de Pedro-Cuesta Jesús, Glatzel Markus, Almazán Javier, Stoeck Katharina, Mellina Vittorio, Puopolo Maria, Pocchiari Maurizio, Zerr Inga, Kretszchmar Hans A, Brandel Jean-Philippe, Delasnerie-Lauprêtre Nicole, Alpérovitch Annick, Van Duijn Cornelia, Sanchez-Juan Pascual, Collins Steven, Lewis Victoria, Jansen Gerard H, Coulthart Michael B, Gelpi Ellen, Budka Herbert, Mitrova Eva
Instituto de Salud Carlos III, Centro Nacional de Epidemiologia, Departamento de Epidemiologia Aplicada, Calle Sinesio Delgado 6, 28029, Madrid, Spain.
BMC Public Health. 2006 Nov 10;6:278. doi: 10.1186/1471-2458-6-278.
The objective of this study was to describe the diagnostic panorama of human transmissible spongiform encephalopathies across 11 countries.
From data collected for surveillance purposes, we describe annual proportions of deaths due to different human transmissible spongiform encephalopathies in eleven EUROCJD-consortium countries over the period 1993-2002, as well as variations in the use of diagnostic tests. Using logistic models we quantified international differences and changes across time.
In general, pre-mortem use of diagnostic investigations increased with time. International differences in pathological confirmation of sporadic Creutzfeldt-Jakob disease, stable over time, were evident. Compared to their counterparts, some countries displayed remarkable patterns, such as: 1) the high proportion, increasing with time, of variant Creutzfeldt-Jakob disease in the United Kingdom, (OR 607.99 95% CI 84.72-4363.40), and France (OR 18.35, 95% CI 2.20-152.83); 2) high, decreasing proportions of iatrogenic Creutzfeldt-Jakob disease in France, (OR 5.81 95% CI 4.09-8.24), and the United Kingdom, (OR 1.54 95% CI 1.03-2.30); and, 3) high and stable ratios of genetic forms in Slovakia (OR 21.82 95% CI 12.42-38.33) and Italy (OR 2.12 95% CI 1.69-2.68).
Considerable international variation in aetiological subtypes of human transmissible spongiform encephalopathies was evident over the observation period. With the exception of variant Creutzfeldt-Jakob disease and iatrogenic Creutzfeldt-Jakob disease in France and the United Kingdom, these differences persisted across time.
本研究的目的是描述11个国家人类可传播性海绵状脑病的诊断全貌。
根据为监测目的收集的数据，我们描述了1993年至2002年期间11个欧洲克雅氏病联盟国家中因不同人类可传播性海绵状脑病导致的年度死亡比例，以及诊断测试使用情况的变化。我们使用逻辑模型对国际差异和随时间的变化进行了量化。
总体而言，生前诊断检查的使用随时间增加。散发性克雅氏病病理确诊的国际差异随时间保持稳定，很明显。与其他国家相比，一些国家呈现出显著模式，例如：1）英国变异型克雅氏病比例较高且随时间增加（比值比607.99，95%置信区间84.72 - 4363.40），法国也是如此（比值比18.35，95%置信区间2.20 - 152.83）；2）法国医源性克雅氏病比例较高且呈下降趋势（比值比5.81，95%置信区间4.09 - 8.24），英国也是如此（比值比1.54，95%置信区间1.03 - 2.30）；3）斯洛伐克（比值比21.82，95%置信区间12.42 - 38.33）和意大利（比值比2.12，95%置信区间1.69 - 2.68）遗传型比例高且稳定。
在观察期内，人类可传播性海绵状脑病因果亚型存在相当大的国际差异。除了英国和法国的变异型克雅氏病和医源性克雅氏病外，这些差异随时间持续存在。
