Aim: To study the health and development of children in a developing and low- income country. Methods: The health and development of children in Lahore in nor thern Pakistan have been studied since 1981 in a collabora...Aim: To study the health and development of children in a developing and low- income country. Methods: The health and development of children in Lahore in nor thern Pakistan have been studied since 1981 in a collaborative project between P akistani and Swedish university institutions and the Swedish Agency for Research Cooperation with Developing Countries (SAREC). The study described in this pape r comprised four different areas in Lahore with different degrees of urbanizatio n and different social conditions. All pregnancies in the four areas were regist ered during the period March 1984 to July 1986 and were followed up from the 5th month of pregnancy. All 1476 children born after 1 September 1984 were followed up from birth to 12 y of age. Results: The perinatal mortality in the whole mat erial was 5.4%. It was highest in the periurban slum (7.5%) and lowest in the upper-middle class cohort (3.3%). Overall infant mortality was 10%. It was hi ghest (14%) in the periurban slum and lowest (2%) in the upper-middle class g roup. Overall incidence of serious birth defects was 5%. It was highest in the periurban slum community (7%) and lowest in the upper-middle class cohort (3% ). The overall cumulative incidence of severe mental retardation per 100 live bi rths was 1.1. It was highest (2.2) in the periurban slum and lowest (0.4) in the upper-middle class group. The overall prevalence of mild mental retardation am ong 6-10-y-old children was 6.2 per 100. It was highest in the periurban slum (10.5) and lowest (1.3 per 100) in the upper-middle class group. Poverty, maln utrition, birth trauma and consanguinity were common causes of infant mortality and mental retardation in Lahore, Pakistan. Conclusion: Preventive measures with provision of obstetric and health services, services for genetic information an d risk evaluation, vaccination programmes and identification of children with re tarded development for specific stimulation and habilitation measures, e.g. orga nized play activities, are important in developing and low-income countries.展开更多
An increase in the prevalence of atopic dermatitis(AD)has been reported since the 1960s. The increase could be due to many factors including a genuine increase of incidence or duration of AD. We decided to study if th...An increase in the prevalence of atopic dermatitis(AD)has been reported since the 1960s. The increase could be due to many factors including a genuine increase of incidence or duration of AD. We decided to study if the increasing trend persisted during the 1990s by comparing the cumulative incidence of AD in 1993 and 1998. Further, we studied the severity and management of AD among children. Two samples of children born in Denmark were drawn from the Danish Medical Birth Register. In the 1993 and 1998 studies a mailed questionnaire with identical questions concerning AD was sent out. In the 1998 follow- up study the questionnaire included a severity score and questions concerning management of AD.In the 1993 study the cumulative incidence of AD at age 7 was 18.9% and in 1998 it was 19.6% . There was no difference in the age- adjusted AD incidence in the 5- year observation period. In the 1998 study, 81% had mild to moderate AD, 90% had been seen by a doctor at least once, 36% had mainly been treated by a dermatologist, and 2% had been hospitalized. It should be kept in mind that we base most of our common knowledge of the disease on AD patients selected for management in dermatology clinics and departments.展开更多
Background: The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A nation...Background: The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A national study has reported a trend towards a decrease in incidence after a change in infant feeding recommendations was introduced in 1996. The aim of this study was to evaluate, in a geographically defined area, the change in incidence with time and the influence of the introduction of antibody analysis. Methods: Cases of suspected paediatric CD between 1980 and 2003 were studied for prevalence, biopsy findings and antibody analyses. Results: A total of 2029 children were investigated by small intestinal biopsy, yielding 554 CD cases. The area initially showed the same trend as the national study, but the annual incidence rate is now increasing again. Median age at diagnosis has increased significantly since 1997 from less than 2 years of age to above 5 years. Cumulative incidence at 2 years of age is much higher for the birth cohorts 1983-96 than 1980-82 or 1997-2001. Diagnostic accuracy was significantly higher after the introduction of antigliadin (AGA) analysis, and especially after anti endomysium (EMA) analysis. Conclusions: The incidence rate of CD in small children in our region has varied widely over the 24-year period observed. Feeding practice and methods of investigation have changed during this period. The annual incidence rate for the total child population in 2003 was almost equal to the peak value observed in 1994. There were no conclusive results on whether antibody analysis had an influence on diagnostic activity, but this seems to have increased diagnostic accuracy.展开更多
Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to ...Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to adult cancers, childhood cancers’ particularities justify to create pediatric registries. The first French population-based registry was created in Lorraine in 1983. The incidence and survival results from a 17 year-period are presented. Methods. - In Lorraine region, all children (0- 14 years) with cancer diagnosed between 1983 and 1999 were included. Crude, age-standardized (world population) and cumulative incidence rates were calculated just as overall, specific- disease and event-free survival rates, using Kaplan-Meier methods. Results. - With 1086 registered cases, the crude incidence rate per million children is 132.4, the age-standardized incidence rate per million is 137.5; 1 out of every 500 children will develop cancer before the age of 15 years. The incidence of all cancers combined is slightly higher in males than in females with a M/F ratio of 1.13. For this 17 years-period, no trend in childhood cancer incidence is observed. The main cancer groups are leukemia (30.7% ), brain and spinal tumors (23.2% )- and lymphomas (12.9% ), sympathetic nervous system tumors (7.4% ), soft-tissue sarcomas (6.1% ), renal tumors (5.2% ), and bone tumors (5.0% ). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5- 74.3]. The prognosis is significatively worse for the< 1 year age group (55% ) and for some histologic types: brain stem gliomas (27% ), hepatic tumors (43% ), osteosarcomas (57% ), neuroblastomas (65% ), rhabdomyosarcomas (55% ). Discussion. - Relative distribution of histologic groups, incidence and survival rates observed in Lorraine registry are compatible with the general pattern in the European Union cancer registries. The lack of significative trend in incidence unlike others country may be explained by too small numbers. Conclusion. - The acquired experience in developping this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.展开更多
文摘Aim: To study the health and development of children in a developing and low- income country. Methods: The health and development of children in Lahore in nor thern Pakistan have been studied since 1981 in a collaborative project between P akistani and Swedish university institutions and the Swedish Agency for Research Cooperation with Developing Countries (SAREC). The study described in this pape r comprised four different areas in Lahore with different degrees of urbanizatio n and different social conditions. All pregnancies in the four areas were regist ered during the period March 1984 to July 1986 and were followed up from the 5th month of pregnancy. All 1476 children born after 1 September 1984 were followed up from birth to 12 y of age. Results: The perinatal mortality in the whole mat erial was 5.4%. It was highest in the periurban slum (7.5%) and lowest in the upper-middle class cohort (3.3%). Overall infant mortality was 10%. It was hi ghest (14%) in the periurban slum and lowest (2%) in the upper-middle class g roup. Overall incidence of serious birth defects was 5%. It was highest in the periurban slum community (7%) and lowest in the upper-middle class cohort (3% ). The overall cumulative incidence of severe mental retardation per 100 live bi rths was 1.1. It was highest (2.2) in the periurban slum and lowest (0.4) in the upper-middle class group. The overall prevalence of mild mental retardation am ong 6-10-y-old children was 6.2 per 100. It was highest in the periurban slum (10.5) and lowest (1.3 per 100) in the upper-middle class group. Poverty, maln utrition, birth trauma and consanguinity were common causes of infant mortality and mental retardation in Lahore, Pakistan. Conclusion: Preventive measures with provision of obstetric and health services, services for genetic information an d risk evaluation, vaccination programmes and identification of children with re tarded development for specific stimulation and habilitation measures, e.g. orga nized play activities, are important in developing and low-income countries.
