Incidence trends in childhood cancer in Queensland, 1973-1988

OBJECTIVE: To determine whether there are any secular trends in the incidence of childhood cancer in Queensland. DESIGN: A retrospective epidemiological study of the incidence of cancer in children, aged 0-12 years, in Queensland during the 16-year period 1973-1988 inclusive. SETTING: Cases were found from the records of the Queensland Childhood Malignancy Registry. Ascertainment is believed to be virtually complete for children aged 0-12 years. PARTICIPANTS: All children who were resident in Queensland and less than 13 years of age at the time of diagnosis of cancer. The cases included all malignant neoplasms and also all intracranial neoplasms in children but excluded Langerhans' cell histiocytosis. MAIN OUTCOME MEASUREMENTS: The incidence by year of diagnosis was calculated for each of a number of standard diagnostic groups of neoplasms. These data were analysed by the chi 2, for trend test. RESULTS: Cancer incidence was found to be increasing at a rate of about 0.9% per year. The rise was almost entirely accounted for by a rise in incidence among boys, whereas there was virtually no change in the incidence in girls. Statistically significant increases in incidence were found in acute non-lymphocytic leukaemia and also in non-Hodgkin's lymphoma in boys; Hodgkin's disease was found to be decreasing in incidence. CONCLUSIONS: The results of this study emphasise the importance of childhood cancer incidence surveillance in Australia to determine whether these trends will continue in the future. The findings also indicate a need for continuing research in childhood cancer epidemiology.     

武汉市儿童胰岛素依赖型糖尿病发病率调查

根据WHO DIAMOND计划,采用“捕获—再捕获”方法.对1989～ 1996年武汉市区 0～14岁儿童胰岛素依赖型糖尿病发病率进行了流行病学双向性前瞻调查。结果表明,其平均年发病率为0.4672/10万/年（男性 0.4526/10 万/年、女性 0.4828/10万/年）,按年龄构成际化后的标化率为 0.4798/10万/年（男性0.4621/10万/年、女性O.4988/10万/年）;男女性发病率比约为0.94。年度发病率呈现波动,1990和1993年最低（0.2492/10万）,1995年最高(0.8721/10万）。两个来源共同登记的确定水平为90.90％,预计年发病率为 0.4983/10万（95％CI=0.4441/10万～0.5526/10 万）。同其他国家和地区相比,武汉市儿童胰岛素依赖型糖尿病发病率较低。     

0～2岁儿童营养性缺铁性贫血的防治及追踪干预研究

目的通过对社区0～2岁儿童营养性缺铁性贫血的防治和追踪指导后,降低儿童营养性缺铁性贫血的患病率。方法连续3年对石围塘街社区本地户口0～2岁健康儿童进行缺铁性贫血筛查,有针对性的对贫血患儿进行治疗,以及为所有研究对象作膳食营养的追踪指导。结果连续3年的防治和追踪指导后,血红蛋白的检测结果显示与第一年的基数有统计学的意义（P〈0.05）。结论通过积极的防治和追踪干预措施能有效的降低社区儿童营养性缺铁性贫血的患病率。     

Incidence of autism spectrum disorders in children in two Australian states

AIM: To ascertain the incidence of autism spectrum disorders in Australian children. SETTING: New South Wales (NSW) and Western Australia (WA), July 1999 to December 2000. DESIGN: Data were obtained for WA from a prospective register and for NSW by active surveillance. MAIN OUTCOME MEASURES: Newly recognised cases of autism spectrum disorders (defined as autistic disorder, Asperger disorder and pervasive developmental disorder not otherwise specified [PDD-NOS]) in children aged 0-14 years; incidence was estimated in 5-year age bands (0-4 years, 5-9 years, 10-14 years). RESULTS: In WA, 252 children aged 0-14 years were identified with autism spectrum disorder (169 with autistic disorder and 83 with Asperger disorder or PDD-NOS). Comparable figures in NSW were 532, 400 and 132, respectively. Most children were recognised with autistic disorder before school age (median age, 4 years in WA and 3 years in NSW). Incidence of autistic disorder in the 0-4-years age group was 5.5 per 10,000 in WA (95% CI, 4.5-6.7) and 4.3 per 10,000 in NSW (95% CI, 3.8-4.8). Incidence was lower in older age groups. The ratio of all autism spectrum disorders to autistic disorder alone was 1.5:1 in WA and 1.3:1 in NSW, and rose with age (1.8:1 and 2.9:1 in 10-14-year-olds in WA and NSW, respectively). CONCLUSIONS: These are the first reported incidence rates for autism for a large Australian population and are similar to rates reported from the United Kingdom. Ongoing information gathering in WA and repeat active surveillance in NSW will help to monitor any future changes.     

