Incidence In Children Research Articles

Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based casecontrol study.

OBJECTIVESSince poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODSThis hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTSGastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONSAddiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

Gestational diabetes associated with incident diabetes in childhood and youth: a retrospective cohort study.

Indicators of childhood- and youth-onset diabetes may be useful for early detection of diabetes; there is a known association between composite exposure of parental type 2 diabetes and gestational diabetes mellitus with childhood- and youth-onset diabetes. We examined associations between gestational diabetes mellitus and incidence of childhood- and youth-onset diabetes in offspring. Using public health insurance administrative databases from Quebec, Canada, we randomly selected singleton live births with maternal gestational diabetes mellitus (1990-2007) and matched them 1:1 with singleton live births without gestational diabetes mellitus. Follow-up was to Mar. 31, 2012. We examined associations of diabetes in offspring with maternal gestational diabetes mellitus through unadjusted and adjusted Cox proportional hazards models. In secondary analyses, we separately considered age groups ranging from birth to age 12 years, and age 12 to 22 years. Incidence of pediatric diabetes (per 10 000 person-years) was higher in offspring born to mothers with gestational diabetes mellitus (4.52, 95% confidence interval [CI] 4.47-4.57) than in mothers without gestational diabetes mellitus (2.4, 95% CI 2.37-2.46). In an adjusted Cox proportional hazards model, maternal gestational diabetes mellitus was associated with development of pediatric diabetes overall (birth to age 22 yr: hazard ratio [HR] 1.77, 95% CI 1.41-2.22), during childhood (birth to age 12 yr: HR 1.43, 95% CI 1.09-1.89), and in youth (age 12 to 22 yr: HR 2.53, 95% CI 1.67-3.85). Gestational diabetes mellitus is associated with incident diabetes in offspring during childhood and adolescence. Future studies are needed to examine longer-term outcomes in patients with pediatric diabetes with a maternal history of gestational diabetes mellitus, to ascertain how they compare with other patients with childhood- or youth-onset diabetes, in terms of disease severity and outcomes.

Does Complete Basic Immunization Correlate with Pneumonia Incidents in Children under Five Years in Depok, Indonesia?

ABSTRACT Pneumonia is the first globally infectious disease causing death in children under five years of age in which the discovery of cases has increased in Indonesia in recent years. Immunization is a major preventive effort against the disease and is administered through the DPT, Hib, measles, PCV, and rotavirus vaccines. The aim of this study was to understand the correlation between complete basic immunization administration, parental characteristics, and the characteristics of children under five years with the incidence of pneumonia among children in this age group in Depok, Indonesia. The study used a cross-sectional design. There were 104 samples chosen by consecutive sampling. The study was conducted at the public health center in Depok between April and June of 2018. The data collection used questionnaires, parental characteristics, characteristics of children under five years, and complete basic immunization data for the children, which was arranged by the researchers. The questionnaire was tested for validity and reliability. The results of the study showed that complete basic immunization (p: 0.000, α: 0.05), age (p: 0.002, α: 0.05), and nutritional status (p: 0.043, α: 0.05) had a significant correlation with the incidence of pneumonia in children under five years. Health education about the importance of complete basic immunization and balanced nutrition needs to be given to parents who have under-five years of age.

The Relationship of Oral Care Practice at Home with Mucositis Incidence in Children with Acute Lymphoblastic Leukemia

ABSTRACT Mucositis is a common and devastating side effect of chemotherapeutic agents in children undergoing chemotherapy. The prevention and management of mucositis are necessary to improve these children’s quality of life. Oral care is a recommended strategy for preventing and managing oral mucositis. Thus, the objective of this study was to identify the relationship between oral care practice and mucositis incidence. A cross-sectional analytical design was used in this study. A total of 34 children from 3 to 12 years of age with acute lymphoblastic leukemia who were in the last cycle of chemotherapy were recruited through a snowball sampling method. The Oral Assessment Guide (OAG) was administered to assess the severity of mucositis. A majority of the participants (51.5%) had mucositis after completing the last cycle of chemotherapy. Furthermore, there was a statistically significant relationship between their oral care practice at home and mucositis incidence. These results show that oral care at home is linked with the incidence and severity of mucositis. Nurses should educate children with leukemia and their parents regarding good oral hygiene practice.

