Surveillance for fetal alcohol syndrome in Colorado.

The authors performed surveillance for fetal alcohol syndrome with an existing birth defects registry. Fetal alcohol syndrome cases were identified from multiple sources using passive surveillance and from two selected medical sites using enhanced surveillance. Between May 1992 and March 1994, a total of 173 cases were identified, and the medical records of the cases were reviewed to determine whether the cases met a surveillance case definition for fetal alcohol syndrome. Of these cases, 37 (21 percent) met either definite (28) or probable (9) criteria for fetal alcohol syndrome, 76 met possible criteria (44 percent), and 60 (35 percent) were defined as not fetal alcohol syndrome. Enhanced surveillance had the highest sensitivity for definite or probable cases, 31 of 37 (84 percent), followed by hospital discharge data, 14 of 37 (38 percent). The authors also compared birth certificate information for 22 definite or probable cases in children born between 1989 and 1992 to birth certificate information for all Colorado births for that period. The proportion of mothers of children with fetal alcohol syndrome was statistically significantly greater (as determined by exact binomial 95 percent confidence limits) than the proportion of all mothers for the following characteristics: black race (0.23 versus 0.05), unmarried (0.55 versus 0.22), not employed during pregnancy (0.86 versus 0.43), and started prenatal care in the third trimester (0.18 versus 0.04). Surveillance for fetal alcohol syndrome can be accomplished with an existing registry system in combination with additional case finding and verification activities. Through followup investigation of reported cases, data can be gathered on the mothers of children with fetal alcohol syndrome. These data could be used to target fetal alcohol syndrome prevention programs.     

Fetal alcohol syndrome prevention in Washington State: evidence of success

Fetal alcohol syndrome (FAS) is a permanent birth defect syndrome caused by maternal consumption of alcohol during pregnancy. It is characterised by growth deficiency, central nervous system damage/dysfunction, and a unique cluster of minor facial anomalies. To assess the effectiveness of fetal alcohol syndrome prevention efforts, one must be able to estimate accurately the prevalence of fetal alcohol syndrome over time in population-based samples. With the establishment of the Washington State Fetal Alcohol Syndrome Diagnostic and Prevention Network of clinics, the development of the Fetal Alcohol Syndrome Facial Photographic Analysis Software, the creation of the Fetal Alcohol Spectrum Disorders (FASD) 4-Digit Diagnostic Code, the establishment of the Foster Care Fetal Alcohol Syndrome Screening Program, and the collection of Pregnancy Risk Assessment Management System data on maternal use of alcohol during pregnancy, the tools, methods and infrastructure for assessing the effectiveness of fetal alcohol syndrome primary prevention efforts in Washington State are in place. A cross-sectional study was conducted to determine whether the prevalence of fetal alcohol syndrome among children in a foster care population, born between 1993 and 1998, decreased with the documented decrease in prevalence of maternal use of alcohol during pregnancy from 1993 and 1998 in Washington State. The prevalence of maternal drinking during pregnancy in Washington State declined significantly (P < 0.001) from 1993 to 1998 as did the prevalence of fetal alcohol syndrome among foster children born 1993-98 (P < 0.03). These observations support the likelihood that fetal alcohol syndrome prevention efforts in Washington State are working successfully.     

Epidemiology of fetal alcohol syndrome in American Indians,Alaskan Natives,and Canadian Aboriginal peoples: a review of the literature.

A critical review of available reports on the epidemiology of fetal alcohol syndrome among American Indians, Alaskan Natives, and Aboriginal peoples of Canada was completed. A search of Medline, the National Institute on Alcohol Abuse and Alcoholism Database, and other relevant data bases was conducted. The reference lists of several publications on fetal alcohol syndrome were reviewed, and four prominent researchers and four government agencies were contacted to identify unpublished articles. This search identified 10 studies, 8 of them cross-sectional. Four of these studies used primary data from the authors'' evaluations of children suspected of having fetal alcohol syndrome; the other six used secondary data. The prevalence of fetal alcohol syndrome in the American Indians of the United States and Aboriginal peoples of Canada was consistently high across the 10 studies. These studies have significant restrictions which limit both the confidence in the rates reported and the generalizability of the results. Three studies used data from the province of British Columbia. No study evaluated all children in the study area. Only two studies reviewed death certificates. In only one study were examiners blinded to maternal alcohol use, and no study presented evidence on the sensitivity and specificity of either the screening efforts or diagnostic criteria. Such evidence is especially important in studies of secondary data and in studies that report rates for newborn populations. Studies of the sensitivity and specificity of both the screening and diagnostic criteria for fetal alcohol syndrome would be useful areas for further study. Other study designs, including longitudinal cohort studies, are needed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Fetal alcohol syndrome--Alaska,Arizona, Colorado,and New York, 1995-1997