文摘An increase in the prevalence of atopic dermatitis(AD)has been reported since the 1960s. The increase could be due to many factors including a genuine increase of incidence or duration of AD. We decided to study if the increasing trend persisted during the 1990s by comparing the cumulative incidence of AD in 1993 and 1998. Further, we studied the severity and management of AD among children. Two samples of children born in Denmark were drawn from the Danish Medical Birth Register. In the 1993 and 1998 studies a mailed questionnaire with identical questions concerning AD was sent out. In the 1998 follow- up study the questionnaire included a severity score and questions concerning management of AD.In the 1993 study the cumulative incidence of AD at age 7 was 18.9% and in 1998 it was 19.6% . There was no difference in the age- adjusted AD incidence in the 5- year observation period. In the 1998 study, 81% had mild to moderate AD, 90% had been seen by a doctor at least once, 36% had mainly been treated by a dermatologist, and 2% had been hospitalized. It should be kept in mind that we base most of our common knowledge of the disease on AD patients selected for management in dermatology clinics and departments.
文摘Background: The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A national study has reported a trend towards a decrease in incidence after a change in infant feeding recommendations was introduced in 1996. The aim of this study was to evaluate, in a geographically defined area, the change in incidence with time and the influence of the introduction of antibody analysis. Methods: Cases of suspected paediatric CD between 1980 and 2003 were studied for prevalence, biopsy findings and antibody analyses. Results: A total of 2029 children were investigated by small intestinal biopsy, yielding 554 CD cases. The area initially showed the same trend as the national study, but the annual incidence rate is now increasing again. Median age at diagnosis has increased significantly since 1997 from less than 2 years of age to above 5 years. Cumulative incidence at 2 years of age is much higher for the birth cohorts 1983-96 than 1980-82 or 1997-2001. Diagnostic accuracy was significantly higher after the introduction of antigliadin (AGA) analysis, and especially after anti endomysium (EMA) analysis. Conclusions: The incidence rate of CD in small children in our region has varied widely over the 24-year period observed. Feeding practice and methods of investigation have changed during this period. The annual incidence rate for the total child population in 2003 was almost equal to the peak value observed in 1994. There were no conclusive results on whether antibody analysis had an influence on diagnostic activity, but this seems to have increased diagnostic accuracy.
文摘Background. - Cancer in childhood account for less than 1% of all cancers and for the second most important cause of death for children aged less than 15 years in France, injuries being the leading cause. Compared to adult cancers, childhood cancers’ particularities justify to create pediatric registries. The first French population-based registry was created in Lorraine in 1983. The incidence and survival results from a 17 year-period are presented. Methods. - In Lorraine region, all children (0- 14 years) with cancer diagnosed between 1983 and 1999 were included. Crude, age-standardized (world population) and cumulative incidence rates were calculated just as overall, specific- disease and event-free survival rates, using Kaplan-Meier methods. Results. - With 1086 registered cases, the crude incidence rate per million children is 132.4, the age-standardized incidence rate per million is 137.5; 1 out of every 500 children will develop cancer before the age of 15 years. The incidence of all cancers combined is slightly higher in males than in females with a M/F ratio of 1.13. For this 17 years-period, no trend in childhood cancer incidence is observed. The main cancer groups are leukemia (30.7% ), brain and spinal tumors (23.2% )- and lymphomas (12.9% ), sympathetic nervous system tumors (7.4% ), soft-tissue sarcomas (6.1% ), renal tumors (5.2% ), and bone tumors (5.0% ). Five-year specific survival rates for all cancers combined is 71.4% [95% CI: 68.5- 74.3]. The prognosis is significatively worse for the< 1 year age group (55% ) and for some histologic types: brain stem gliomas (27% ), hepatic tumors (43% ), osteosarcomas (57% ), neuroblastomas (65% ), rhabdomyosarcomas (55% ). Discussion. - Relative distribution of histologic groups, incidence and survival rates observed in Lorraine registry are compatible with the general pattern in the European Union cancer registries. The lack of significative trend in incidence unlike others country may be explained by too small numbers. Conclusion. - The acquired experience in developping this regional registry allowed us to create a national registry of childhood solid tumors and contribute to valid national data.
