Rosie Bronwyn, Dalziel Stuart, Wilson Elizabeth, Best Emma J
Paediatric Registrar, Starship Children's Health, Auckland.
Paediatric Emergency Consultant, Starship Children's Health, Auckland.
N Z Med J. 2016 Sep 23;129(1442):36-45.
To describe the epidemiology of intussusception in New Zealand children aged 0-36 months prior to the introduction of routine rotavirus vaccination.
ICD-10 coding data from the New Zealand National Minimum Data Set (NMDS) was used to identify all cases of intussusception in children aged 0-36 months between January 1998 and December 2013. These data were linked with birth data from the New Zealand census. Population incidence rates of intussusception were calculated, and demographic characteristics described.
Over the 16-year study period, there were 794 cases of intussusception. The majority (56%) occurred in the first year of life (age adjusted incidence rate 56.1/100,000 child-years, 95% confidence interval (CI) 41.7-71.2). Intussusception occurred more frequently in males (36.4/100,000 (95% CI 24.6-48.2) versus 19.5/100,000 (95% CI 10.8-28.1, p<0.001)). There was no difference in intussusception incidence between ethnic groups, although cases occurred at a younger age in Māori and Pacific infants compared to Asian and other ethnicities (Pacific median 7.5 months (interquartile range 5.9-11.6), Māori 7.8 months (IQR 5.5-12.3), European 9.2 months (IQR 5.8-15.8), Other Ethnicity 10.2 months (IQR 8.2-12.3), Asian 10.5 months (IQR 7.0-17.1 )). There was a weak seasonal trend with incidence troughs in January and July, and corresponding peaks in March and September. There was wide variation in presentation rates across District Health Board (DHB) regions, with a national average of 18.0/100,000 child-years (95% CI 9.7-26.3). Most patients were admitted on a single occasion to a single hospital for treatment (81%).
This study updates background incidence rates of intussusception prior to the introduction of a national rotavirus vaccination programme in July 2014. It identifies a trend of earlier intussusception in Māori and Pacific infants; the relationship between earlier intussusception and the risk of vaccine-associated events is unknown.
描述在新西兰常规轮状病毒疫苗接种引入之前，0至36个月大儿童肠套叠的流行病学情况。
利用新西兰国家最低数据集（NMDS）中的国际疾病分类第十版（ICD - 10）编码数据，识别1998年1月至2013年12月期间0至36个月大儿童的所有肠套叠病例。这些数据与新西兰人口普查的出生数据相关联。计算肠套叠的人群发病率，并描述人口统计学特征。
在16年的研究期间，共有794例肠套叠病例。大多数（56%）发生在生命的第一年（年龄调整发病率为56.1/100,000儿童年，95%置信区间（CI）41.7 - 71.2）。肠套叠在男性中更常见（36.4/100,000（95%CI 24.6 - 48.2），而女性为19.5/100,000（95%CI 10.8 - 28.1，p<0.001））。不同种族之间肠套叠发病率没有差异，尽管与亚洲及其他种族相比，毛利和太平洋岛屿婴儿发病年龄更小（太平洋岛屿婴儿中位数为7.5个月（四分位间距5.9 - 11.6），毛利婴儿为7.8个月（IQR 5.5 - 12.3），欧洲裔婴儿为9.2个月（IQR 5.8 - 15.8），其他种族为10.2个月（IQR 8.2 - 12.3），亚洲裔婴儿为10.5个月（IQR 7.0 - 17.1））。存在微弱的季节性趋势，1月和7月发病率较低，3月和9月相应出现高峰。各地区卫生委员会（DHB）区域的发病率差异很大，全国平均为18.0/100,000儿童年（95%CI 9.7 - 26.3）。大多数患者仅在一家医院接受过一次治疗（81%）。
本研究更新了2014年7月全国轮状病毒疫苗接种计划引入之前肠套叠的背景发病率。它确定了毛利和太平洋岛屿婴儿肠套叠发病更早的趋势；肠套叠发病更早与疫苗相关事件风险之间的关系尚不清楚。