Fetal alcohol syndrome (FAS) is caused by maternal alcohol use during pregnancy and is one of the leading causes of preventable birth defects and developmental disabilities in the United States. FAS is diagnosed on the basis of a combination of growth deficiency (pre- or postnatal), central nervous system (CNS) dysfunction, facial dysmorphology, and maternal alcohol use during pregnancy. Estimates of the prevalence of FAS vary from 0.2 to 1.0 per 1,000 live-born infants. This variation is due, in part, to the small size of the populations studied, varying case definitions, and different surveillance methods. In addition, differences have been noted among racial/ethnic populations. To monitor the occurrence of FAS, CDC collaborated with five states (Alaska, Arizona, Colorado, New York, and Wisconsin*) to develop the Fetal Alcohol Syndrome Surveillance Network (FASSNet). This report summarizes the results of an analysis of FASSNet data on children born during 1995-1997, which indicate that FAS rates in Alaska, Arizona, Colorado, and New York ranged from 0.3 to 1.5 per 1,000 live-born infants and were highest for black and American Indian/Alaska Native populations. This study demonstrates that FASSNet is a useful tool that enables health care professionals to monitor the occurrence of FAS and to evaluate the impact of prevention, education, and intervention efforts.     

Incidence of fetal alcohol syndrome in northeastern Manitoba.

The incidence of fetal alcohol syndrome (FAS) in northeastern Manitoba was investigated by examining all 745 live births occurring in Thompson General Hospital in 1994. Birth records were screened with criteria designed to capture all potential FAS cases. Cases were then eliminated if follow-up records indicated the child was not developmentally delayed or no longer had the small head or body size identified at birth. Cases still meeting criteria were personally examined. Five cases of FAS were identified among the 46% of eligible children screened at age 2, roughly an incidence of 7.2/1,000. However, because only 46% of the high risk cases were personally examined, incidence could be as high as 14.8/1,000. Only 1/5 FAS cases had been identified prior to our investigation. The results indicate the incidence of FAS in northeastern Manitoba is very high and that much greater effort needs to be made in its prevention and early detection.     

A fetal alcohol syndrome surveillance pilot project in American Indian communities in the Northern Plains.

A pilot fetal alcohol syndrome (FAS) surveillance was carried out in four American Indian communities in the Northern Plains by the Aberdeen Area Indian Health Service to determine the incidence of FAS and to evaluate the feasibility of establishing continuing surveillance for FAS. Baseline data on the incidence of FAS would be used by the Indian Health Service to develop and evaluate preventive interventions, including treatment programs for pregnant women who drink alcohol. Four of the 1,022 children included in the project were found to have FAS, a rate of 3.9 per 1,000 live births. The rate is believed to underestimate the true rate of FAS because some low birth weight children were not screened, parents or guardians were reluctant to bring children suspected of FAS for evaluation, clinicians were hesitant to diagnose possible alcohol-damaged children for fear of labeling the child, and some children with FAS died before the diagnosis of FAS could be confirmed. If the rate of FAS is similar for the 39 percent of the infants not screened and for the 25 percent of suspected infants who were not evaluated, a rate of 8.5 cases of FAS per 1,000 live births may be postulated. The authors recommend routine screening of prenatal patients for substance abuse and establishing a tracking system for low birth weight infants suspected to have FAS or other alcohol-related developmental disorders, in an effort to establish more accurate FAS rates.(ABSTRACT TRUNCATED AT 250 WORDS)     