The rising incidence of childhood type 1 diabetes in New South Wales, 1990-2002

OBJECTIVES: To determine the incidence of childhood type 1 diabetes mellitus (T1DM) in New South Wales from 1997 to 2002; to compare with previously published rates (1990-1996); and to analyse trends in incidence from 1990 to 2002. DESIGN, SETTING AND PARTICIPANTS: Prospective population-based incidence study. Primary ascertainment of incident cases aged < 15 years was from the Australasian Paediatric Endocrine Group NSW children's diabetes register. Secondary ascertainment was from the National Diabetes Supply Scheme until 1999 and from the Australian Institute of Health and Welfare thereafter. Childhood population data were obtained from the Australian Bureau of Statistics. MAIN OUTCOME MEASURES: Age-standardised incidence; trends in incidence by calendar year, and sex and age at diagnosis. RESULTS: There were 3260 incident cases (1629 boys, 1631 girls) in the 13 years. Case ascertainment was 99.7% complete using the capture-recapture method. Mean age-standardised incidence per 100 000 person-years was 20.9 (95% CI, 19.9 to 21.9) from 1997 to 2002 compared with 17.8 (95% CI, 17.0 to 18.7) from 1990 to 1996; there was a plateau in incidence between 1997 and 2002. Overall, the incidence increased on average by 2.8% per year (95% CI, 1.9% to 3.8%, P < 0.001) and increased with age, being 12.2 (95% CI, 11.3 to 13.1) in 0-4 year olds; 18.9 (95% CI, 17.8 to 20.0) in 5-9 year olds and 26.7 (95% CI, 25.4 to 28.1) in 10-14 year olds. The increase per year in 0-4 year olds (3.9%) was not significantly higher than in older children. The mean incidence of T1DM was 19.8 (95% CI, 18.8 to 20.7) in girls and 18.8 (95% CI, 17.9 to 19.7) in boys (P = 0.02). CONCLUSIONS: The incidence of childhood-onset T1DM has increased significantly in all age groups in NSW since 1990. Resource planning in the management of childhood diabetes in NSW should take these findings into account.     

Follow up study of children born elsewhere but attending schools in Seascale, West Cumbria (schools cohort)

Records on 1546 children who were identified as having attended schools in Seascale up to November 1984 and were born since 1950 but not in the civil parish were studied. These children lived in or near Seascale for a period of time while they were attending one or more of three local schools and are an additional group to the 1068 children who were identified as born to mothers resident in Seascale in an accompanying study. Even though some of the schoolchildren apparently remained in the village for a short period only all but 7% were followed up through the National Health Service Central Register. Mortality among these children to 30 June 1986 is comparable to that expected at national rates. From all causes there were 10 observed deaths compared with 12.69 expected--a ratio of 0.79 (95% confidence interval 0.38 to 1.45)--and from cancer one observed death compared with 2.04 expected--a ratio of 0.49 (95% CI 0.01 to 2.73). No deaths from leukaemia or lymphoma were reported, but only 0.83 was expected. Since 1971 (the year when cases of cancer were first notified to the NHS Central Register) three non-fatal cases of cancer were reported, including two lymphomas, compared with 2.04 expected and two cases of carcinoma in situ of the cervix compared with 1.79 expected. In addition, there was a case of leukaemia among the schoolchildren which was known previously and had been diagnosed in 1968. There is an interesting difference between the results of this study and the results of the study of children born to mothers who were resident in Seascale. In the latter study there was an excess of leukaemia and of other cancers, but a similar finding is not apparent among children who spent some time at schools in Seascale but were born elsewhere. This raises the question of whether one or more aetiological factors in childhood cancer were acting on a locality specific basis before birth or early in life. This cannot be answered from these cohort studies, but it is hoped that the case-control study that is under way in West Cumbria will provide relevant information.     

淮北市3224例肺炎患儿病例流行特征及住院时间分析

目的分析2017年～2018年淮北市3 224例0～14岁肺炎患儿就诊病例,分析以淮北市为代表的皖北地区肺炎流行性发病规律,为少年儿童肺炎防治提供依据。方法收集淮北市人民医院与淮北市妇幼保健院2017～2018年0～14岁、住院天数<83 d肺炎患儿的住院资料和人口学信息。结合淮北市的气温特征,对3 224例病例进行描述性流行病学分析。结果男女病例数比为1.61∶1。<1岁、1～5岁、>5岁的患儿分别为1 790、1 199和235例。整体入院时间以11月、5月和1月占多数。<5岁的低龄儿童集中于春夏、秋冬换季时节发病,而>5岁的儿童的发病高峰出现在寒暑假期间。各年龄段儿童患病入院时间的差异有统计学意义(P<0.05)。住院天数主要集中在3～15 d,平均为(7.63±5.19) d。不同年龄段儿童肺炎住院天数的差异有统计学意义(P<0.05)。此外,淮北市冬季寒冷干燥,夏季炎热多雨的气候特点对不同年龄段儿童肺炎患病时间与住院天数均存在影响。结论淮北市肺炎发病存在显著的年龄和季节性分布差异。<5岁特别是未满1岁的儿童是肺炎的高发人群,年龄...     

