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Sex differences in common childhood infections in Taiwan
TienYu Owen Yang1, Wan-Ting Huang2, Mei-Huei Chen3
1Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Insights
This study analyzed healthcare visits for 278,000 Taiwanese children, finding similar infection rates between boys and girls overall. However, boys showed higher rates for most infections before age six, while urinary tract infections displayed distinct age-related sex differences.
Area of Science:
- Pediatrics
- Epidemiology
- Infectious Diseases
Background:
- Sex differences in childhood infections are frequently observed in case-only studies.
- Understanding these differences within a population context is crucial for public health.
Purpose of the Study:
- To compare age-trajectories of healthcare visits for all-cause and infection-specific conditions between boys and girls.
- To investigate age-specific sex differences in childhood infections using a large population-based cohort.
Main Methods:
- A population-based study of 278,000 Taiwanese children aged 3 months to 18 years (2000-2012).
- Analysis of monthly healthcare visit data for all-cause and specific infections.
- Comparison of age trajectories and rates between boys and girls.
Main Results:
- Age trajectories for most infections (conjunctivitis, respiratory, enteritis, HFMD, herpangina) showed resemblance between sexes.
- Boys exhibited slightly higher infection rates than girls before age six, except for herpangina.
- Urinary tract infections (UTIs) demonstrated significant age-specific sex differences: higher in boys during infancy, then higher in girls for kidney and bladder infections.
Conclusions:
- While overall infection trajectories are similar, subtle sex differences exist in childhood, with boys showing a slight tendency towards higher rates before age six.
- Urinary tract infections present a strong, age-dependent sex disparity, confirming and elaborating on findings from case-only studies.
- This population-based analysis provides valuable insights into the age dynamics of sex differences in childhood infections.
Abstract:
Sex differences in childhood infections are commonly reported in case-only studies. In this population-based study of 278000 Taiwanese children followed from 3 months to 18 years of age during the period 2000-2012, age-trajectories of monthly numbers of all-cause healthcare visits and monthly rates of infection-specific healthcare visits were compared between boys and girls. For all-cause healthcare visits and for healthcare visits related to conjunctivitis, respiratory tract infections, enteritis, hand, foot, and mouth disease, and herpangina, there was good resemblance of age trajectories between boys and girls. Despite this resemblance, there was evidence of a slightly higher rate in boys than in girls under age 6 years (i.e., a male tendency, or male-to-female ratio >1.0) across all diagnoses except herpangina. For urinary tract infection, where an age-specific sex difference is well reported in case-only studies, this population-based study confirmed that there was a much higher rate of kidney infection among boys than among girls during infancy, and a higher rate of kidney and bladder infection among girls than among boys after this period. The age-specific sex difference in urinary tract infections was so strong that the age trajectories in boys and girls were qualitatively different. This report confirms previously reported sex differences in other countries, whilst placing this in the context of age dynamics in childhood infection.
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