Spatial patterns of the congenital heart disease prevalence among 0- to 14-year-old children in Sichuan Basin, P. R China, from 2004 to 2009.

Li-Guang Ma,Zuo-Qi Peng,Jun Zhao,Zhou-Peng Ren,Jin-Feng Wang,Yuan-Yuan Wang,Xu Ma

doi:10.1186/1471-2458-14-595

Abstract

BackgroundCongenital heart disease (CHD) is the most common type of major birth defects in Sichuan, the most populous province in China. The detailed etiology of CHD is unknown but some environmental factors are suspected as the cause of this disease. However, the geographical variations in CHD prevalence would be highly valuable in providing a clue on the role of the environment in CHD etiology. Here, we investigate the spatial patterns and geographic differences in CHD prevalence among 0- to 14-year-old children, discuss the possible environmental risk factors that might be associated with CHD prevalence in Sichuan Basin from 2004 to 2009.MethodsThe hierarchical Bayesian model was used to estimate CHD prevalence at the township level. Spatial autocorrelation statistics were performed, and a hot-spot analysis with different distance thresholds was used to identify the spatial pattern of CHD prevalence. Distribution and clustering maps were drawn using geographic information system tools.ResultsCHD prevalence was significantly clustered in Sichuan Basin in different spatial scale. Typical hot/cold clusters were identified, and possible CHD causes were discussed. The association between selected hypothetical environmental factors of maternal exposure and CHD prevalence was evaluated.ConclusionsThe largest hot-spot clustering phenomena and the CHD prevalence clustering trend among 0- to 14-year-old children in the study area showed a plausibly close similarity with those observed in the Tuojiang River Basin. The high ecological risk of heavy metal(Cd, As, and Pb)sediments in the middle and lower streams of the Tuojiang River watershed and ammonia–nitrogen pollution may have contribution to the high prevalence of CHD in this area.

Highlights

Congenital heart disease (CHD) is the most common type of major birth defects in Sichuan, the most populous province in China
The prevalence Themerange map of CHD in the 673 townships was drawn and shown in Figure 2, which illustrates the distribution of CHD prevalence before adjustment by the HB model and the CHD prevalence estimates after adjustment by the HB model in the study area respectively
The global spatial autocorrelation statistic and corresponding p-values were estimated by Moran’s I statistic to HB model smoothed CHD prevalence

Summary

Introduction

Congenital heart disease (CHD) is the most common type of major birth defects in Sichuan, the most populous province in China. The detailed etiology of CHD is unknown but some environmental factors are suspected as the cause of this disease. Surveillance data shows that CHD has the highest prevalence among other birth defects in Sichuan Province in recent years [3,4,5,6]. A group of CHD lesions with unknown etiology follows a multifactorial inheritance model, approximately 90% CHD cases are multifactorial [10,11,12], which implicates both genetic and environmental factors in disease development. 80% CHD cases are multifactorial and arise through various combinations of genetic and environmental factors [1,13]

Objectives

Methods

Results

Discussion

Conclusion