PubMed · 6017537
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1967-02-25. Epidemiology.. https://pubmed.ncbi.nlm.nih.gov/6017537/
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BACKGROUND: A recent study concluded that between 1980 and 1992, deaths from infectious diseases increased 58%. This article explores trends in infectious diseases as a cause of hospitalization. METHODS: We analyzed data from the National Hospitalization Discharge Survey for 1980 through 1994 using a previously developed approach to evaluate infectious diseases in data coded according to the International Classification of Diseases, Ninth Revision. RESULTS: Between 1980 and 1994, the rate of hospitalizations in the United States declined approximately 33%; hospitalizations occurred at a rate of 133+/-5 per 1000 US population (35 million+/-1 million discharges) in 1994. The rate of hospitalization for infectious diseases declined less steeply--12% during this interval--resulting in an increased proportion of hospitalizations because of infectious diseases. In 1994, the rate of hospitalizations for infectious diseases was 15.4+/-0.7 per 1000 US population (4.0 million+/-0.2 million discharges). The fatality rate associated with hospitalizations for infectious diseases increased from 1.9%+/-0.1% to 4.0%+/-0.3%, attributable to increased hospitalizations of elderly persons and an increased fatality rate among those younger than 65 years. Among selected categories, hospitalizations for human immunodeficiency virus infections and acquired immunodeficiency syndrome, prosthetic device infections, sepsis, and mycosis increased substantially, and hospitalizations for upper respiratory tract infections, pelvic inflammatory disease, and oral infections declined sharply. Hospitalizations for lower respiratory tract infections constituted 37% of all infectious disease hospitalizations in 1994. CONCLUSIONS: Considering hospitalizations as a dimension of the burden of infectious diseases involves an array of factors: secular trends in hospitalization, changing case management practices, demographic changes, and trends in the variety of infectious diseases themselves. Increases in the proportions of hospitalizations because of infectious diseases during years when hospitalizations for all causes were decreasing reflect an increasing burden of infectious diseases in the United States between 1989 and the mid-1990s.
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OBJECTIVE: Study of the exhaustibility and reliability of the recording of obligatory notifiable diseases (EDO) and the accumulated incidence of the EDO in a health area. DESIGN: Descriptive study. SETTING: Community setting. Epidemiological surveillance. PATIENTS: People who have suffered in 1996 some EDO (excluded measles, rubella, mumps, chickenpox and influenza). MEASUREMENTS AND MAIN RESULTS: They have been selected a total of 205 EDO-disease cases starting from the two recording systems: laboratory and obligatory surveillance diseases system. The exhaustibility of the laboratory has been 82%, 95% confidence interval (76-87%) and that of the EDO system 45%, 95% confidence interval (38-52%). The rate kappa for the diseases global is 0.42 95%, confidence interval (0.4-0.43) and the specific accordance proportion 0.27, 95% confidence interval (0.21-0.34). The cases search in the recording of the laboratory increases the incidence declared to the EDO system in all the diseases. The diseases with greater incidence are the hepatitis (73.59 x 10(5)), the pulmonary tuberculosis (27.07 x 10(5)) and the syphilis (18.05 x 10(5)). CONCLUSIONS: The EDO system presents a clear understatement, variable according to the different diseases and being maximum for the hepatitis B and C. The laboratory quantifies a high exhaustibility, and it can increase between 55 and 30% the EDO recording cases, increasing the knowledge of the morbidity caused by EDO in the Area 11. The valuation of the EDO in addition to improving the information for the assumptions of decisions in sanitary planning, optimizes the necessary elements when it is compared the EDO incidence among different geographical areas or within a same area at a different time.