Population mortality during the outbreak of Severe Acute Respiratory Syndrome in Toronto
Identifieur interne : 001984 ( Ncbi/Merge ); précédent : 001983; suivant : 001985Population mortality during the outbreak of Severe Acute Respiratory Syndrome in Toronto
Auteurs : Stephen W. Hwang ; Angela M. Cheung ; Rahim Moineddin ; Chaim M. BellSource :
- BMC Public Health [ 1471-2458 ] ; 2007.
Abstract
Extraordinary infection control measures limited access to medical care in the Greater Toronto Area during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. The objective of this study was to determine if the period of these infection control measures was associated with changes in overall population mortality due to causes other than SARS.
Observational study of death registry data, using Poisson regression and interrupted time-series analysis to examine all-cause mortality rates (excluding deaths due to SARS) before, during, and after the SARS outbreak. The population of Ontario was grouped into the Greater Toronto Area (N = 2.9 million) and the rest of Ontario (N = 9.3 million) based upon the level of restrictions on delivery of clinical services during the SARS outbreak.
There was no significant change in mortality in the Greater Toronto Area before, during, and after the period of the SARS outbreak in 2003 compared to the corresponding time periods in 2002 and 2001. The rate ratio for all-cause mortality during the SARS outbreak was 0.99 [95% Confidence Interval (CI) 0.93–1.06] compared to 2002 and 0.96 [95% CI 0.90–1.03] compared to 2001. An interrupted time series analysis found no significant change in mortality rates in the Greater Toronto Area associated with the period of the SARS outbreak.
Limitations on access to medical services during the 2003 SARS outbreak in Toronto had no observable impact on short-term population mortality. Effects on morbidity and long-term mortality were not assessed. Efforts to contain future infectious disease outbreaks due to influenza or other agents must consider effects on access to essential health care services.
The online version of this article (doi:10.1186/1471-2458-7-93) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1471-2458-7-93
PubMed: 17535440
PubMed Central: 1894965
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PMC:1894965Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Population mortality during the outbreak of Severe Acute Respiratory Syndrome in Toronto</title>
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<author><name sortKey="Moineddin, Rahim" sort="Moineddin, Rahim" uniqKey="Moineddin R" first="Rahim" last="Moineddin">Rahim Moineddin</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Extraordinary infection control measures limited access to medical care in the Greater Toronto Area during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. The objective of this study was to determine if the period of these infection control measures was associated with changes in overall population mortality due to causes other than SARS.</p>
</sec>
<sec><title>Methods</title>
<p>Observational study of death registry data, using Poisson regression and interrupted time-series analysis to examine all-cause mortality rates (excluding deaths due to SARS) before, during, and after the SARS outbreak. The population of Ontario was grouped into the Greater Toronto Area (N = 2.9 million) and the rest of Ontario (N = 9.3 million) based upon the level of restrictions on delivery of clinical services during the SARS outbreak.</p>
</sec>
<sec><title>Results</title>
<p>There was no significant change in mortality in the Greater Toronto Area before, during, and after the period of the SARS outbreak in 2003 compared to the corresponding time periods in 2002 and 2001. The rate ratio for all-cause mortality during the SARS outbreak was 0.99 [95% Confidence Interval (CI) 0.93–1.06] compared to 2002 and 0.96 [95% CI 0.90–1.03] compared to 2001. An interrupted time series analysis found no significant change in mortality rates in the Greater Toronto Area associated with the period of the SARS outbreak.</p>
</sec>
<sec><title>Conclusion</title>
<p>Limitations on access to medical services during the 2003 SARS outbreak in Toronto had no observable impact on short-term population mortality. Effects on morbidity and long-term mortality were not assessed. Efforts to contain future infectious disease outbreaks due to influenza or other agents must consider effects on access to essential health care services.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/1471-2458-7-93) contains supplementary material, which is available to authorized users.</p>
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<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