Incidence, clinical distribution, and patient characteristics of childhood cancer in Saudi Arabia: A population-based analysis.

Information regarding the incidence and patterns of childhood malignancies is disproportionately overrepresented by high-income countries, representing mainly the Caucasian population. There is a need to evaluate and disseminate information for other ethnicities, particularly from the Middle East. Data from the National Cancer Registry, Saudi Arabia (SA-NCR), for pediatric patients (age 0-14 years) diagnosed between 2005 and 2009 and for similar patients at our institution during the same period were analyzed. Population numbers reported in the 2007 national census were used to calculate the annual incidence of childhood cancer. Data from SA-NCR on 3885 patients were included in this analysis. The median age was 5.58 years, and 57.3% were males. The annual age-specific cancer incidence rate (ASR) for children in SA is 99.83 per million population; ASR per million for lymphoid leukemia is 25.75, 12.05 for brain tumors, and 9.82 for Hodgkin lymphoma. Of all childhood cancers in SA, 35% were treated at our institution. The five-year overall survival for these 1350 patients is 74.6% (median follow-up 7.52 years [95% confidence interval: 7.36-7.68]). Significant differences in the distribution of childhood malignancy subtypes were evident compared with other countries. We have reported differences in the cancer ASR and cancer subtype distribution for children in SA as compared with the worldwide incidence and with other populations. This paper provides a comprehensive epidemiological overview of childhood cancer in SA, which could be extrapolated to other regional Arab populations.

Fetal inflammation is associated with persistent systemic and hippocampal inflammation and dysregulation of hippocampal glutamatergic homeostasis.

BACKGROUND:Inflammation is a major cause of preterm birth and often results in a fetal inflammatory response syndrome (FIRS). Preterm infants with FIRS have a higher childhood incidence of neurodevelopmental disability than preterm infants without FIRS. The mechanisms connecting FIRS to neurodevelopmental disability in formerly preterm infants are not fully understood, but the effect on premature gray matter may have an important role.METHODS:Fetal rats were exposed to intra-amniotic (i.a.) LPS two days prior to birth to model FIRS. On postnatal day 7, expression of inflammatory mediators was measured in the liver, lung and brain. Activation of microglia and expression of glutamatergic receptor subunits and transporters were measured in the hippocampus and cortex.RESULTS:LPS caused persistent systemic inflammatory mediators gene expression. In the brain, there was corresponding activation of microglia in the hippocampus and cortex. Expression of inflammatory mediators persisted in the hippocampus, but not the cortex, and was associated with altered glutamatergic receptor subunits and transporters.CONCLUSION:Hippocampal inflammation and dysregulation of glutamate metabolism persisted well into the postnatal period following i.a. LPS. Poor neurodevelopmental outcomes after FIRS in preterm infants may result in part through glutamatergically-driven gray matter injury to the neonatal hippocampus.

Psychiatric Disorders in Mothers of Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Perspective

The purpose of this study was to conduct a long-term, population-based, epidemiologic study of psychiatric disorders in mothers of children with attention-deficit/hyperactivity disorder (ADHD). Subjects included mothers of 306 childhood incident cases of ADHD and mothers of 617 age/gender matched controls from a 1976–1982 birth cohort. Compared to mothers of controls, mothers of children with ADHD were significantly more likely to be diagnosed prior to the child’s birth with a depressive disorder (adjusted odds ratio (aOR), 3.1; 95% confidence interval (CI), 1.3–7.7), an adjustment disorder (aOR, 8.1; 95% CI, 1.7–39.5), or any psychiatric disorder (aOR, 2.5; 95% CI, 1.61–4.7) and were likewise significantly more likely to be diagnosed with a de novo (i.e., first diagnosed after the child’s birth) depressive disorder (adjusted hazard ratio (aHR), 1.7; 95% CI, 1.2–2.4), de novo adjustment disorder (aHR, 2.0; 95% CI, 1.4–2.7), or any de novo psychiatric disorder (aHR, 1.7; 95% CI, 1.4–2.2) during the 21 years after the child’s birth. This study provides an opportunity to study the natural occurrence of psychiatric disorders in mothers of children with ADHD and suggests that the likelihood of having a child with ADHD is associated with maternal psychopathology both before and after the birth. This adds to existing knowledge of maternal psychopathology for children with ADHD and has implications for screening and monitoring. Future research is needed to clarify the role that both genetic and environmental risk factors play in the increased rates of psychopathology in mothers of children with ADHD.