Child maltreatment in Missouri: combining data for public health surveillance

BACKGROUND: Public health surveillance was established for nonfatal child maltreatment in Missouri using two data sources. This paper describes the epidemiology of nonfatal child maltreatment using this surveillance system, and assesses the usefulness of combining medical data with child protective services (CPS) reports for child maltreatment surveillance. METHODS: Child abuse and neglect reports for children aged <10 years for 2000 were obtained from the Missouri Division of Family Services (DFS) and linked to hospital discharge and emergency department (ED) data for 2000. Children were classified as maltreated if they had an International Classification of Disease (ICD) maltreatment code for a hospital or ED visit, or a substantiated report to DFS. Validity of the ICD maltreatment codes was assessed in a 10% random sample of the hospital/ED visits. Medical records were reviewed to determine the accuracy of the maltreatment code assigned. The data analyses reported here were conducted in 2002 and 2003. RESULTS: In the linked data, 5657 children met the case definition of maltreatment, providing a nonfatal maltreatment rate of 7.4/1000 children. Rates were higher among children aged <1 year (8.4/1000), females (7.7/1000), African Americans (11.8/1000), and children residing in rural counties (8.7/1000). The hospital/ED data identified proportionately more children who were African American, urban, physically abused, or infants, and uniquely identified only 10% of the total cases. In the validation sample, maltreatment was documented in 110 (87%) of the 127 records reviewed. CONCLUSIONS: CPS and medical data can be linked for surveillance. However, the medical data add few unique cases and identify only a subset of maltreated children.     

Completeness of pediatric TB reporting in New York City

OBJECTIVE: Accurate surveillance of tuberculosis (TB) in children is critical because such cases represent recent transmission, but surveillance is difficult as only 10% to 50% of cases are culture-confirmed. Hospital-based sources were used to develop alternative surveillance to assess completeness of reporting for pediatric TB in northern Manhattan and Harlem from 1993 through 1995. METHODS: Alternative surveillance sources included ICD-9-CM hospital discharge codes for active TB and gastric aspirate reports. Cases identified by alternative surveillance were compared with cases previously reported to the New York City Department of Health (NYC DOH). RESULTS: Alternative surveillance detected 25 cases of possible pediatric TB, of which four (16%) had never been reported to the NYC DOH and three (12%) had been reported as suspect cases, but had not fulfilled the criteria for a reportable case of pediatric TB. Of these seven newly counted cases, three were detected by ICD-9-CM codes, three by a gastric aspirate log book, and one by both. In contrast, 13 other cases had been reported to the NYC DOH, but were undetected by our alternative surveillance; eight of these could be verified with available medical records. Thus, the demographic and clinical characteristics of the 25 detected and the eight undetected cases with available medical records were evaluated in this study. CONCLUSION: Alternative surveillance proved effective, was complementary to the NYC DOH surveillance efforts, and increased the number of pediatric TB cases identified during the study period by 21%.     

Critiquing Fetal Alcohol Syndrome Health Communication Campaigns Targeted to American Indians

It is widely recognized American Indians and Alaska Natives have suffered from far worse health status than that of other Americans. Health communication campaigns directed to American Indians and Alaska Natives and their outcomes must be grounded in an understanding of the historical and ongoing marginalization and cultural dislocation of these groups. The authors draw upon the specific case of health communication campaigns to reduce cases of fetal alcohol syndrome among American Indians and Alaska Natives. Counteracting stereotyping of American Indians and alcohol consumption by mainstream American popular culture and mediated discourses, coverage of fetal alcohol syndrome in the media is assessed. The study analyzes 429 American Indian news articles from 1990 to 2010. Mainstream American and American Indian media should cover health concerns such as fetal alcohol syndrome more extensively. Researchers, health communication campaign developers, health policy makers, and mainstream media must be knowledgeable about American Indian and Alaskan Native identity, cultures, and history, and diversity across Nations. Last, and most important, health communication strategists and health policy makers must welcome American Indians and Alaska Natives to take leadership roles in communicating culture- and Nation-specific health campaign strategies to eliminate health disparities.     

Critiquing fetal alcohol syndrome health communication campaigns targeted to American Indians

It is widely recognized American Indians and Alaska Natives have suffered from far worse health status than that of other Americans. Health communication campaigns directed to American Indians and Alaska Natives and their outcomes must be grounded in an understanding of the historical and ongoing marginalization and cultural dislocation of these groups. The authors draw upon the specific case of health communication campaigns to reduce cases of fetal alcohol syndrome among American Indians and Alaska Natives. Counteracting stereotyping of American Indians and alcohol consumption by mainstream American popular culture and mediated discourses, coverage of fetal alcohol syndrome in the media is assessed. The study analyzes 429 American Indian news articles from 1990 to 2010. Mainstream American and American Indian media should cover health concerns such as fetal alcohol syndrome more extensively. Researchers, health communication campaign developers, health policy makers, and mainstream media must be knowledgeable about American Indian and Alaskan Native identity, cultures, and history, and diversity across Nations. Last, and most important, health communication strategists and health policy makers must welcome American Indians and Alaska Natives to take leadership roles in communicating culture- and Nation-specific health campaign strategies to eliminate health disparities.     

Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province

OBJECTIVES: This study determined the characteristics of fetal alcohol syndrome in a South African community, and methodology was designed for the multidisciplinary study of fetal alcohol syndrome in developing societies. METHODS: An active case ascertainment, 2-tier methodology was used among 992 first-grade pupils. A case-control design, using measures of growth, development, dysmorphology, and maternal risk, delineated characteristics of children with fetal alcohol syndrome. RESULTS: A high rate of fetal alcohol syndrome was found in the schools--40.5 to 46.4 per 1000 children aged 5 to 9 years--and age-specific community rates (ages 6-7) were 39.2 to 42.9. These rates are 18 to 141 times greater than in the United States. Rural residents had significantly more fetal alcohol syndrome. After control for ethnic variation, children with fetal alcohol syndrome had traits similar to those elsewhere: poor growth and development, congruent dysmorphology, and lower intellectual functioning. CONCLUSIONS: This study documented the highest fetal alcohol syndrome rate to date in an overall community population. Fetal alcohol syndrome initiatives that incorporate innovative sampling and active case ascertainment methods can be used to obtain timely and accurate data among developing populations.     

Invasive pneumococcal disease epidemiology and effectiveness of 23-valent pneumococcal polysaccharide vaccine in Alaska native adults

Alaska Native persons have age-adjusted invasive pneumococcal disease (IPD) rates two- to three-fold greater than non-Native Alaskans. To characterize IPD epidemiology and 23-valent polysaccharide pneumococcal vaccine (PPV-23) effectiveness in Alaska Native adults we reviewed IPD cases from Alaska-wide, laboratory-based surveillance. Sterile site isolates were serotyped. Vaccine effectiveness (VE) was estimated using the indirect cohort method. 394 cases (44.5 cases/100,000/year) occurred in 374 Alaska Native adults (36.0% aged > or =55 years). Underlying conditions included heavy alcohol use (65.7%), smoking (60.8%) and COPD (25.0%). Overall VE was 75% (95% confidence interval [CI]: 27%, 91%) but declined with increasing age; for persons > or =55 years (VE=<0; 95% CI: <0, 78%; p=0.713). Alaska Native adults experience high rates of IPD. The majority of IPD cases occurred in persons with underlying conditions and behaviors associated with increased risk of IPD in other populations. PPV-23 vaccine effectiveness was confirmed in younger Alaska Native adults but not among adults > or =55 years.     

Using the two-source capture-recapture method to estimate the incidence of acute flaccid paralysis in Victoria,Australia

OBJECTIVE: To estimate the incidence and the completeness of ascertainment of acute flaccid paralysis (AFP) in Victoria, Australia, in 1998-2000 and to determine its common causes among children aged under 15 years. METHODS:: The two-source capture-recapture method was used to estimate the incidence of cases of AFP and to evaluate case ascertainment in the routine surveillance system. The primary and secondary data sources were notifications from this system and inpatient hospital records, respectively. FINDINGS: The routine surveillance system indicated that there were 14 cases and the hospital record review identified 19 additional cases. According to the two-source capture-recapture method, there would have been 40 cases during this period (95% confidence interval (CI) = 29-51), representing an average annual incidence of 1.4 per 100000 children aged under 15 years (95% CI = 1.1- 1.7). Thus case ascertainment based on routine surveillance was estimated to be 35% complete. Guillain-Barré syndrome was the commonest single cause of AFP. CONCLUSIONS: Routine surveillance for AFP in Victoria was insensitive. A literature review indicated that the capture-recapture estimates obtained in this study were plausible. The present results help to define a target notification rate for surveillance in settings where poliomyelitis is not endemic.     

