Is socioeconomic position associated with bronchiolitis seasonality? A cohort study

Abstract

BackgroundUnderstanding differences in the seasonality of bronchiolitis can help to plan the timing of interventions. We quantified the extent to which seasonality in hospital admissions for bronchiolitis is modified by socioeconomic position.MethodsUsing Hospital Episode Statistics, we followed 3 717 329 infants born in English National Health Service hospitals between 2011 and 2016 for 1 year. We calculated the proportion of all infant admissions due to bronchiolitis and the incidence rate of bronchiolitis admissions per 1000 infant-years, according to year, month, age, socioeconomic position and region. We used harmonic Poisson regression analysis to assess whether socioeconomic position modified bronchiolitis seasonality.ResultsThe admission rate for bronchiolitis in England increased from 47.4 (95% CI 46.8 to 47.9) to 58.9 per 1000 infant-years (95% CI 58.3 to 59.5) between 2012 and 2016. We identified some variation in the seasonality of admissions by socioeconomic position: increased deprivation was associated with less seasonal variation and a slightly delayed epidemic peak. At week 50, the risk of admission was 38% greater (incidence rate ratios 1.38; 95% CI 1.35 to 1.41) for infants in the most deprived socioeconomic group compared with the least deprived group.ConclusionThese results do not support the need for differential timing of prophylaxis or vaccination by socioeconomic group but suggest that infants born into socioeconomic deprivation should be considered a priority group for future interventions. Further research is needed to establish if the viral aetiology of bronchiolitis varies by season and socioeconomic group, and to quantify risk factors mediating socioeconomic deprivation and bronchiolitis rates.

Respiratory syncytial virus-associated hospitalisation in children aged ≤5 years: a scoping review of literature from 2009 to 2021

“…Three studies in the UK produced similar findings, with a peak in admissions seen in infants born during the winter months of September to December [ 7 , 15 , 16 ]. R eeves et al .…”

“…L ewis et al . (2020) [ 16 ] documented the increased bronchiolitis admission rate in England from 47.4 (95% CI 46.8–47.9) to 58.9 per 1000 infant-years (95% CI 58.3–59.5) between 2012 and 2016. A study by T umba et al .…”

“…Across the Clinical Commissioning Groups in England, L ewis et al . (2020) [ 16 ] found there was a 5.3-fold variation in incidence with area-level deprivation and the epidemic peak ranged from week 49.3 to 52.2. A study by G lick et al .…”

Air Pollution, housing and respiratory tract Infections in Children: NatIonal birth Cohort study (PICNIC): study protocol

“…The PICNIC study population includes two national birth cohorts comprising all children born in England between 2005 and 2014 inclusive and in Scotland between 1997 and 2020 inclusive. Children will be followed from the discharge date of their postnatal admission until their date of death, migration out of Scotland or England (defined using the methods described in Hardelid et al 6 for Scotland and Lewis et al 2 for England), or their fifth birthday, whichever occurs first, via hospital admission and death records. The Scottish birth cohort will also include longitudinal data on community dispensed drugs, microbiology test results, vaccination and health visiting (see the following sections).…”

“…1 RTI admission rates peak in winter months, contributing to the ‘winter crisis’ in the National Health Service (NHS). 2 Severe RTI symptoms in infancy and early childhood have been linked to adverse respiratory health outcomes in later childhood, including asthma. 3 We have previously shown that 79% of annual admissions for RTIs in infants <1 year old can be attributed to respiratory syncytial virus (RSV) and other viral infections for which no vaccines are currently available.…”