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Article: Trends in mortality from septicaemia and pneumonia with economic development: An age-period-cohort analysis

TitleTrends in mortality from septicaemia and pneumonia with economic development: An age-period-cohort analysis
Authors
KeywordsAdaptive immunity
Age distribution
Death
Pneumonia
Mortality
Issue Date2012
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2012, v. 7 n. 6 How to Cite?
AbstractBackground: Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong's unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching "first world" status over the last 60 years (i.e., in two or three generations), we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic transition affects infection-related mortality. Methods: We used deaths from septicemia and pneumonia not specified as bacterial, and population figures in Hong Kong from 1976-2005. We fitted age-period-cohort models to decompose septicemia and non-bacterial pneumonia mortality rates into age, period and cohort effects. Results: Septicaemia-related deaths increased exponentially with age, with a downturn by period. The birth cohort curves had downward inflections in both sexes in the 1940s, with a steeper deceleration for women. Non-bacterial pneumonia-related deaths also increased exponentially with age, but the birth cohort patterns showed no downturns for those born in the 1940s. Conclusion: The observed changes appeared to suggest that better early life conditions may enable better development of adaptive immunity, thus enhancing immunity against bacterial infections, with greater benefits for women than men. Given the interaction between the immune system and the gonadotropic axis, these observations are compatible with the hypothesis that upregulation of the gonadotropic axis underlies some of the changes in disease patterns with economic development. © 2012 Wong et al.
Persistent Identifierhttp://hdl.handle.net/10722/152936
ISSN
2015 Impact Factor: 3.057
2015 SCImago Journal Rankings: 1.395
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical SciencesU54 GM088558
MedImmune Inc.
Funding Information:

BJC was supported by the Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical Sciences (grant no. U54 GM088558). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

 

DC FieldValueLanguage
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorSchooling, CMen_HK
dc.date.accessioned2012-07-16T09:52:37Z-
dc.date.available2012-07-16T09:52:37Z-
dc.date.issued2012en_HK
dc.identifier.citationPlos One, 2012, v. 7 n. 6en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/152936-
dc.description.abstractBackground: Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong's unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching "first world" status over the last 60 years (i.e., in two or three generations), we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic transition affects infection-related mortality. Methods: We used deaths from septicemia and pneumonia not specified as bacterial, and population figures in Hong Kong from 1976-2005. We fitted age-period-cohort models to decompose septicemia and non-bacterial pneumonia mortality rates into age, period and cohort effects. Results: Septicaemia-related deaths increased exponentially with age, with a downturn by period. The birth cohort curves had downward inflections in both sexes in the 1940s, with a steeper deceleration for women. Non-bacterial pneumonia-related deaths also increased exponentially with age, but the birth cohort patterns showed no downturns for those born in the 1940s. Conclusion: The observed changes appeared to suggest that better early life conditions may enable better development of adaptive immunity, thus enhancing immunity against bacterial infections, with greater benefits for women than men. Given the interaction between the immune system and the gonadotropic axis, these observations are compatible with the hypothesis that upregulation of the gonadotropic axis underlies some of the changes in disease patterns with economic development. © 2012 Wong et al.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAdaptive immunity-
dc.subjectAge distribution-
dc.subjectDeath-
dc.subjectPneumonia-
dc.subjectMortality-
dc.titleTrends in mortality from septicaemia and pneumonia with economic development: An age-period-cohort analysisen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.emailCowling, BJ: bcowling@hku.hken_HK
dc.identifier.emailLeung, GM: gmleung@hkucc.hku.hken_HK
dc.identifier.emailSchooling, CM: cms1@hkucc.hku.hken_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authoritySchooling, CM=rp00504en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0038988en_HK
dc.identifier.pmid22720008-
dc.identifier.pmcidPMC3375224-
dc.identifier.scopuseid_2-s2.0-84862259313en_HK
dc.identifier.hkuros200921en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84862259313&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume7en_HK
dc.identifier.issue6en_HK
dc.identifier.isiWOS:000305347800033-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWong, IOL=7102513940en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridSchooling, CM=12808565000en_HK

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