Coi Alessio, Santoro Michele, Pierini Anna, Marrucci Sonia, Pieroni Federica, Bianchi Fabrizio
Institute of Clinical Physiology, National Research Council, Pisa, Italy.
Public Health Genomics. 2017;20(4):229-234. doi: 10.1159/000481358. Epub 2017 Sep 19.
BACKGROUND/AIMS: Population-based registries play a key role in the epidemiological surveillance of congenital anomalies (CAs). This study is aimed at improving the epidemiological surveillance and providing prevalence estimates of rare CAs using the Registry of Rare Diseases as an added data source to the Registry of Congenital Anomalies.
Cases of diagnosed rare CAs (2006-2013) were extracted from the Tuscany Registry of Rare Diseases and the Tuscany Registry of Congenital Anomalies in order to set up an integrated dataset. Prevalence (per 100,000 births; 95% confidence interval) was calculated for each rare CA.
Overall, 56 rare CAs were analyzed including 656 cases, of whom 121 (18.4%) were retrieved from the Registry of Rare Diseases that provided a major contribution for rare CAs for which a prenatal diagnosis is difficult, or for CAs more easily diagnosed in the postneonatal period. After data integration, an increased prevalence estimate was observed in particular for atresia of bile ducts (6.24; 3.57-10.14), tuberous sclerosis (2.34; 0.86-5.10), Kabuki syndrome (1.95; 0.63-4.55), and some monogenic CAs.
This study represents an example of integration of registries operating in the field of rare diseases. Providing the accurate prevalence of rare CAs is a key point to improving surveillance, supporting public health policies, and planning healthcare.
背景/目的:基于人群的登记系统在先天性异常(CA)的流行病学监测中发挥着关键作用。本研究旨在通过将罕见病登记系统作为先天性异常登记系统的补充数据源,改善流行病学监测并提供罕见CA的患病率估计。
从托斯卡纳罕见病登记系统和托斯卡纳先天性异常登记系统中提取2006 - 2013年确诊的罕见CA病例,以建立一个综合数据集。计算每种罕见CA的患病率(每10万例出生;95%置信区间)。
总体而言,共分析了56种罕见CA,包括656例病例,其中121例(18.4%)来自罕见病登记系统,该系统为产前诊断困难的罕见CA或更容易在新生儿后期诊断的CA做出了重大贡献。数据整合后,尤其观察到胆管闭锁(6.24;3.57 - 10.14)、结节性硬化症(2.34;0.86 - 5.10)、歌舞伎综合征(1.95;0.63 - 4.55)以及一些单基因CA的患病率估计有所增加。
本研究是罕见病领域登记系统整合的一个实例。提供罕见CA的准确患病率是改善监测、支持公共卫生政策和规划医疗保健的关键。