鲁山县2011年呼吸道MP—DNA感染情况调查分析

目的探讨鲁山县呼吸道感染患者肺炎支原体（MP）感染阳性率及男女、季节和年龄段的关系。方法回顾我院2011年全年在呼吸道门诊及儿科门诊就诊的成人及儿科患者11004例。用实时荧光PCR技术对MP-DNA进行检测,将筛查人群对性别、年龄和不同季节的阳性检出率进行比较分析。结果2011年的11004例患者中共检出MP-DNA阳性2400例,阳性率21．81％,支原体感染一年四季均可发生,但有季节性差异,冬季发病率最高,夏季最低,男女发病无明显差异,与年龄段关系明显,特别是14岁以上组阳性率为42．50％（51／120）,其次为1-3岁儿童感染率为26．47％,0-1岁以下儿童感染率最低为14．28％。结论支原体感染在每个年龄段均可发病,儿童发病有提前的趋势：成人也不可忽视,特别是对于长期不明原因的呼吸道感染患者的检测。     

2005—2015年中国0~14岁儿童恶性肿瘤流行特征研究

背景 恶性肿瘤已经成为我国儿童主要死亡原因之一,给社会及家庭带来极大经济负担。因此掌握儿童恶性肿瘤的流行规模和趋势具有重要意义。 目的 分析2005—2015年中国0~14岁儿童恶性肿瘤的流行病学特征,为我国儿童恶性肿瘤防控战略的制订和卫生资源的合理分配提供参考。 方法 收集2008—2018年"中国肿瘤登记年报"中0~14岁儿童恶性肿瘤的发病和死亡等数据,利用2010年全国人口构成计算标化发病率、死亡率,并通过Joinpoint模型计算年度变化百分比（annual change percentage,APC）来反映时间趋势。 结果 （1）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗发病率为9.35/10万,中位粗死亡率为3.91/10万,其中0~4岁组中位粗发病率、死亡率均高于5~9岁组和10~14岁组（P<0.05）。（2）2005—2015年中国0~14岁男童中位粗发病率和死亡率均高于女童（发病率：10.21/10万vs 8.91/10万,P<0.05;死亡率：4.18/10万vs 3.47/10万,P<0.05）。（3）2005—2015年中国0~14岁城市儿童恶性肿瘤中位粗发病率和死亡率均高于农村儿童（发病率：10.87/10万vs 7.20/10万,P<0.05;死亡率：4.08/10万vs 3.54/10万,P<0.05）。（4）2005—2015年中国0~14岁儿童恶性肿瘤的中位粗死亡率呈上升趋势（APC=1.01%,P<0.05）,其中0~4岁组中位粗死亡率随时间呈下降趋势（APC=-1.19%,P<0.05）;5~9岁组中位粗死亡率随时间呈上升趋势（APC=2.50%,P<0.05）;10~14岁组中位粗死亡率为随时间呈稳定状态（APC=0.64%,P>0.05）。（5）2005—2015年中国农村0~14岁儿童恶性肿瘤的发病率与死亡率均呈上升趋势（APC分别为7.73%和2.22%,P<0.05）。（6）2005—2015年中国0~14岁儿童恶性肿瘤发病与死亡前六位分别为白血病、脑癌、淋巴癌、骨癌、肾癌、肝癌。 结论 中国儿童恶性肿瘤发病和死亡在时间、人群、地区方面呈现出特定的分布特点,今后应将农村地区、5~9岁年龄组以及脑癌、白血病癌种的儿童作为重点防控对象。 该文的微信推文请扫描下方二维码查看！     

湖南省长沙市1989～1994年儿童Ⅰ型糖尿病发病率调查

根据WHODIAMOND计划的方法，对湖南省长沙市1989～1994年0～14岁儿童Ⅰ型糖尿病（IDDM）发病率进行了调查。从全市23所医院和193所中、小学调查出19例患者，其中男性12例，女性7例，均为汉族。以1990年全国人口统计资料计算出长沙市儿童IDDM发病率为每年0．23／10万，冬春季节和10～14岁年龄组呈现发病高峰。长沙市儿童IDDM发病率是迄今国内外报道中最低的。     

