Invasive pneumococcal disease burden in Hong Kong children

In a retrospective, population-based study, we estimated the age-specific incidence of invasive pneumococcal disease in Hong Kong between 1995 and 2004. The incidence rates per 100,000 were 18.3 (95% confidence interval [CI], 13.9-23.3) for children aged 相似文献   

A twelve year study of the incidence of childhood type 1 diabetes mellitus in the Eastern Province of Saudi Arabia

OBJECTIVE: Study of the incidence of childhood type 1 diabetes in the Eastern Province of Saudi Arabia. METHODS: Analysis included all children eligible for care in our hospital who had type 1 diabetes diagnosed before their 15th birthday between 1986 and 1997. RESULTS: A total of 46 children (27 girls and 19 boys) were identified, with a median age at diagnosis of 10.3 yr. The overall age-adjusted incidence rate was 12.3 x 10(5)/yr; it was 9.9 x 10(5)/yr for males and 14.8 x 10(5)/yr for females. The number of patients increased significantly (relative risk of 46) over the study period (p=0.01), more significantly in females (p=0.007) and in the 10-14 year age group (p=0.01). CONCLUSIONS: The incidence of type 1 diabetes increased markedly over the past 12 years, mainly in females and children over 10 years of age. The data confirm the need to develop a national registry and the need for further epidemiological research.     

Long-term trends in the incidence of type 1 diabetes in Denmark: the seasonal variation changes over time

There is a worldwide increase of type 1 diabetes mellitus (T1DM). In 1996, the Danish population-based registry was initiated including all newly diagnosed children aged 0–15 yr. This is the report of incidence and seasonal variation for the first 10 yr of the registry. The data was analyzed using Poisson's regression analysis. A total of 2166 children with diabetes were diagnosed before the age of 15 yr between 1996 and 2005. In this period, the annual increase in childhood T1DM was 3.43% (95% confidence interval: 1.91–4.97), which was unaffected by age and gender. Seasonal variation in incidence rates varied by year but not by age and gender. In conclusion, there is a steep increase in incidence of childhood T1DM in Denmark; the increase is comparable with the increase seen in other European countries. There is a significant seasonal variation that changes on a year-to-year basis. The observed variations in cadence rates may be associated with viral epidemics, sunshine exposure, or vitamin D levels and suggest further exploration of these relations.     

Meningitis in Hong Kong children, with special reference to the infrequency of haemophilus and meningococcal infection

Objective: To study the epidemiologic and aetiologic features of meningitis in children in Hong Kong.
Methodology: A retrospective study of 85 children resident in the New Territory East region of Hong Kong admitted to a teaching Hospital because of meningitis during a 9 year period.
Results: Mycobacterium tuberculosis was the most common aetiological agent accounting for 13 cases (15.3%). Other bacteria accounted for 41 cases (48%); among these one fifth were caused by Haemophilus influenzae type b. The overall admission rates for tuberculous meningitis in Chinese children were 0.76/100 000 (95% CI 0.25-1.78) and 0.42/100 000 (CI 0.19-0.8) per year, respectively, for under 5 year olds and under 15 year olds. The overall annual incidence rates of bacterial meningitis other than tuberculous were 5.2/100 000 (CI 3.72-7.43) and 1.6/100 000 (CI 1.14-2.29) for Chinese children under 5 years and under 15 years, respectively. The annual incidence of H. influenzae meningitis in Chinese children under 5 years old was low at 1.1/100 000 (0.43-2.2). All five cases of meningococcal meningitis were in Vietnamese children (under 5 years of age incidence: 13.0/100 000 per year, CI 4.2-30.3). There were no cases of meningococcal meningitis in Chinese children during the 9 year period.
Conclusion: M. tuberculosis was the most common aetiological agent of meningitis in Hong Kong children. The incidence of haemophilus or meningococcal meningitis was very low.     

Incidence of childhood diabetes mellitus in Austria 1979-1984

The mean annual incidence of childhood diabetes mellitus in Austria was 7.22 cases per 100,000 with a year to year variation of 6.09-8.67 per 100,000. A seasonal variation of onset, with peaks in autumn and winter and with lower rates in summer in children older than 4 years, could be observed. The peak incidence in girls occurred at 11-12 years and preceded the highest incidence in boys by 1-2 years. Both sexes showed a small peak around 6 years of age. The male to female ratio was 1.2/1. Compared to epidemiologic studies in north-western Europe the incidence of childhood diabetes in Austria is low, however higher than in France or Italy.     