Incidence of Epilepsy after Neonatal Seizures: A Population-Based Study

Background: The incidence of childhood and adolescence epilepsy varies in different areas and over time. Published reports in the Italian pediatric population are few and there is no information on the incidence of epilepsy using the new clinical definition of the disease signed by the International League Against Epilepsy. An increased risk of epilepsy is reported in subjects who presented with neonatal seizures (NS), but few population-based studies are available that compare incidence and age at onset of epilepsy in children with and without NS. Objectives: Ascertain the incidence of epilepsy in children in the province of Parma by applying the new practical clinical definition of epilepsy, and compare incidence and age of epilepsy onset in children with and without previous NS. Methods: The study was carried out in the province of Parma, Emilia-Romagna Region, Northern Italy, using different data sources (clinical records and administrative data), and considered all the children born in the province of Parma between January 2002 and December 2014 and developing epilepsy by December 2016. We calculated the incidence of epilepsy in patients up to 14 years of age, incidence of epilepsy after NS and cumulative incidence of epilepsy at 1, 5, and 10 years’ follow-up. To evaluate age at onset of epilepsy, we divided patients into 3 groups (epilepsy onset within 1 month, between 1 and 12 months, and after 1 year of life) and we compared age at onset of epilepsy between patients who had had previous NS and those who had not. Results: The incidence of epilepsy was 78.6/100,000 persons-years (boys 88.1/100,000, girls 68.6/100,000). The incidence of epilepsy after NS was 15.2% (8.2% for male, 23.5% for female; 16.3% in born at term, 14.3% in pre-term). The incidence of epilepsy at 1, 5, and 10 years’ follow-up was higher in patients with previous NS than in others. The age at onset of epilepsy was significantly different in the 2 groups, and was younger in those with history of NS: mean age at onset was 10.5 months in those with NS and of 61.8 months in the others. Conclusions: The incidence rate of epilepsy in the Parma district was higher than that reported in other Italian areas studied, probably due to the different methodology used and the application of the most recent definition of epilepsy. Children with NS were at higher risk of epilepsy and develop the disease at a younger age.

A Study Concerning Tooth Decay Incidence in Children with Ages Between 3 and 6 Years

Abstract Deciduous teeth cavities represent a frequent type of illness, which constitutes one of the most important dental health problems in pre-school children, caused by the direct implications and the possible consequences that it may have on permanent teeth. Even if a decrease in the incidence of dental cavities is registered in the industrialized countries of the world, when it comes to deciduous teeth, the frequency of the cavities is still high, at least for some certain social groups of the population. The purpose of the study is to collect current data on dental morbidity in the preschool population. There is not as much data concerning dental health in pre-school children as there is about school children, the reason being that preschoolar children are more difficult to consult. Material and Method: The study was conducted in a pediatric-clinic in Bucharest for a period of 5 years (ian. 01, 2013-dec. 31, 2018). The children included in the study are children who have had tooth decay. The number of children who participated in the study is 276. Results and Discussions: Of the 276 children studied, the highest incidence of tooth decay was for the age group between 3-4 years. This may signify, on one hand, a relatively high number of cavities at a young age, and on the other hand, the level of parental interest in dental care. Conclusions: The main conclusion of our study highlights the need to establish dental health education programs in both national and community level, where kindergartens and schools, have a great potential for influencing dental health care habits in children.

Contrast Between Incidence of Childhood and Adolescent Cancers: Using a Population Based Cancer Registry, Kyadondo County, Uganda: 2009 to 2014