不同年龄儿童传染性单核细胞增多症临床分析

目的探讨不同年龄儿童传染性单核细胞增多症（infectious mononucleosis,IM）临床及细胞免疫特点。方法将本院儿科收治的IM患儿87例分成0-3岁、3—6岁、6—14岁3组进行临床及实验资料分析。结果0～6岁发病率59．77％。发热天数0—3岁组平均（6．25±2．9）d,3—6岁组（7．83±2．79）d,6—14岁组（10．73±2．91）d,热程在6～14岁组与其它年龄组间差异有统计学意义（P〈0．05）。肝肿大48例（55．1％）,脾肿大21例（24．1％）,3岁以上年龄组多见,差异有统计学意义（P〈0．05）。眼睑浮肿25例（28．7％）,以0—6岁低年龄组多见。6岁以上儿童咽峡炎表现突出。颈淋巴结肿大68例（78．1％）,皮疹12例（13．7％）,各年龄组间无显著性差异。3岁以下婴幼儿白细胞总数升高明显,而变异淋比例偏低。发病年龄越大,肝功能损害、心肌酶异常、外周血CD4^＋T、CD4^＋／CD8^＋及CD16^＋CD56下降愈明显。结论儿童IM的某些临床特点与发病年龄及细胞免疫状态有关,应予以重视。     

Accidents in the home among children under 5: ethnic differences or social disadvantage?

Accidents in the home to children under 5 in a multiracial population with a high level of social disadvantage were studied by interviewing at home the parents of 402 children attending the accident department of a west London hospital during one year. The parents' country of birth, whether they were employed, and their housing conditions were recorded using the definitions of the 1981 census. Four ethnic groups (British (183 children), Asian (127), Caribbean (61), and other (31)) were identified. Though attendance rates based on the populations of electoral wards at the census and standardised for distance from the hospital showed no significant differences among the ethnic groups, there was a strong gradient by social class and strong associations with unemployment of the mother (although not of the father), overcrowding, and tenure of housing. Social disadvantage seems to be more important than ethnicity as a determinant of accidents to children in the home.     

Deaths in children with a diagnosis of acute appendicitis in England and Wales 1980-4

Thirty five children died of acute appendicitis in England and Wales in 1980-4 compared with 204 in 1963-7. Thirteen of the 35 deaths in 1980-4 took place at home or on the day of admission to hospital before operation and a further 18 on the day of operation or the first day after it. Thirty one of the children had peritonitis. A third of the deaths were in children aged 0-4 years, and the hospital fatality rate in this age group was one death in 320 cases compared with one death in 4760 cases in children aged 5-14 years. The fall in the number of deaths between the 1960s and the 1980s was due to improvements in medical care, a reduction in the incidence of appendicitis, and changes in the age structure of the child population. Difficulty and delay in diagnosis and inadequate intravenous therapy are now the main factors contributing to death.     

Invasive Haemophilus influenzae type b disease in Sydney children 1985-1987: a population-based study

OBJECTIVE: To determine the incidence and age distribution of invasive Haemophilus influenzae type b (Hib) disease in children (0-14 years) in the Sydney Statistical Division (SSD). DESIGN: Retrospective ascertainment from a defined population, 1985-1987. Eligible cases had Hib isolated from a normally sterile site or endoscopically proven epiglottitis. SETTING: Sydney Statistical Division, which had a population of children aged 0-4 years of 229 165 in 1986. PATIENTS: Cases were identified from all potential sources of relevant recorded information. MAIN OUTCOMES: There were 292 eligible cases. Among 284 previously well children, those under 18 months of age contributed 81 of 143 cases (57%) of meningitis and 22 of 71 (71%) of cellulitis/arthritis but only 8 of 91 (11%) of epiglottitis and 4 of 18 (22%) of infection in other foci. Overall, 9% of cases had occurred by 6 months of age, 42% by 18 months and 55% by 24 months. The annual incidence of invasive Hib disease was 38.5 per 100,000 children aged 0-4 years. In areas with the lowest proportion of young children (less than 5.5%), the incidence of Hib disease in the first 12 months of life was significantly lower than in the remainder of Sydney, although there were no differences in overall disease incidence in the age group 0-4 years. CONCLUSIONS: This study indicates that approximately 1 in 500 urban Australian children develop invasive Hib disease by their fifth birthday. Vaccination of children in Sydney with a conjugate Hib vaccine at 18 months of age would result in a greater potential reduction in Hib disease than in the United States, where universal vaccination at this age is current policy.     