Significant urban/rural differences in the incidence of type 1 (insulin-dependent) diabetes mellitus among Bulgarian children (1982-1998)

The systematic registration of the incidence of childhood (0-14 yr) type 1 (insulin-dependent) diabetes mellitus in Bulgaria dates back to 1973, with an invariably present difference in the incidence according to the area of residence. The present study has been undertaken to assess the trends in the incidence of type 1 diabetes among children in eastern Bulgaria (1982-1998) with respect to area of residence at onset. The data were collected prospectively, with an ascertainment of the primary source of 95.8%. The mean annual incidence is 6.99/100,000 (95% CI = 6.45-7.54), varying between 5.09 and 11.54/100,000. The mean annual incidence in towns is higher than in villages: 7.89 vs. 5.26/100,000, p < 0.0001. A linear trend of increase in the incidence with time is revealed applying Poisson regression analysis, with the area of residence as a strong predictor of the risk (p < 0.001). According to the model, the age-adjusted incidence rose by 4.1% annually. The stratified analysis by age group has found a significant linear trend in those aged 5-9 (p < 0.001) and 10-14 yr (p = 0.002) for both sexes. In conclusion, the markedly increasing incidence of type 1 diabetes among children in this study is strongly dependent on area of residence at onset. We suggest that in conjunction with the pronounced seasonality at the onset of diabetes and its connection with population density, this phenomenon should be regarded as a reflection of environmental influence and further explored.     

Incidence and prevalence of type 1 diabetes in children aged <15 yr in Castilla-Leon (Spain)

OBJECTIVES: To determine the incidence and prevalence of type 1 diabetes in children younger than 15 yr in the Autonomous Community of Castilla-Leon (Spain). RESEARCH DESIGN AND METHODS: All type 1 diabetic cases with onset at <15 yr of age were recorded during 2003-2004. Identified case subjects were ascertained from several sources and the capture-recapture method was used to estimate the completeness of ascertainment. For prevalence, all patients younger than 15 yr with type 1 diabetes at the beginning and at the end of the study were identified. RESULTS: Over the study period, 130 children aged 0-14 yr were diagnosed with type 1 diabetes. The average observed incidence of type 1 diabetes in this population was 22.22/100 000/yr (95% CI 14.57-29.81). Age-standardized incidence was 22.01/100 000/yr (95% CI 18.18-25.83). The highest incidence was observed in the 5-9 yr age-group (32.45/100 000/yr, 95% CI 24.31-40.59). The prevalence at the beginning and at the end of the study was 1.01/1000 and 1.18/1000, respectively. CONCLUSION: Castilla-Leon appears to have one of the highest incidences of childhood type 1 diabetes in Spain, with recent incidence approaching those of some northern European countries.     

Incidence, prevalence, and mortality of insulin-dependent (type 1) diabetes mellitus in Lithuanian children during 1983-98

Abstract: Aims/hypothesis: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood‐onset insulin‐dependent diabetes mellitus (type 1) in Lithuania. Methods: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983–98. The cohort study was performed to evaluate the standardized mortality ratios. Results: The average incidence of type 1 diabetes during the 16‐yr study period was 7.36 per 100 000/yr. For both males and females the highest incidence of type 1 diabetes was recorded in the 10–14 yr age group. The regression‐based linear trends of the increase in incidence in various age groups and the annual percentage change for both genders was 2.05 (p = 0.0039) and the greatest regression slope is observed for both genders in the 10–14 yr age group. Regression‐based linear trends in type 1 diabetes prevalence indicate an even growth in all age groups (3.47; p = 0.001), although the annual percentage change is most prominent in the 5–9 yr age group for girls (4.95%/yr) and in the 10–14 yr age group for boys (4.06%/yr). The standardized mortality ratio of all‐cause mortality in people with diabetes is higher than in the common population 7.71 (p < 0.0001). The standard mortality ratio for all causes increases with longer diabetes duration. Conclusion/interpretation: The significant increasing trend of incidence and prevalence during 1983–98 is observed. The annual percentage change is similar. The young patients with type 1 diabetes have a higher mortality risk.     

