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Epidemiol Infect. 2018 Jan;146(1):37-45. doi: 10.1017/S095026881700259X. Epub 2017 Nov 23.

Seasonality of urinary tract infections in the United Kingdom in different age groups: longitudinal analysis of The Health Improvement Network (THIN).

Author information

Modelling and Economics Unit,National Infection Service, PHE,NW9 5EQ London,UK.
Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases unit,B2PHI, UMR1181, Inserm,Université de Versailles Saint Quentin, Institut Pasteur,France.
Mathematical and Economic Modelling Department,Mahidol Oxford Tropical Medicine Research Unit,10400 Bangkok,Thailand.
Institute of Health Informatics, Farr Institute of Health Informatics Research, UCL,NW1 2DA London,UK.
Department of Infectious Diseases and Microbiology,Royal Free London NHS Foundation Trust,NW3 2QG London,UK.
Data Analytics, The Health Foundation,WC2E 9RA London,UK.


Evidence regarding the seasonality of urinary tract infection (UTI) consultations in primary care is conflicting and methodologically poor. To our knowledge, this is the first study to determine whether this seasonality exists in the UK, identify the peak months and describe seasonality by age. The monthly number of UTI consultations (N = 992 803) and nitrofurantoin and trimethoprim prescriptions (N = 1 719 416) during 2008-2015 was extracted from The Health Improvement Network (THIN), a large nationally representative UK dataset of electronic patient records. Negative binomial regression models were fitted to these data to investigate seasonal fluctuations by age group (14-17, 18-24, 25-45, 46-69, 70-84, 85+) and by sex, accounting for a change in the rate of UTI over the study period. A September to November peak in UTI consultation incidence was observed for ages 14-69. This seasonality progressively faded in older age groups and no seasonality was found in individuals aged 85+, in whom UTIs were most common. UTIs were rare in males but followed a similar seasonal pattern than in females. We show strong evidence of an autumnal seasonality for UTIs in individuals under 70 years of age and a lack of seasonality in the very old. These findings should provide helpful information when interpreting surveillance reports and the results of interventions against UTI.


The Health Improvement Network; Urinary tract infections (UTIs); seasonality

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