山西省四县出生缺陷监测质量的评估

目的 了解山西省出生缺陷高发的平定县、昔阳县、太谷县和泽州县出生缺陷监测系统的可靠性。方法 2004年每个县各选取1个乡（镇），由统一培训的乡村级调查员于2004年2—3月人户对2003年该地区的出生情况和出生缺陷病例进行调查与核实。调查获得的出生数、出生缺陷数与监测系统上报的结果进行比较。各县的监测出生数还要与当地其他部门收集的资料进行比较。漏报评价标准为：抽样地区出生漏报应≤5％，重大体表畸形漏报≤10％。此外，北京大学医学部项目人员对部分监测点的基础卫生工作情况进行检查。结果 4个乡镇通过人户调查得到的出生数为1043人，而监测系统上报的出生数为997人，漏报46人，漏报率为4．4％。调查共核实30例体表先天畸形病例，而通过监测系统上报的先天畸形数为29例，漏报1例，漏报率为3．3％。4个县监测系统的出生数与当地出生人口资料估计的出生数相差1．2％。对部分监测点的工作情况调查发现，各监测点均有较为完善的卫生常规登记资料，有专门负责出生缺陷监测工作的人员。结论 山西省4个县出生缺陷监测系统尽管存在一定的出生和畸形病例的漏报，但漏报率很低。基层监测点具有较为完善的出生和畸形登记、上报和管理机制，监测人员对于出生缺陷监测相关知识有所了解，并且具备对于出生和畸形的记录和报告意识，因此监测资料的来源较为可靠。     

The need for surveillance of delay in age-appropriate immunization

BACKGROUND: Vaccination status is assessed nationally in terms of up-to-date status without regard to the age at which recommended doses were actually received. Our study was conducted in 2000-2001 using the most current National Health Interview Survey (NHIS) public use files available. METHODS: Retrospective analysis to determine up-to-date and age-appropriate vaccination status for children aged 25 to 72 months. Five years of pooled data (1992-1996) were obtained from the NHIS Immunization Supplement for children aged 25 to 72 months with immunization data based on written records. The outcome measures used were months of vaccination delay relative to age-appropriate vaccination standard as well as up-to-date vaccination status for the fourth diphtheria-tetanus-pertussis (DTP 4), Polio3, the first measles-mumps-rubella (MMR1) doses, and the 4:3:1 series. RESULTS: Of the 9223 eligible children, 80% were up-to-date for the 4:3:1 vaccination series, but 48% had experienced delays relative to age-appropriate standards. For the DTP4 dose, 85% were up-to-date, although only 46% had received this dose at the appropriate age. Similarly, 90% of children were up-to-date with their Polio3 dose, with 64% receiving this dose at the appropriate age; 96% were up-to-date for the MMR1, and 58% received this dose at the appropriate age. Age-appropriate DTP4 vaccination increased by 17 percentage points from 1992 to 1996, whereas up-to-date DTP4 status increased by only 6% during the same period. CONCLUSIONS: Children with up-to-date vaccination status often experienced considerable delay relative to age-appropriate vaccination standards. Consequently, vaccination status measures based solely on up-to-date status tend to understate the degree of underimmunization in a population. National surveillance of age-appropriate vaccination is necessary to identify subpopulations with the greatest prevalence of vaccination delay and to reveal underlying trends that may not be evident through assessments of up-to-date status.     

The prevalence of ear, nose and throat disorders in preschool children with Down's syndrome in Glasgow

Guidelines suggest that all children with Down's syndrome have hearing testing on a regular basis. Since 2004, the ear, nose and throat (ENT), audiology and education services have conducted a joint clinic for annual ENT health and hearing surveillance of all preschool children with Down's syndrome in Greater Glasgow. The aim of this study is to report the prevalence of ENT problems in this well-defined birth cohort, and the proportion of children for whom ENT surgery is required. A prospective database has been kept since 2004, detailing the ENT health status of every child attending the community-based surveillance clinic. Between September 2004 and September 2008, 87 preschool (aged 9 months to 6 years) children with Down's syndrome were sent appointments for the clinic. Of these, 48 (55%) were female and 39 were male. Data were available for 79 (91%). Over the course of the study, 37% were listed for surgery at some point, either adenotonsillectomy for obstructive symptoms or grommet insertion for otitis media with effusion (OME). The prevalence of OME was 93% at age 1, falling to 68% by age 5. None had significant sensorineural hearing impairment. Obstructive symptoms were also common, with 79% of children having either currently symptomatic upper airways obstruction or a history of adenotonsillectomy by age 5. One child had laryngomalacia and two had symptomatic congenital subglottic stenosis. The prevalence of ENT problems in these children is high. Surgical intervention is frequently required. We advocate a proactive approach of regular ENT and audiology surveillance leading to early intervention, with the aim of maximizing health and educational achievement in the long term.     