Rising incidence of type 1 diabetes in Scottish children, 1984-93. The Scottish Study Group for the Care of Young Diabetics

OBJECTIVES: To calculate the incidence of type 1 diabetes in Scottish children aged less than 15 years between 1984 and 1993; to examine changes in incidence; and to calculate the prevalence of diabetes at the end of this period. DESIGN: Three data sources were used to construct the Scottish Study Group for the Care of Young Diabetics register: active reporting of all new cases; reports from the Scottish Morbidity Register 1; and local registers. SUBJECTS: All children resident in Scotland diagnosed with primary insulin dependent diabetes mellitus when less than 15 years of age between 1984 and 1993. MAIN OUTCOME MEASURES: Annual incidence and prevalence rate for Scotland; time trend in incidence over the 10 years; differences in incidence between the three different age groups; and completeness of the register. RESULTS: The average annual incidence for Scotland was 23.9/100,000 children. The prevalence rate was 1.5/1000 in 1993. A total of 2326 cases was identified from the three sources. Capture-recapture analysis suggests a case ascertainment of 98.6%. The annual incidence rates increased at a rate of 2% each year (rate ratio = 1.02, 95% confidence interval (CI) 1.01 to 1.03). The incidence was higher in boys than girls (rate ratio = 1.08, 95% CI 1.00 to 1.18), and the incidence rates increased with age: 15.3/100,000/year for age 0-4 years, 24.4/ 100,000/year for age 5-9 years, and 31.9/ 100,000/year for age 10-14 years. CONCLUSIONS: The incidence of type 1 diabetes in Scotland is increasing and the prevalence is relatively high. These findings have important implications for health service resource allocation. The Scottish Study Group for the Care of Young Diabetics' register provides a base for monitoring and research.     

Fetal size to final height in Hong Kong Chinese children

OBJECTIVES: It has been known that size at birth is important for postnatal growth and final height. However, there are few data in the literature on the difference in height growth patterns from fetal size to final height between less privileged and more privileged populations. The aim of this study was to describe the important features in height growth from birth to maturity in an underprivileged Hong Kong Chinese cohort in comparison to a more privileged Swedish cohort. METHODS: The longitudinal height growth data from birth to maturity in full-term healthy Hong Kong Chinese children (n=132) who were born in 1967 were analyzed, and compared with those for Swedish children who were born in 1973-75 (n=3650). RESULTS: Children with longer birth length achieved taller adult stature with respect to their target height. The mean final height retained the same order as that of the mean length at birth for various birth length groups. All children in the Hong Kong Chinese series showed catch-down height growth during the first 2 years of life, in contrast to the catch-up in smaller babies and catch-down in larger babies for the Swedish series. The growth deficit for the Hong Kong Chinese was -0.9 SDS at birth, -1.8 SDS at 2.0 years of age, -2.1 SDS at 8 years of age, and -1.7 SDS at final height. CONCLUSIONS: Fetal size is important for postnatal growth and attained final height with respect to a child's familial genetic potential in stature, not only for privileged populations, but also for underprivileged populations. However, children in underprivileged populations experience a persistent increasing growth deficit during infancy and childhood. Special attention should be given to monitor their growth status in early years and to institute appropriate intervention programs.     

Insulin-dependent diabetes mellitus in southern Chinese children: An overview

Thirty-three southern Chinese children with insulin-dependent diabetes mellitus (IDDM) were studied. The patients had a mean follow-up of 5.2 years (range 1.2–8.2). The mean age of onset was 8.3 years (range 1.7–13.5). The mean duration of symptoms before diagnosis was 22 days. Ten patients (30%) presented with diabetic ketoacidosis at diagnosis. Only one patient (3%) was found to have thyroid microsomal antibodies and none was found to have hypothyroidism or hyperthyroidism. Incidence and prevalence were calculated from data recorded retrospectively and prospectively in a population-based registry of IDDM. The prevalence in 1991 and 1992 was 8.3 per 100000 children under 15 years of age. The age-standardized incidence of IDDM was 1.7/100 000 per year with the 95% confidence interval of 1.2–2.4/100 000 per year for children under 15 years of age during the years 1986–93. The incidence for males was 1.1/100 000 per year and for females, 2.4/100 000 per year.     