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<title-group><article-title>Population mortality during the outbreak of Severe Acute Respiratory Syndrome in Toronto</article-title>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Hwang</surname>
<given-names>Stephen W</given-names>
</name>
<address><email>hwangs@smh.toronto.on.ca</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
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<contrib contrib-type="author"><name><surname>Cheung</surname>
<given-names>Angela M</given-names>
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<address><email>angela.cheung@uhn.on.ca</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
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<contrib contrib-type="author"><name><surname>Moineddin</surname>
<given-names>Rahim</given-names>
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<address><email>rahim.moineddin@utoronto.ca</email>
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<contrib contrib-type="author"><name><surname>Bell</surname>
<given-names>Chaim M</given-names>
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<aff id="Aff1"><label>1</label>
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Canada</aff>
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<pub-date pub-type="epub"><day>29</day>
<month>5</month>
<year>2007</year>
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<pub-date pub-type="pmc-release"><day>29</day>
<month>5</month>
<year>2007</year>
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<pub-date pub-type="collection"><year>2007</year>
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<volume>7</volume>
<elocation-id>93</elocation-id>
<history><date date-type="received"><day>26</day>
<month>10</month>
<year>2006</year>
</date>
<date date-type="accepted"><day>29</day>
<month>5</month>
<year>2007</year>
</date>
</history>
<permissions><copyright-statement>© Hwang et al; licensee BioMed Central Ltd. 2007</copyright-statement>
<license license-type="OpenAccess"><license-p>This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Extraordinary infection control measures limited access to medical care in the Greater Toronto Area during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. The objective of this study was to determine if the period of these infection control measures was associated with changes in overall population mortality due to causes other than SARS.</p>
</sec>
<sec><title>Methods</title>
<p>Observational study of death registry data, using Poisson regression and interrupted time-series analysis to examine all-cause mortality rates (excluding deaths due to SARS) before, during, and after the SARS outbreak. The population of Ontario was grouped into the Greater Toronto Area (N = 2.9 million) and the rest of Ontario (N = 9.3 million) based upon the level of restrictions on delivery of clinical services during the SARS outbreak.</p>
</sec>
<sec><title>Results</title>
<p>There was no significant change in mortality in the Greater Toronto Area before, during, and after the period of the SARS outbreak in 2003 compared to the corresponding time periods in 2002 and 2001. The rate ratio for all-cause mortality during the SARS outbreak was 0.99 [95% Confidence Interval (CI) 0.93–1.06] compared to 2002 and 0.96 [95% CI 0.90–1.03] compared to 2001. An interrupted time series analysis found no significant change in mortality rates in the Greater Toronto Area associated with the period of the SARS outbreak.</p>
</sec>
<sec><title>Conclusion</title>
<p>Limitations on access to medical services during the 2003 SARS outbreak in Toronto had no observable impact on short-term population mortality. Effects on morbidity and long-term mortality were not assessed. Efforts to contain future infectious disease outbreaks due to influenza or other agents must consider effects on access to essential health care services.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/1471-2458-7-93) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Influenza</kwd>
<kwd>Severe Acute Respiratory Syndrome</kwd>
<kwd>Severe Acute Respiratory Syndrome</kwd>
<kwd>Infection Control Measure</kwd>
<kwd>Great Toronto Area</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2007</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Bell, Chaim M" sort="Bell, Chaim M" uniqKey="Bell C" first="Chaim M" last="Bell">Chaim M. Bell</name>
<name sortKey="Cheung, Angela M" sort="Cheung, Angela M" uniqKey="Cheung A" first="Angela M" last="Cheung">Angela M. Cheung</name>
<name sortKey="Hwang, Stephen W" sort="Hwang, Stephen W" uniqKey="Hwang S" first="Stephen W" last="Hwang">Stephen W. Hwang</name>
<name sortKey="Moineddin, Rahim" sort="Moineddin, Rahim" uniqKey="Moineddin R" first="Rahim" last="Moineddin">Rahim Moineddin</name>
</noCountry>
</tree>
</affiliations>
</record>
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