TY - JOUR
T1 - Respective roles of non-pharmaceutical interventions in bronchiolitis outbreaks
T2 - an interrupted time-series analysis based on a multinational surveillance system
AU - Lenglart, Lea
AU - Ouldali, Naim
AU - Honeyford, Kate
AU - Bognar, Zsolt
AU - Bressan, Silvia
AU - Buonsenso, Danilo
AU - Da Dalt, Liviana
AU - De, Tisham
AU - Farrugia, Ruth
AU - Maconochie, Ian K.
AU - Moll, Henriette A.
AU - Oostenbrink, Rianne
AU - Parri, Niccolo
AU - Roland, Damian
AU - Rose, Katy
AU - Akyüz Özkan, Esra
AU - Angoulvant, François
AU - Aupiais, Camille
AU - Barber, Clarissa
AU - Barrett, Michael
AU - Basmaci, Romain
AU - Castanhinha, Susana
AU - Chiaretti, Antonio
AU - Durnin, Sheena
AU - Fitzpatrick, Patrick
AU - Fodor, Laszlo
AU - Gomez, Borja
AU - Greber-Platzer, Susanne
AU - Guedj, Romain
AU - Hey, Florian
AU - Jankauskaite, Lina
AU - Kohlfuerst, Daniela
AU - Mascarenhas, Ines
AU - Musolino, Anna Maria
AU - Pučuka, Zanda
AU - Reis, Sofia
AU - Rybak, Alexis
AU - Salamon, Petra
AU - Schaffert, Matthias
AU - Shahar-Nissan, Keren
AU - Supino, Maria Chiara
AU - Teksam, Ozlem
AU - Turan, Caner
AU - Velasco, Roberto
AU - Nijman, Ruud G.
AU - Titomanlio, Luigi
AU - EPISODES Study Group
N1 - Funding Information:
Support statement: N. Ouldali is supported by the ESPID 2021-2023 fellowship award, R.G. Nijman by the NIHR ACL 2018-021-007 award and K. Honeyford by the NIHR (HS&DR) project NIHR129082. Funding information for this article has been deposited with the Crossref Funder Registry.
Publisher Copyright:
Copyright © The authors 2023.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - BACKGROUND: Bronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries. METHODS: We conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling. RESULTS: In total, 42 916 children were included. We observed an overall cumulative 78% (95% CI -100- -54%; p<0.0001) reduction in bronchiolitis cases following NPI implementation. The decrease varied between countries from -97% (95% CI -100- -47%; p=0.0005) to -36% (95% CI -79-7%; p=0.105). Full lockdown (incidence rate ratio (IRR) 0.21 (95% CI 0.14-0.30); p<0.001), secondary school closure (IRR 0.33 (95% CI 0.20-0.52); p<0.0001), wearing a mask indoors (IRR 0.49 (95% CI 0.25-0.94); p=0.034) and teleworking (IRR 0.55 (95% CI 0.31-0.97); p=0.038) were independently associated with reducing bronchiolitis. CONCLUSIONS: Several NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis.
AB - BACKGROUND: Bronchiolitis is a major source of morbimortality among young children worldwide. Non-pharmaceutical interventions (NPIs) implemented to reduce the spread of severe acute respiratory syndrome coronavirus 2 may have had an important impact on bronchiolitis outbreaks, as well as major societal consequences. Discriminating between their respective impacts would help define optimal public health strategies against bronchiolitis. We aimed to assess the respective impact of each NPI on bronchiolitis outbreaks in 14 European countries. METHODS: We conducted a quasi-experimental interrupted time-series analysis based on a multicentre international study. All children diagnosed with bronchiolitis presenting to the paediatric emergency department of one of 27 centres from January 2018 to March 2021 were included. We assessed the association between each NPI and change in the bronchiolitis trend over time by seasonally adjusted multivariable quasi-Poisson regression modelling. RESULTS: In total, 42 916 children were included. We observed an overall cumulative 78% (95% CI -100- -54%; p<0.0001) reduction in bronchiolitis cases following NPI implementation. The decrease varied between countries from -97% (95% CI -100- -47%; p=0.0005) to -36% (95% CI -79-7%; p=0.105). Full lockdown (incidence rate ratio (IRR) 0.21 (95% CI 0.14-0.30); p<0.001), secondary school closure (IRR 0.33 (95% CI 0.20-0.52); p<0.0001), wearing a mask indoors (IRR 0.49 (95% CI 0.25-0.94); p=0.034) and teleworking (IRR 0.55 (95% CI 0.31-0.97); p=0.038) were independently associated with reducing bronchiolitis. CONCLUSIONS: Several NPIs were associated with a reduction of bronchiolitis outbreaks, including full lockdown, school closure, teleworking and facial masking. Some of these public health interventions may be considered to further reduce the global burden of bronchiolitis.
UR - http://www.scopus.com/inward/record.url?scp=85148306715&partnerID=8YFLogxK
U2 - 10.1183/13993003.01172-2022
DO - 10.1183/13993003.01172-2022
M3 - Article
C2 - 36356971
AN - SCOPUS:85148306715
SN - 0903-1936
VL - 61
JO - The European respiratory journal
JF - The European respiratory journal
IS - 2
M1 - 2201172
ER -