Syncope in children and adolescents of Hong Kong

OBJECTIVES: Syncope occurs commonly in children and adolescents. The objectives of the present study were to quantify this occurrence locally and to examine the profiles of subjects experiencing syncope. METHODOLOGY: A self-administered questionnaire was filled out by students between 6 and 17 years of age from a selected school in January 1999. RESULTS: Out of 2574 completed questionnaires, a total of 121 subjects reported having had at least one previous episode of syncope, including 9.0% of the 15-17 years age group. The overall incidence of a first syncope in the preceding 12 months was 1.7% and was highest (3.3%) in the 15-17 years age group. No significant difference in incidence was noted between sexes. Among those who experienced syncope, 32.2% had sought medical advice and 9.1% had been admitted to hospital; 57.9% became worried, while 37.2% reported restriction of daily activities because of syncope. CONCLUSION: Syncope is a common event in children and adolescents in Hong Kong. It can cause a considerable degree of anxiety and activity restriction. The impact on medical services due to syncope in Hong Kong has been substantial.     

Growth and nutrition of Hong Kong children aged 0-7 years

OBJECTIVE: To study the early dietary practices in relation to growth of Hong Kong children from birth to 7 years. METHODOLOGY: One hundred and seventy-three full-term Hong Kong Chinese babies were recruited at birth and were followed up for anthropometric measurements using standardized methods and dietary assessment using a combination of dietary history, 24 h recall and food frequency. At 7 years, 125 children remained in the study. RESULTS: Mean (SD) birthweight was 3.3 (0.38) kg for boys and 3.1 (0.38) kg for girls. Mean (SD) weight at 7 years was 22.4 (4.2) kg for boys and 21.1 (3.7) kg for girls, and mean (SD) height was 120.3 (4.8) cm for boys and 119.8 (5.1) cm for girls. Hong Kong children were lighter and shorter than Australian children and the National Centre for Health Statistics (NCHS) references, but the magnitude is less than one standard deviation score. Mean weight and height of Hong Kong children were lower compared to Caucasian and Beijing children, with more obvious differences between 1 and 5 years. At 1 year, mean (SD) daily energy intake was 98 (24) kcal/kg/day for boys and 100 (26) kcal/kg/day for girls. By 7 years, it decreased to 82 (18) kcal/kg/day for boys and 73 (22) kcal/kg/day for girls. Between 2 to 4 years of age the energy intake of studied children were slightly lower than the Australian and Finnish children, but the protein intake was higher. Percentage of fat contributing to total daily energy intake was lower throughout at a level of 30%. Such differences in diet reflect a lower consumption of milk fat, higher consumption of meat and lower level of physical activity in Hong Kong children. Intakes of calcium, iron and vitamin C all reached 60% or above of US recommended daily allowance. CONCLUSIONS: The smaller body build of Chinese compared to Caucasians cannot be explained by dietary differences. The diet of Hong Kong children is changing to one which is more Westernized with a higher consumption of animal products.     

Critical growth phases for adult shortness in Hong Kong Chinese.

OBJECTIVES: This study was designed to explore whether the influence of subnormal growth in fetal, infancy, childhood and pubertal phases on adult short stature was the same when comparing privileged and underprivileged populations. METHODS: Data came from two longitudinal growth studies: 1) Hong Kong Chinese children who were born in 1967 (n = 132), and 2) the comparatively more privileged Swedish children who were born in 1973-1975 (n = 2,850). RESULTS: 68% of Hong Kong Chinese children had two or more growth phases subnormal, much higher than the 12.4% for Swedish children. 42.4% of Hong Kong Chinese were short at final height, much higher than the 2.2% for Swedish children. Subnormal growth in any growth phase was associated with an increased risk of adult short stature in both series (p<0.01). After adjustment for mid-parental height, the place of residence (Hong Kong/Sweden) was not significant for adult shortness (p>0.05) in the pooled data. CONCLUSIONS: The impact of subnormal growth in any phase on adult shortness is similar in privileged and underprivileged populations. The much higher prevalence of subnormal growth and consequently adult short stature in developing countries is likely mainly attributable to adverse extrinsic or environmental influences.     