Background: Cancer is relatively rare in childhood compared with later in life. In high-income countries, hematologic malignancies are the most common, then brain tumors and solid tumors. World age-standardized incidence rates in Ireland averaged 142 cases per million children per year, higher than European average and lower than US average. In Africa, distribution of childhood cancers is quite similar, commonest being Kaposi sarcoma (KS), Burkitt's lymphoma, retinoblastoma, leukemia and Hodgkin lymphomas (HL). Among adolescent in Zimbabwe, leukemia has highest incidence rates then osteosarcoma, non-Hodgkin lymphoma (NHL) and KS. Aim: To describe the incidence of cancer among children and adolescents in Kyadondo County, Uganda from 2009 to 2014 which is necessary for planning of cancer control programs. Methods: Descriptive cross-sectional study which involved review of data from Kampala Cancer Registry that gathers information on cancers diagnosed within Kyadondo County (formed by Kampala and Wakiso districts) and analyzed using STATA 13. From 2014 Uganda population census, Kyadondo County had a population of 3,523,910 (32.2% children and 10% adolescents). Study population was children (0-14 years) and adolescents (15-19 years) diagnosed with cancer from January 2009 to December 2014. Results: The spectrum of cancers in adolescents reflects a transition. Carcinomas which are so prevalent in adults occur but at lower frequencies in adolescents. Study results are comparable to others studies indicating that nephroblastoma and retinoblastoma were common among children and not adolescents. Leukaemia and lymphomas cut across both children and adolescents. Conclusion: The spectrum of cancers in adolescents reflects a transition. Carcinomas which are so prevalent in adults occur but at lower frequencies in adolescents. Study results indicate that nephroblastoma and retinoblastoma were common among children and not adolescents. New prospective studies should be done on children and adolescent cancers covering a wide population size. Leukaemia and lymphomas cut across both children and adolescents. National cancer registries should be set up.

Childhood Incident Obesity and Traffic-Related Air Pollution among School-Aged Children

Childhood Incident Obesity and Traffic-Related Air Pollution among School-Aged Children

The association between gestational age and otitis media during childhood: a population-based cohort analysis.

Otitis media (OM) carries a tremendous global health burden and potentially severe long-term consequences. The objective of this study was to determine the impact of birth at different gestational ages on the incidence of childhood OM.A population-based cohort analysis was conducted. All singleton deliveries occurring between 1991 and 2014 at a regional tertiary medical center were included. Gestational age on delivery was divided into six subgroups: early (&lt;34 weeks gestation; 0 out of 7) and late (34 weeks gestation; 0 out of 7 to 36 weeks gestation; 6 out of 7) preterm, and early (37 weeks gestation; 0 out of 7 to 38 weeks gestation; 6 out of 7), full (39 weeks gestation; 0 out of 7 to 40 weeks gestation; 6 out of 7), late (41 weeks gestation; 0 out of 7 to 41 weeks gestation; 6 out of 7) and post (⩾42 weeks 0 out of 7) term deliveries. Rates of OM-related hospitalizations up to 18 years of age were assessed. Weibull parametric hazards model was used to study the association between gestational age at birth and the risk for OM-related hospitalizations while controlling for potential confounders.During the study period, 238,622 deliveries met the inclusion criteria. OM-related hospitalizations of the offspring (n=4724) were significantly more common in the preterm (early 3.6%, late 2.4%) and early-term born children (2.2%) and decreased gradually across the full (1.9%), late (1.7%) and post (1.6%) term groups (χ2-test for trends P&lt;0.001). In the Weibull regression model, early preterm, as well as early-term deliveries exhibited an independent association with pediatric OM (adjusted hazard ratios: 1.67 and 1.09, respectively, P&lt;0.02).Deliveries occurring at preterm and early term are associated with higher rates of pediatric OM-related hospitalizations, which decrease gradually as gestational age advances.

International testicular cancer incidence rates in children, adolescents and young adults

BackgroundTesticular cancer is the most common cancer in young men in developed countries. In adults, international variation in testicular cancer incidence rates has been well-described, while previous research on pediatric and adolescent testicular cancer has been more geographically limited. MethodsIn this analysis, we used data from the three most recent volumes of Cancer Incidence in Five Continents (CI5) and the National Cancer Institute’s SEER 18 registries to compare incidence rates for testicular cancer in children (ages 0–14) and adolescents and young adults (AYA; ages 15–39). ResultsWe find that geographic incidence patterns in AYA are different from patterns in children under 15. In AYA, incidence is highest in Europe (137.4 per million), followed by Oceania (116.9 per million), North America (94.9 per million), South and Central America (66.5 per million), and lowest in Asia (27.1 per million). In contrast, childhood incidence is highest in Asia (4.2 per million) and South America (5.0 per million) and lowest in Europe (2.1 per million) and North America (2.5 per million). In the United States, patterns in incidence rates in racial and ethnic groups mirror international rates. ConclusionThese differences in incidence rate variations in pediatric and AYA testicular cancer are intriguing and may aid in understanding the different etiologies of testicular cancer by age group.

