Incidence of Lower Respiratory Tract Infections and Atopic Conditions in Boys and Young Male Adults: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2015-2016

Abstract

BackgroundThe Royal College of General Practitioners Research and Surveillance Centre comprises more than 150 general practices, with a combined population of more than 1.5 million, contributing to UK and European public health surveillance and research.ObjectiveThe aim of this paper was to report gender differences in the presentation of infectious and respiratory conditions in children and young adults.MethodsDisease incidence data were used to test the hypothesis that boys up to puberty present more with lower respiratory tract infection (LRTI) and asthma. Incidence rates were reported for infectious conditions in children and young adults by gender. We controlled for ethnicity, deprivation, and consultation rates. We report odds ratios (OR) with 95% CI, P values, and probability of presenting.ResultsBoys presented more with LRTI, largely due to acute bronchitis. The OR of males consulting was greater across the youngest 3 age bands (OR 1.59, 95% CI 1.35-1.87; OR 1.13, 95% CI 1.05-1.21; OR 1.20, 95% CI 1.09-1.32). Allergic rhinitis and asthma had a higher OR of presenting in boys aged 5 to 14 years (OR 1.52, 95% CI 1.37-1.68; OR 1.31, 95% CI 1.17-1.48). Upper respiratory tract infection (URTI) and urinary tract infection (UTI) had lower odds of presenting in boys, especially those older than 15 years. The probability of presenting showed different patterns for LRTI, URTI, and atopic conditions.ConclusionsBoys younger than 15 years have greater odds of presenting with LRTI and atopic conditions, whereas girls may present more with URTI and UTI. These differences may provide insights into disease mechanisms and for health service planning.

Household presentation of acute gastroenteritis in a primary care sentinel network: retrospective database studies

“…The factors associated with increased household incidence may provide some insights into where public health interventions might best be directed. Gender differences are hard to explain, but we have reported, by way of contrast, greater presentation of boys with respiratory infections and atopic conditions to primary care [27]. We are unclear as to whether this is related to disease frequency or propensity to consult, of if due to another cause of gender bias.…”

“…We can't differentiate what might be increased propensity to consult, or to attend with an unwell child under 5-years than an older adult, something demonstrated in rotavirus infection [43]. However, the propensity to consult is also impacted by gender, ethnicity or socioeconomic status [27]. However, the need to consult is also driven by the health of the child and our pattern of attendance appears to be similar to that of admission to hospital with AGE [44,45].…”

Demographic and socioeconomic patterns in healthcare-seeking behaviour for respiratory symptoms in England: a comparison with non-respiratory symptoms and between three healthcare services

“…Previous studies have reported that male children have higher rates of respiratory illnesses. 16 17 36 Lusignan et al, 36 observed a higher incidence of family doctors contacts in males <15 years due to LRTI compared with females of the same age, with the largest gender difference in the youngest age group (<1 year). This study also noted a higher contact rate in males <15 years due to asthma.…”

Investigating regional variation of respiratory infections in a general practice syndromic surveillance system

“…Primary care surveillance systems such as the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) are considered the 'gold standard' for primary care surveillance. [2][3][4] Respiratory infections cause an annual burden on health services, particularly during the winter. 5 General practitioner (GP) consultations, emergency department attendances, hos-pital admissions and deaths can all increase during the winter season, placing added pressures on di erent aspects of the health service.…”