Increasing incidence of childhood‐onset type 1 diabetes mellitus among Estonian children in 1999–2006. Time trend analysis 1983–2006

Teeäär T, Liivak N, Heilman K, Kool P, ?or R, Paal M, Einberg Ü, Tillmann V. Increasing incidence of childhood‐onset type 1 diabetes mellitus among Estonian children in 1999–2006. Time trend analysis 1983–2006. Background: The incidence of childhood‐onset type 1 diabetes mellitus (T1DM) among Estonian children under 15 years of age was 10.1 per 100 000 per year in 1983–1990 and 12.2 per 100 000 per year in 1991–1998 with the highest incidence in age‐group 10.0–14.9 years in both periods. From 1983 to 1998, the incidence increased most rapidly in age‐group 0–4.9 years. Objective: To determine the incidence of T1DM among Estonian children in 1999–2006 and to compare the results with the data from 1983 to1998. Subjects and methods: In 1999–2006, population‐based incidence data were collected from two centers where all children with T1DM are seen after the diagnosis. Data for earlier periods were obtained from previously published data. Subjects were divided into three age‐groups: 0–4.9 years, 5.0–9.9 years and 10.0–14.9 years. Results: Between 1999 and 2006, 310 new cases of T1DM were diagnosed in Estonian children aged 0–14.9 years. The age‐standardized incidence rate for that period was 17.2 [95% confidence interval (CI) 13.1–21.2]. The incidence was the highest, 21.2 (95% CI 17.7–25.3) in age‐group 5.0–9.9 years. Over the time period 1983–2006, the incidence of childhood‐onset T1DM in Estonian children under 15 years of age increased annually by an average 3.3% with the most rapid annual increase–9.3%–occurring in the youngest age‐group. Conclusions: The incidence of childhood‐onset T1DM in Estonia continues to rise and the age of onset of the disease becomes younger.     

Late-onset hypolactasia in Hong Kong school children.

Three hundred and twenty Chinese school children aged between 6 and 19 years from six schools in Hong Kong were tested for their lactose digestion status. After an overnight fast, the children were challenged with cow's milk, 5 ml/kg bodyweight (i.e. lactose approximately 0.25 g/kg). Malabsorption was assessed by measuring hydrogen concentration from end-expiratory breath samples taken in duplicate before and at 90 and 180 minutes after the challenge. On average, 10% of the children showed an increase in breath hydrogen excretion within 3 h after the challenge, indicating malabsorption of lactose. None of the children complained of gastro-intestinal symptoms or showed any clinical sign of intolerance to the milk. The number of malabsorbers increased significantly (p less than 0.001) with age, starting at about 3% at the age of 8 and reaching about 27% at the age of 18 years. The sharpest rise occurred between 14 and 15 years. It is concluded that, despite the high prevalence of hypolactasia, Hong Kong Chinese children can consume normal amounts of milk without developing any untoward clinical symptom or sign.     

Epidemilogy of Insulin-Dependent Diabetes Mellitus in Korea

The prevalence of diabetes mellitus in the age group5–16 years, determined from 13,152 subjects residing in Kwangju, Chonnam Provice was 0.099 per cent or 98.9/100,000 in a study performed from December, 1976 to June 1977. On the other hand an epidemiologic study carried out on 254,835 subjects in the age groups14–15 and17–18 years from March 1981 to March 1982 in Seoul City revealed on overall prevalence of 7.85/100,000. In a retrospective study, 88.0/100,000 or out of a total of 10,228 pediatric inpatients were confirmed casesw of insulin-dependent diabetes mellitus, during 7 years and 2 months (from january 1974 to March 1981) at a general hospital located in Jeonju City. The wide range in the prevalence and incidence figures of diabetes mellitus in Korean children probably resulted from lack of uniformity in epidemiological methodology and the degree of ascertainment. The adge distribution at onset of diabetes mellitus showed a gradual incdrease and peak incidences at 3,8 and 12 years of age. The4 sex difference in incidence was not obvious, though girls slightly outnumbered boys. Seasonal variation at onset of diabetes mellitus showed the highest frequency of new cases in winter and spring months.     

