南非索韦托儿童热性惊厥的发生率及相关因素。

Incidence of febrile seizures and associated factors in children in Soweto, South Africa.

机构信息

South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

S Afr Med J. 2021 Aug 2;111(8):796-802. doi: 10.7196/SAMJ.2021.v111i8.15431.

DOI:10.7196/SAMJ.2021.v111i8.15431

PMID:35227362

Abstract

BACKGROUND

Febrile seizures (FSs) are a common cause of paediatric emergencies, but there is limited research on the aetiology and epidemiology of FSs, especially in Africa.

OBJECTIVES

To determine the incidence of FS hospitalisations in children aged 6 - 59 months in Soweto, South Africa, and factors associated with FS hospitalisations.

METHOD

In a secondary data analysis using a cohort of children enrolled in a 9-valent pneumococcal conjugate vaccine efficacy trial conducted in Soweto during 1998 - 2005, the incidence of FS hospitalisation was calculated and stratified by age group. Regression analysis was used to investigate factors associated with FS at the time of hospitalisation. Influenza A, influenza B, respiratory syncytial virus (RSV), adenovirus and parainfluenza were investigated for among those with respiratory symptoms using immunofluorescent assays.

RESULTS

FSs accounted for 780 (11.0%) of 7 126 hospitalisations during the study period. The overall incidence of FSs was 4.4 (95% confidence interval (CI) 4.10 - 4.97) per 1 000 person-years, with the highest incidence in children aged 12 - 23 months (7.25; 95% CI 6.44 - 8.14). Among hospitalised children, FS hospitalisation was associated with HIV-negative status (odds ratio (OR) 6.25; 95% CI 4.34 - 8.99), body temperature ≥39ºC (OR 2.03; 95% CI 1.56 - 2.64) and concurrent diagnosis of acute otitis media (OR 2.16; 95% CI 1.74 - 2.67). Influenza A was identified in 44/515 FS hospitalisations (8.5%) compared with 123/3 794 non-FS hospitalisations (3.2%) (OR 2.22; 95% CI 1.56 - 3.16). In contrast, RSV detection was less commonly identified in children with FSs (21; 4.1%) than without (419; 11.0%) (OR 0.36; 95% CI 0.24 - 0.54).

CONCLUSIONS

FSs contributed significantly to the burden of paediatric hospitalisations in Soweto, and were strongly associated with influenza A virus infection.

摘要

背景

热性惊厥（FSs）是儿科急症的常见原因，但关于 FSs 的病因和流行病学的研究有限，特别是在非洲。

目的

确定南非索韦托 6-59 月龄儿童 FS 住院的发生率，并确定与 FS 住院相关的因素。

方法

在使用 1998-2005 年期间在索韦托开展的 9 价肺炎球菌结合疫苗效力试验纳入的儿童队列进行的二次数据分析中，计算了 FS 住院的发生率，并按年龄组进行分层。回归分析用于调查住院时与 FS 相关的因素。使用免疫荧光测定法检测有呼吸道症状的儿童中流感 A、流感 B、呼吸道合胞病毒（RSV）、腺病毒和副流感病毒。

结果

在研究期间，FS 占 7126 例住院患儿的 780 例（11.0%）。FS 总发生率为每 1000 人年 4.4（95%置信区间[CI]4.10-4.97），12-23 月龄儿童发生率最高（7.25；95%CI 6.44-8.14）。在住院患儿中，FS 住院与 HIV 阴性状态（比值比[OR]6.25；95%CI 4.34-8.99）、体温≥39°C（OR 2.03；95%CI 1.56-2.64）和急性中耳炎并存诊断（OR 2.16；95%CI 1.74-2.67）相关。在 515 例 FS 住院患儿中，检出流感 A 44 例（8.5%），而非 FS 住院患儿中检出 123 例（3.2%）（OR 2.22；95%CI 1.56-3.16）。相比之下，在 FS 患儿中，呼吸道合胞病毒的检出率较低（21 例[4.1%]），而非 FS 患儿中（419 例[11.0%]）（OR 0.36；95%CI 0.24-0.54）。