Life for a Child Program, Diabetes NSW, Glebe, New South Wales, Australia.
Santé Diabète, Mali delegation, Bamako, Mali.
Pediatr Diabetes. 2021 Jun;22(4):545-551. doi: 10.1111/pedi.13191. Epub 2021 Feb 22.
Determine incidence, prevalence and mortality of Type 1 diabetes (T1D) in children and youth <25 years (y) in Mali during the first 10 years of the Santé Diabète/Life for a Child program.
Data were collected from the prospective program register. Diagnosis of T1D was clinical, based on presentation, clinical features, immediate requirement for insulin, and no suggestion of other diabetes types.
Total of 460 cases were diagnosed with T1D <25 years in 2007-2016. Male-to-female ratio was 1.04:1. Peak age at onset was 15-16 years (range 1.1-24 years). T1D incidence <25 years per 100,000 population/year increased from 0.12 in 2007 to 0.74 in 2016 (an 18% annualized increase, p < 0.001). Incidence peaked at 0.80 in 2014, the year after an education campaign was conducted. Incidence <15 years rose from 0.12 to 0.35 per 100,000/year in 2007 and 2016, respectively, (14% annualized increase, p < 0.001). There was a steep, consistent increase in prevalence (per 100,000) from 0.43 in 2007 to 2.90 in 2016 (p < 0.001). Prevalence <15 years was 0.34/100,000 in 2007 and 1.02/100,000 by 2016 (p < 0.001). Overall crude mortality rate was 30.0/1000 patient years, equating to a standardized mortality rate of 9.0, with vital status known for 99.8% of cases.
Known incidence and prevalence of diabetes in Mali increased rapidly from 2007 to 2016, contemporaneous with the introduction and development of the Santé Diabète/Life for a Child program. Improved diagnosis and care resulting in lower mortality are likely contributors. True incidence may still be underestimated, with some cases still dying undiagnosed and full study ascertainment being uncertain.
在 Santé Diabète/Life for a Child 项目的前 10 年期间，确定马里 25 岁以下儿童和青少年 1 型糖尿病（T1D）的发病率、患病率和死亡率。
数据来自前瞻性项目登记处。T1D 的诊断是临床诊断，基于表现、临床特征、立即需要胰岛素以及没有其他糖尿病类型的提示。
2007 年至 2016 年期间，共有 460 例 25 岁以下儿童被诊断患有 T1D。男女性别比为 1.04:1。发病高峰年龄为 15-16 岁（年龄 1.1-24 岁）。25 岁以下每 100,000 人口/年的 T1D 发病率从 2007 年的 0.12 增加到 2016 年的 0.74（年增长率为 18%，p<0.001）。发病率在 2014 年达到峰值，当年开展了一项教育活动。2007 年至 2016 年，15 岁以下的发病率分别从每 100,000 人 0.12 增加到 0.35（年增长率为 14%，p<0.001）。患病率（每 100,000 人）从 2007 年的 0.43 急剧增加到 2016 年的 2.90（p<0.001）。2007 年患病率为 0.34/100,000，到 2016 年为 1.02/100,000（p<0.001）。总体粗死亡率为 30.0/1000 患者年，标准化死亡率为 9.0，99.8%的病例已知存活状态。
2007 年至 2016 年期间，马里糖尿病的已知发病率和患病率迅速增加，与 Santé Diabète/Life for a Child 项目的引入和发展同时发生。诊断和治疗的改善导致死亡率降低，这可能是其中的原因。真实的发病率可能仍然被低估，一些病例仍死于未确诊，且全面研究的确定情况不确定。
