of pneumonia. Age-specific trend in diagnoses showed greater proportion of asthma in all visits for the children aged 7 to < 18 years than younger children. Gender-specific trend in diagnoses showed the proportion of asthma was greater for males but the AAGR was greater for females.ConclusionThe persistent upward trend in ROVs was observed among children at different ages and a gender difference was also seen. In contrast to what has been reported, burden of asthma and allergies diseases continues to increase locally.
Highlights
Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported
When we further analyzed the trends in diagnoses of respiratory diseases, we found that bronchitis, pneumonia, asthma and status asthmaticus were main Respiratory outpatient diagnoses (RODs), Fig. 4 Time trends of proportion of respiratory diagnoses by gender and age groups, 2009–2018 accounting for more than 80% of total visits during the past 10 years (Fig. 3)
For outpatient children diagnosed with asthma and status asthmaticus, we found a U-shape time trend of the proportion of asthma, which decreased till 2015 and increased till 2018 (Fig. 4e, f)
Summary
Respiratory infections are one of three leading causes of childhood mortality, and worldwide increase and recent plateau in childhood asthma has been reported. This study aimed to determine the trends of respiratory disease outpatient visits (ROVs) and diagnoses (RODs) in one of the largest children’s teaching hospitals in China between 2009 and 2018. Compared with the report from the US, studies in Shanghai showed an almost five-fold increased prevalence of asthma among children in China, from 2.1% in 1990 to 10.2% in 2011, with a higher prevalence of asthma in boys than in girls in the age group of 3–7 years [10]. We used 10-year routine administrative data and reported age- and gender-specific trends in ROVs and RODs among children visiting one of the largest tertiary-level pediatric hospitals in China
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