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Epidemiology and policy
P1-372 An age-period-cohort analysis of mortality associated with bacterial diseases in Hong kong
  1. I O L Wong,
  2. B J Cowling,
  3. G M Leung,
  4. C M Schooling
  1. School of Public Health, The University of Hong Kong, Hong Kong SAR, Hong Kong

Abstract

Introduction We aim to investigate longitudinal trends in bacterial disease related mortality in HK in order to describe how socio-economic transition affects mortality due to infections and to provide generalised aetiological insights. We use one of the major bacterial disease related death, septicaemia, as an exemplar.

Methods We used local data on mortality due to septicaemia and mid-year population figures (1976–2005). We fitted Poisson age-period-cohort models on the age, period and cohort effects. We also looked for any possible difference in age, cohort or period effects by sex assessed from the model fit using the deviance information criterion (DIC).

Results Septicaemia-related deaths increased exponentially with age in both sexes, while there was a down turn in the period effects in both sexes (peaked in the 1991–1995 for females, and in the 1986–1990 for males). The birth cohort curves mainly had downward inflections in both sexes, however there was a steeper deceleration in women after 1945s, which was confirmed by the model fit as shown by the DIC.

Conclusion Sex difference in birth cohort effects might reflect changes which affect mortality risk due to septicaemia in a given birth cohort throughout their lifetime. The observed changes could be living conditions of the individual at different stages in life, and better immunity against bacteria in women born in HK but not in men. It is compatible with our hypothesis that the gonadotropic axis upregulation with better early living conditions enhance immunity in women but not men.

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