Space-time analysis of pneumonia hospitalisations in the Netherlands

Elisa Benincà, Michiel van Boven, Thomas Hagenaars, Wim van der Hoek

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Community acquired pneumonia is a major global public health problem. In the Netherlands there are 40,000-50,000 hospital admissions for pneumonia per year. In the large majority of these hospital admissions the etiologic agent is not determined and a real-time surveillance system is lacking. Localised and temporal increases in hospital admissions for pneumonia are therefore only detected retrospectively and the etiologic agents remain unknown. Here, we perform spatio-temporal analyses of pneumonia hospital admission data in the Netherlands. To this end, we scanned for spatial clusters on yearly and seasonal basis, and applied wavelet cluster analysis on the time series of five main regions. The pneumonia hospital admissions show strong clustering in space and time superimposed on a regular yearly cycle with high incidence in winter and low incidence in summer. Cluster analysis reveals a heterogeneous pattern, with most significant clusters occurring in the western, highly urbanised, and in the eastern, intensively farmed, part of the Netherlands. Quantitatively, the relative risk (RR) of the significant clusters for the age-standardised incidence varies from a minimum of 1.2 to a maximum of 2.2. We discuss possible underlying causes for the patterns observed, such as variations in air pollution.

LanguageEnglish
Article numbere0180797
JournalPLoS ONE
Volume12
Issue number7
DOIs
Publication statusPublished - 2017

Fingerprint

Netherlands
pneumonia
Pneumonia
Hospitalization
angle of incidence
Cluster analysis
Cluster Analysis
Space-Time Clustering
cluster analysis
Incidence
Spatio-Temporal Analysis
Wavelet Analysis
Air Pollution
Computer Systems
air pollution
Public health
relative risk
Medical problems
Air pollution
space and time

Cite this

Benincà, Elisa ; van Boven, Michiel ; Hagenaars, Thomas ; van der Hoek, Wim. / Space-time analysis of pneumonia hospitalisations in the Netherlands. In: PLoS ONE. 2017 ; Vol. 12, No. 7.
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Space-time analysis of pneumonia hospitalisations in the Netherlands. / Benincà, Elisa; van Boven, Michiel; Hagenaars, Thomas; van der Hoek, Wim.

In: PLoS ONE, Vol. 12, No. 7, e0180797, 2017.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Benincà, Elisa

AU - van Boven, Michiel

AU - Hagenaars, Thomas

AU - van der Hoek, Wim

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N2 - Community acquired pneumonia is a major global public health problem. In the Netherlands there are 40,000-50,000 hospital admissions for pneumonia per year. In the large majority of these hospital admissions the etiologic agent is not determined and a real-time surveillance system is lacking. Localised and temporal increases in hospital admissions for pneumonia are therefore only detected retrospectively and the etiologic agents remain unknown. Here, we perform spatio-temporal analyses of pneumonia hospital admission data in the Netherlands. To this end, we scanned for spatial clusters on yearly and seasonal basis, and applied wavelet cluster analysis on the time series of five main regions. The pneumonia hospital admissions show strong clustering in space and time superimposed on a regular yearly cycle with high incidence in winter and low incidence in summer. Cluster analysis reveals a heterogeneous pattern, with most significant clusters occurring in the western, highly urbanised, and in the eastern, intensively farmed, part of the Netherlands. Quantitatively, the relative risk (RR) of the significant clusters for the age-standardised incidence varies from a minimum of 1.2 to a maximum of 2.2. We discuss possible underlying causes for the patterns observed, such as variations in air pollution.

AB - Community acquired pneumonia is a major global public health problem. In the Netherlands there are 40,000-50,000 hospital admissions for pneumonia per year. In the large majority of these hospital admissions the etiologic agent is not determined and a real-time surveillance system is lacking. Localised and temporal increases in hospital admissions for pneumonia are therefore only detected retrospectively and the etiologic agents remain unknown. Here, we perform spatio-temporal analyses of pneumonia hospital admission data in the Netherlands. To this end, we scanned for spatial clusters on yearly and seasonal basis, and applied wavelet cluster analysis on the time series of five main regions. The pneumonia hospital admissions show strong clustering in space and time superimposed on a regular yearly cycle with high incidence in winter and low incidence in summer. Cluster analysis reveals a heterogeneous pattern, with most significant clusters occurring in the western, highly urbanised, and in the eastern, intensively farmed, part of the Netherlands. Quantitatively, the relative risk (RR) of the significant clusters for the age-standardised incidence varies from a minimum of 1.2 to a maximum of 2.2. We discuss possible underlying causes for the patterns observed, such as variations in air pollution.

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