Abstract 4800: Targeting the polyamine pathway as a novel therapeutic treatment against diffuse intrinsic pontine glioma

Abstract Diffuse intrinsic pontine glioma (DIPG) is a highly aggressive paediatric brainstem tumour, with a peak incidence in middle childhood and a median survival of less than 1 year in the majority of cases. The dismal prognosis associated with DIPG is exacerbated by the repeated failure of over 250 clinical trials to improve survival over standard radiotherapy. Therefore novel and innovative therapeutic approaches are urgently needed to needed to treat this devastating disease. Polyamines are small intracellular polycations that control key aspects of cell biology, such as cell replication/growth, differentiation and survival and can be found up-regulated in many cancers. Difluoromethylornithine (DFMO) is an FDA-approved inhibitor of the enzyme ornithine decarboxylase (ODC1) which is involved in polyamine synthesis. The aim of this study was to investigate the efficacy of polyamine pathway inhibitors such as DFMO as a therapeutic strategy against DIPG. By RT-qPCR and western blotting, we observed high expression levels of key players of the polyamine pathway in a panel of DIPG samples. Through alamar blue cytotoxicity assays and soft-agar clonogenic assays, DFMO was found to be effective against a panel of neurosphere-forming DIPG cells. The activity of DFMO was synergistically enhanced when combined with a polyamine transport inhibitor, AMXT-1501. Increased apoptotic activity following either DFMO or AMXT-1501 treatment, alone or in combination, was observed by western blotting and flow cytometric analysis of Annexin V/7AAD stained cells. In addition, reduced uptake of the radiolabelled polyamine, spermidine, in the presence of AMXT-1501 confirmed polyamine transport inhibition in DIPG cells. Consistent with the in vitro results, the combination of DFMO and AMXT-1501 significantly prolonged the survival of mice bearing DIPG orthografts, and the combination therapy represents the most effective combination treatment we have tested to date in our DIPG animal model. Our results suggest that the polyamine pathway is a potential therapeutic target for this highly aggressive paediatric brain tumour while a number of clinical trials based on this approach are currently underway in a variety of malignancies. Citation Format: Aaminah Khan, Maria Tsoli, Denise Yu, Swapna Joshi, Laura Gamble, Laura Franshaw, Michelle Haber, David S. Ziegler. Targeting the polyamine pathway as a novel therapeutic treatment against diffuse intrinsic pontine glioma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4800.

Comparison of current trends of incidence of childhood and adolescent cancers in Sub-Saharan Africa and International Incidences, 2009 to 2014.

Comparison of current trends of incidence of childhood and adolescent cancers in Sub-Saharan Africa and International Incidences, 2009 to 2014.

Sleeping, TV, Cognitively Stimulating Activities, Physical Activity, and Attention-Deficit Hyperactivity Disorder Symptom Incidence in Children: A Prospective Study.

To analyze associations between time spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity, all at 4 years, and (1) attention-deficit/hyperactivity disorder (ADHD) symptoms and (2) behavior problems, both assessed at 7 years, in ADHD-free children at baseline. In total, 817 participants of the Infancia y Medio Ambiente birth cohort, without ADHD at baseline, were included. At the 4-year follow-up, parents reported the time that their children spent sleeping, watching TV, engaging in cognitively stimulating activities, and engaging in physical activity. At the 7-year follow-up, parents completed the Conners' Parent Rating Scales and the Strengths and Difficulties Questionnaire, which measure ADHD symptoms and behavior problems, respectively. Negative binomial regression models were used to assess associations between the activities at 4 years and ADHD symptoms and behavior problems at 7 years. Children (48% girls) spent a median (p25-p75) of 10 (10-11) hours per day sleeping, 1.5 (0.9-2) hours per day watching TV, 1.4 (0.9-1.9) hours per day engaging in cognitively stimulating activities, and 1.5 (0.4-2.3) hours per day engaging in physical activity. Longer sleep duration (>10 hours per day) was associated with a lower ADHD symptom score (adjusted incidence rate ratio = 0.97, 95% confidence interval, 0.95-1.00). Longer time spent in cognitively stimulating activities (>1 hours per day) was associated with lower scores of both ADHD symptoms (0.96, 0.94-0.98) and behavior problems (0.89, 0.83-0.97). Time spent watching TV and engaging in physical activity were not associated with either outcomes. A shorter sleep duration and less time spent in cognitively stimulating activities were associated with an increased risk of developing ADHD symptoms and behavior problems.

