ABSTRACT
OBJECTIVES: Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. METHODS: All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3, 874 cases from 136 general hospitals was performed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive predictive value = proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. RESULTS: Among 3, 874 cases, CSF examinations were performed on 1, 845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1, 568/1, 845), 86.0 (1, 239/1, 440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within +/-7%. CONCLUSIONS: In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be performed.
Subject(s)
Child , Humans , Enterovirus , Epidemiologic Studies , Hospitals, General , Incidence , Insurance, Health , International Classification of Diseases , Medical Records , Meningitis , Meningitis, Aseptic , National Health ProgramsABSTRACT
PURPOSE: Tetanus toxoid specific IgG titers were measured in 76 cases on children ranging from neonates to 18 yr old adolescents according to the frequency of DPT vaccination. METHODS: The Enzyquick tetanus Kit was used to measure tetanus toxoid specific IgG titers by the ELISA method. RESULTS: 1) In infants less than 2 months-olg, the mean tetanus toxoid specific IgG titer was 1.07 IU/ml. 2) In infants ranging from 2 months to 12 months of age, the mean was 3.59 IU/ml in 11 infant with primary vaccination, and 2.05 IU/ml in 2 infants with out vaccination. 3) In children ranging from 1 year to 2 years of age, the mean was 3.60 IU/ml in 4 children with booster vaccination, and 1.43 IU/ml in 4 children without bosster vaccination. 4) In children ranging from 2yrs to 4 yrs of age, the mean was 2.60 IU/ml in 11 children with booster vaccination, and 1.03 IU/ml in 5 children without booster vaccination. 5) In children ranging from 4 years to 7 years of age, the mean was 3.64 IU/ml in 7 children with booster vaccination, and 0.76 IU/ml in 5 children without vaccination. 6) In children ranging from 7 years to 11 years of age, the mean was 1.19 IU/ml in 4 children with booster vaccination, 0.44 IU/ml in a ten years old gir 1 without booster vaccination, and 0.93 IU/ml in 3 children whose vaccination history was unknown. 7) In the 11 year old to 18 year old age group, The mean 1.23 IU/ml in 5 children with booster vaccination, and 0.84 IU/ml in 8 children whose vaccination history was unknown. CONCLUSIONS: The antibody titers for tetanus toxoid is adquate to protect tetanus infection, if DPT vaccination is performed as scheduled. But the antibody titers fell rapidly, when the booster vaccination was not performed after primary vaccination. In conclusion, the booster accination after primary vaccination is necessory for the prevention of tetanus infectioin.
Subject(s)
Adolescent , Child , Humans , Infant , Infant, Newborn , Enzyme-Linked Immunosorbent Assay , Immunoglobulin G , Immunoglobulins , Tetanus Toxoid , Tetanus , VaccinationABSTRACT
A clinical study was made on 10 neonates with gastrointestinal perforation admitted to the department of pediatrics and surgery of Severance hospital from January, 1965, through Jane, 1978. The following results were obtained; 1) Males predominate (7M : 3F). 2) 7 cases of perforations occur in the first 2 days of life. 3) The most common site of perforations is stomach (3 cases) and terminal lieum (3 cases). The lesion showes inflammation, submucosal hemorrhage, atresia and muscular defect. 4) The clinical picture is abdominal distension developing repidly, cyanosis, vomiting, poor sucking, etc. 5) Abdominal X-rays are diagnostic, Massive pneumoperitoneum is visible in 5 cases. 6) Seven patients in 9 operated neonates died.