Incidence and prevalence of childhood type 1 diabetes mellitus in Germany--model-based national estimates

Fitting a Poisson model to national data on the incidence of type 1 diabetes mellitus (T1DM) under 5 years (1993-95) and to age-specific incidence data from three different German regions (age groups 0-4, 5-9, 10-14, 15-19 years, 1988-1995), national age-specific incidences of T1DM in childhood were estimated. From these the age-standardized national incidence and prevalence were derived for age groups 0-15 and 0-19 years. In 1993-95 the age-standardized national incidences (95% CIs) in the age groups 0-14 and 0-19 years were 14.2 (12.9-15.5) and 17.0 (15.2-18.8) per 100,000 person-years, respectively. The respective national prevalences were 86.7 (83.4-90.0) and 140.2 (134.3-146.1) per 100,000 persons. These estimates of the national incidence and prevalence of T1DM for the mid-1990s were about twofold higher than estimates from the former Eastern Germany in the late 1980s. This striking high frequency of T1DM in Germany has an important impact on clinical and economic aspects of diabetes care in childhood and adolescence.     

Incidence of rotavirus diarrhea and intussusception in Hong Kong using standardized hospital discharge data

Incidence for rotavirus and intussusception was estimated from standardized discharge data for all Hong Kong government hospitals (1997 to 1999). Intussusception incidence in infants (78 to 100 of 100,000) was relatively high. The distinct winter seasonality of rotavirus was not evident for intussusception. During the first 5 years of life an estimated 1 child of 28 is admitted with rotavirus infection (4% of all medical admissions).     

Type 2 diabetes mellitus is rare but not absent in children under 15 years of age in Austria

Until recently, most children with diabetes mellitus had type 1 diabetes (T1DM). The prevalence of type 2 diabetes (T2DM) is on the rise in North America, especially in risk populations such as the American Indians. Few epidemiological data on the incidence of the disease exist in Europe. In a prospective population-based epidemiological study, all newly diagnosed cases of diabetes mellitus in patients under 15 years of age were registered nation-wide in Austria between 1999 and 2001. Differential diagnosis (according to the American Diabetes Association diagnostic criteria) was based on clinical case definition. During the 3 years of the study period, 529 cases of DM <15 years were documented, of which 510 were clinically assigned to T1DM (271 boys, 239 girls) resulting in an incidence rate of 12.4/100,000. In the same network, eight cases were diagnosed as T2DM (one boy, seven girls) and two cases with an atypical form of T2DM (two girls). The age of onset of T2DM was 12–15 years and all patients were overweight (body mass index >90th percentile).The calculated incidence for T2DM <15 years in Austria was 0.25/100,000. Conclusion: at present, type 2 diabetes mellitus is rare but exists in children aged under 15 years in Austria. Follow-up of this registration will help to describe the secular trend.Abbreviations BMI body mass index - GAD glutamic acid decarboxylase - IAA insulin autoantibody - IA2 tyrosine like phosphatase - MODY maturity onset diabetes in the young - T1DM type 1 diabetes mellitus - T2DM type 2 diabetes mellitus Members of the Austrian Diabetes Incidence Study Group: Arocker W., Bauer M., Baumgartner F., Bali C., Borkenstein M., Bittmann B., Coradello H., Dorninger L., Fussenegger J., Jäger A., Gröblacher H., Guttenberger K. H., Häckel F., Heijbl L., Höller W., Holzer H, Holzleitner C., Jäger A., Jürgenssen O. A., Kovac U., Kitzler P., Köfler T. H., Kurnik P., Lindauer E., Meisel A., Moser G., Mühleder J., Müller G., Müllner M., Paier R., Popper-Preising C., Prchla C., Rausch-Schott G., Rauscher R., Reindl R., Resch R., Rezaka E., Rittinger O., Rubens K., Salzer H., Schally-Stebl A., Schermann A., Schlager J., Schmitt K., Schneider U., Sellner-Horstmann S., Sonnberger H, Stainer A., Steichen E., Stöllinger O., Sulzer M., Von den Thannen T., Walser I, Wakolbinger G., Weinhandl G., Wutte A., Zieglauer H., Zwiauer K.