Epidemiology of birth defects among children in 8 provinces in China]

In 1988, birth defects (BD) among 85,170 children aged 0-14 were investigated in eight provinces and cities of China. The overall prevalence rate was 15.13% in urban, 15.40% in rural areas. The prevalence rate of BD was significantly higher in males than in females (16.66% vs 13.70%). The prevalence rate of BD was significantly higher in mothers aged > or = 35 years than in mothers aged < 35. 20 of 82 categories of BD accounted for > or = 1% of all BD. The 3 leading BD were: cutis angioma, congenital heart disease and indirect hernia. The incidence of mental retardation was significantly higher in children with BD than in children without BD.     

Epidemiology of invasive pneumococcal infections in children in Finland.

OBJECTIVE--To study the epidemiologic characteristics of invasive infections in children caused by Streptococcus pneumoniae to provide background data for vaccination programs. DESIGN--A nationwide laboratory-based prospective surveillance of all invasive pneumococcal infections in children during 1985 through 1989. SETTING--A network of all microbiologic laboratories and pediatric wards in Finland. PATIENTS--Children aged 0 to 15 years who were admitted to a hospital with S pneumoniae isolated from blood, cerebrospinal fluid, or deep aspirate sample. RESULTS--Four hundred fifty-two invasive pneumococcal infections were diagnosed in 1985 through 1989. The annual incidence rate was 8.9 per 100,000 children less than 16 years of age (24.2 per 100,000 among children less than 5 years of age and 45.3 per 100,000 among those less than 2 years of age). The most common clinical entities were bacteremia without focus (310 cases), pneumonia (66 cases), and meningitis (51 cases), with other focal infections seen in 25 cases. The pneumococcal groups/types 14, 6, 19, 7, 18, and 23 comprised 78% of all invasive infections. CONCLUSIONS--Streptococcus pneumoniae is a common cause of invasive infections in children in Finland. A pneumococcal conjugate vaccine containing the six most common groups/types could prevent up to 70% of invasive pneumococcal infections of children in Finland if fully protective in infancy.     

肠道菌群及免疫调节与儿童哮喘关系的研究进展

支气管哮喘（以下简称哮喘）是一种常见的慢性呼吸系统疾病,严重威胁人类健康。迄今为止,全球约有3亿多人患有哮喘,其中儿童居多。流行病学调查研究显示,我国0~14岁儿童哮喘患病率为2.32%,且呈明显上升趋势。对于儿童而言,免疫系统发育不全且肠道菌群正处于生理性演替过程,极容易发生肠道菌群失调,导致肠黏膜屏障的破坏以及局部免疫失调,进而严重影响儿童哮喘的发生发展。本文将论述儿童哮喘发生、发展的免疫调节作用机制与肠道微生物的关系,并基于肠道菌群探讨干预措施,为哮喘的治疗提供新思路。     

儿童社区获得性肺炎的流行分布和常见菌种特征及变迁研究

目的掌握广州地区儿童社区获得性肺炎（Communityacquiredpneumonia,CAP）的流行特点和病原微生物的分布及变迁情况。方法选取2010年8月至2012年2月在广州地区7所医院就诊的4856例2d-14岁患儿分别进行多病原联合检测,采集呼吸道分泌物标本进行细菌培养;鼻咽拭子检测呼吸道病毒抗原;静脉血液检查肺炎支原体和衣原体。结果CAP患儿主要以1岁以下的居多,且发病季节亦主要以秋冬为主;共培养分离1131株病原菌（23．29％）,其中,革兰氏阴性菌63l株（55．79％）,阳性菌500株（44．21％）;检出前5位的细菌分别是肺炎克雷伯氏菌（28．65％）、肺炎链球菌（25．29％）、大肠埃希氏菌（23．08％）、金黄色葡萄球菌（12．20％）、凝固酶阴性葡萄球菌（4．5l％）;革兰氏阴性菌对氨苄西林的耐药性最高,达92．55％,而革兰氏阳性菌对青霉素的耐药性最高,耐药率高达98．40％;1岁以上患儿除肺炎支原体的感染率均高于l岁以下,其余均显著低于1岁以下（P〈0．05）,金黄色葡萄球菌呈逐年增长的趋势,肺炎链球菌感染逐年下降,肺炎克雷伯菌发生率比较稳定,大肠埃希菌感染逐年增长。结论肺炎克雷伯氏菌、肺炎链球菌、大肠埃希氏菌等为广州地区儿童CAP的主要病原体,多数病原微生物在1岁以下患儿中感染率高于l岁以上。