Todberg Tanja, Koch Anders, Andersson Mikael, Olsen Sjurdur F, Lous Jørgen, Homøe Preben
Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Denmark; Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
PLoS One. 2014 Dec 29;9(12):e111732. doi: 10.1371/journal.pone.0111732. eCollection 2014.
In recent years welfare in Denmark has increased which might be expected to reduce otitis media (OM) incidence. We examined the age-specific incidence of OM in a nation-wide cohort of children aged 0-7 years born in 1996-2003 (Danish National Birth Cohort, DNBC). Only selection was ability to understand and speak Danish.
Information of OM and ventilation tubes (VT) was collected through three maternal interviews at 6-month, 18-month and 7-years of age and based on this age-specific and cumulative incidence of OM was calculated. As different numbers of the total population answered the different interviews, the calculations are done with different denominators. The information in DNBC was validated against two population based registries containing information of VT insertions.
Cumulative incidence of OM at 7 years was 60.6% (31,982/52,755). For children with OM, 16.2% (7143/44194) had their first OM episodes between 0-6 months of age, 44.3% (19579/44194) between 7-18 months, and 39.5% (17472/44194) between 19 months and 7 years. Four or more OM episodes before 7 years were reported by 39.5% (12620/31982) and by 64.0% (2482/3881) of those who had their OM debut between 0-6 months; by 48.2% (4998/10378) with debut between 7-18 months; and by 28.7% (4996/17344) with debut between 19 months and 7 years. These figures are essentially unchanged from earlier figures from Denmark. VT insertion at least once was reported by 26,1% in the 7-year interview. Assuming recordings in the Danish National Patient Registry to be gold standard, maternal self-reportings in DNBC of insertion of VT showed high sensitivity (96.4%), specificity (98.2%), and positive (94.8%) and negative predictive values (98.8%).
OM affects nearly 2/3 of preschool children in Denmark despite reduction in known OM risk factors.
近年来丹麦的福利有所增加,这可能会降低中耳炎(OM)的发病率。我们在一个全国性队列中研究了1996 - 2003年出生的0至7岁儿童(丹麦国家出生队列,DNBC)中按年龄划分的中耳炎发病率。入选标准仅为具备理解和说丹麦语的能力。
通过在6个月、18个月和7岁时对母亲进行三次访谈收集中耳炎和通气管(VT)的信息,并据此计算按年龄划分的中耳炎发病率及累积发病率。由于参与不同访谈的总人口数量不同,计算时采用了不同的分母。DNBC中的信息与两个包含通气管插入信息的基于人群的登记处进行了验证。
7岁时中耳炎的累积发病率为60.6%(31,982/52,755)。在患有中耳炎的儿童中,16.2%(7143/44194)在0至6个月大时首次发作中耳炎,44.3%(19579/44194)在7至18个月大时发作,39.5%(17472/44194)在19个月至7岁之间发作。7岁前有4次或更多次中耳炎发作的情况,在0至6个月大时首次发作中耳炎的儿童中占39.5%(12620/31982),在7至18个月大时首次发作的儿童中占64.0%(2482/3881),在19个月至7岁之间首次发作的儿童中占28.7%(4996/17344)。这些数字与丹麦早期的数据基本没有变化。在7岁访谈中,有26.1%的儿童报告至少进行过一次通气管插入。假设丹麦国家患者登记处的记录为金标准,DNBC中母亲对通气管插入的自我报告显示出高敏感性(96.4%)、特异性(98.2%)、阳性预测值(94.8%)和阴性预测值(98.8%)。
尽管已知的中耳炎危险因素有所减少,但在丹麦,近三分之二的学龄前儿童受中耳炎影响。