Emory University Rollins School of Public Health, Atlanta, GA.
Emory University Rollins School of Public Health, Atlanta, GA.
Ann Epidemiol. 2019 Apr;32:72-77.e2. doi: 10.1016/j.annepidem.2018.11.012. Epub 2018 Dec 5.
Although congenital heart defects (CHD) are one of the most common types of birth defects in the United States, subnational prevalence estimates beyond early childhood are limited.
We used capture-recapture methodology and logistic regression to estimate CHD prevalence per 1000 residents as of January 1, 2010, separately for adolescents and adults treated and living within five metropolitan Atlanta, Georgia counties, during 2008-2010.
Data sources differed by age. Adolescents (n = 1621, aged 11-20 years) and adults (n = 3176, aged 21-64 years) were captured from at least one source. We estimated CHD prevalence to be 7.85 per 1000 adolescents (estimated n = 3718 [95% CI: 3471-4004]) and 6.08 per 1000 adults (estimated n = 12,969 [95% CI: 13,873-18,915]). When we included persons found in age-inappropriate sources, prevalence estimates increased to 11 per 1000 adolescents and 6.5 per 1000 adults.
This method for obtaining subnational prevalence estimates provided reasonable prevalence results and identified needs for service improvement. Only one half of adolescents and one-quarter of adults with CHD were in health care within a 3-year time frame, suggesting need for better access to health insurance, transition care, and an increased number of physicians specializing in CHD care.
尽管先天性心脏病(CHD)是美国最常见的出生缺陷类型之一,但对儿童期以后的亚国家级患病率估计数据有限。
我们使用捕获-再捕获方法和逻辑回归来估计 2008 年至 2010 年期间,在佐治亚州亚特兰大五个大都市区内接受治疗并居住的青少年和成年人(11-20 岁,n=1621;21-64 岁,n=3176)每 1000 名居民的 CHD 患病率。
各年龄段的数据源不同。青少年(n=1621,年龄 11-20 岁)和成年人(n=3176,年龄 21-64 岁)至少从一个来源捕获。我们估计青少年 CHD 的患病率为每 1000 人 7.85 例(估计人数 n=3718 [95%CI:3471-4004]),成年人的患病率为每 1000 人 6.08 例(估计人数 n=12969 [95%CI:13873-18915])。当我们纳入在年龄不适当的来源中发现的患者时,患病率估计值分别增加到每 1000 名青少年 11 例和每 1000 名成年人 6.5 例。
这种获取亚国家级患病率估计的方法提供了合理的患病率结果,并确定了需要改进服务。只有一半的青少年和四分之一的成年 CHD 患者在三年内接受了医疗保健,这表明需要更好地获得医疗保险、过渡护理,并增加专门从事 CHD 护理的医生数量。