Managing Asthma in Pregnancy (MAP) trial: FENO levels and childhood asthma

The single-center double-blind, randomized controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FENO) in combination with asthma symptoms (FENO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (Australian New Zealand Clinical Trials Registry, no. 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FENO group. However, the effect of FENO-guided management on the development of asthma in the offspring is unknown. We sought to investigate the effect of FENO-guided asthma management during pregnancy on asthma incidence in childhood. A total of 179 mothers consented to participate in the Growing into Asthma (GIA) double-blind follow-up study with the primary aim to determine the effect of FENO-guided asthma management on childhood asthma incidence. A total of 140 children (78%) were followed up at 4 to 6years of age. FENO-guided as compared to symptoms-only approach significantly reduced doctor-diagnosed asthma (25.9% vs 43.2%; odds ratio [OR], 0.46, 95% CI, 0.22-0.96; P=.04). Furthermore, frequent wheeze (OR, 0.27; 95% CI, 0.09-0.87; P=.03), use of short-acting β-agonists (OR, 0.49; 95% CI, 0.25-0.97; P=.04), and emergency department visits for asthma (OR, 0.17; 95% CI, 0.04-0.76; P=.02) in the past 12months were less common in children born to mothers from the FENO group. Doctor-diagnosed asthma was associated with common risk alleles for early onset asthma at gene locus 17q21 (P=.01 for rs8069176; P=.03 for rs8076131), and higher airways resistance (P=.02) and FENO levels (P=.03). Acausal mediation analysis suggested natural indirect effects of FENO-guided asthma management on childhood asthma through "any use" and "time to first change in dose" of inhaled corticosteroids during the MAP trial (OR: 0.83; 95% CI: 0.59-0.99, and OR: 0.90; 95% CI: 0.70-1.03, respectively). FENO-guided asthma management during pregnancy prevented doctor-diagnosed asthma in the offspring at preschool age, in part mediated through changes in use and dosing of inhaled corticosteroids during the MAP trial.

Caries Incidence in Children of Primorsko Goranska County, Croatia

Caries Incidence in Children of Primorsko Goranska County, Croatia

The Relationship between Healthy and Clean Life Behavior and Hepatitis A Incidence in Children of Rural Areas

The Relationship between Healthy and Clean Life Behavior and Hepatitis A Incidence in Children of Rural Areas

Incidence of type 1 diabetes in Navarre (2009-2016): higher in the southern regions of the autonomous community

Geographical and seasonal variations of type 1 diabetes (T1D) are useful for establishing the key ethio-pathogenic factors of the disease. The present work seeks to analyze the incidence rates of T1D in Navarre for the 2009-2016 period, its geographical distribution and seasonal variations in birth and diagnosis in affected persons. Prospective study with one primary and three secondary sources. The completeness of the registry, determined using the capture-recapture method, was 96.08%. The confidence intervals of zone and onset season incidence rates were determined assuming an underlying Poisson distribution. Adjusted effect of onset age, sex, onset season and geographical area over changes in incidence rates were analyzed using a Poisson regression model. Comparison among areas was carried out after the corresponding adjustments of incidence by the indirect standardization method. Four hundred and twenty-eight new cases were detected (incidence= 8.36/100,000 inhabitants per year, CI95%: 7.58-9.19). The disease is predominant in males (63% of patients). The incidence in children under 15 years was higher than in adults (21.54, CI95%: 18.43-25.02 vs. 5.94, CI95%: 5.23-6.71; p<0.001). Incidence was highest in the four southern regions of Navarre, most of the cases being in winter and spring. No differences were found regarding birth season over incidence. Navarre maintains a high T1D incidence in childhood that decreases progressively with age. Sex, age group, geographical zone and onset season are independently associated with the incidence rates observed in the study.