Maternal smoking during pregnancy and the prevalence of autism spectrum disorders, using data from the autism and developmental disabilities monitoring network

Background: Reported associations between gestational tobacco exposure and autism spectrum disorders (ASDs) have been inconsistent.Objective: We estimated the association between maternal smoking during pregnancy and ASDs among children 8 years of age.Methods: This population-based case–cohort study included 633,989 children, identified using publicly available birth certificate data, born in 1992, 1994, 1996, and 1998 from parts of 11 U.S. states subsequently under ASD surveillance. Of these children, 3,315 were identified as having an ASD by the active, records-based surveillance of the Autism and Developmental Disabilities Monitoring Network. We estimated prevalence ratios (PRs) of maternal smoking from birth certificate report and ASDs using logistic regression, adjusting for maternal education, race/ethnicity, marital status, and maternal age; separately examining higher- and lower-functioning case subgroups; and correcting for assumed under-ascertainment of autism by level of maternal education.Results: About 13% of the source population and 11% of children with an ASD had a report of maternal smoking in pregnancy: adjusted PR (95% confidence interval) of 0.90 (0.80, 1.01). The association for the case subgroup autistic disorder (1,310 cases) was similar: 0.88 (0.72, 1.08), whereas that for ASD not otherwise specified (ASD-NOS) (375 cases) was positive, albeit including the null: 1.26 (0.91, 1.75). Unadjusted associations corrected for assumed under-ascertainment were 1.06 (0.98, 1.14) for all ASDs, 1.12 (0.97, 1.30) for autistic disorder, and 1.63 (1.30, 2.04) for ASD-NOS.Conclusions: After accounting for the potential of under-ascertainment bias, we found a null association between maternal smoking in pregnancy and ASDs, generally. The possibility of an association with a higher-functioning ASD subgroup was suggested, and warrants further study.     

Trends in diabetes prevalence among American Indian and Alaska native children,adolescents, and young adults

OBJECTIVES: This study determined trends in diabetes prevalence among young American Indians and Alaska Natives. METHODS: American Indian and Alaska Native children (< 15 years), adolescents (15-19 years), and young adults (20-34 years) with diabetes were identified from the Indian Health Service (IHS) outpatient database. The population living within IHS contract health service delivery areas was determined from census data. RESULTS: From 1990 to 1998, the total number of young American Indians and Alaska Natives with diagnosed diabetes increased by 71% (4534 to 7736); prevalence increased by 46% (6.4 per 1000 to 9.3 per 1000 population). Increases in prevalence were greater among adolescents and among young men. CONCLUSIONS: Diabetes should be considered a major public health problem among young American Indians and Alaska Natives.     

Tobacco and other substance use among Alaska Native youth in western Alaska

OBJECTIVE: To examine tobacco, alcohol, and other drug use rates among Alaska Native youth from western Alaska. METHODS: The sample consisted of 665 youth ages 6-18. RESULTS: Of children 6-10 years of age, 12% reported current use, and the prevalence rates increased with age. Females were significantly more likely than males to report tobacco use. The rates of alcohol and other drug use were very low. After adjusting for age and gender, significant correlates of tobacco use were maternal tobacco use during and after pregnancy. CONCLUSIONS: Expanded efforts are needed to address tobacco use among Alaska Native youth.     

捕获-标记-再捕获法在出生缺陷监测系统评估中的应用

目的 了解和评估现行的医院出生缺陷监测系统和人群出生缺陷监测系统的监测效率.方法 以湖南省某县2006年10月1日至12月31日人群出生缺陷监测数据作为第一来源资料,以同时期当地医院出生缺陷监测数据作为第二来源资料,利用捕获-标记-再捕获法(CMR)进行评价.结果 人群监测系统发现缺陷儿49例,医院监测系统发现缺陷儿28例,重复病例为20例;根据CMR法的计算公式,该县2006年10月1日至12月31日出生缺陷总体估计值为68例(N=68),95%CI:56～70;人群监测系统和医院监测系统的符合率分别为72.1%和41.2%,总符合率为83.8%,两种监测系统来源相互之间的符合率为57.1%;漏报率分别为27.9%与58.8%.结论 人群出生缺陷监测系统和医院出生缺陷监测系统均存在一定的漏报情况,可应用CMR法尽可能的校正.