Incidence and prevalence of childhood diabetes in Slovakia (1985-1992). Slovak Childhood Diabetes Epidemiology Study Group.

OBJECTIVE: To provide reliable data on the incidence and prevalence of insulin-dependent diabetes mellitus (IDDM) in children in Slovakia. RESEARCH DESIGN AND METHODS: A total of 754 Slovak children with IDDM, aged 0-14 years, were identified during an 8-year study period. There were 369 boys and 385 girls from an average population of 1,363,499 children. All patients were prospectively recorded. The primary ascertainment was based on notifications by physicians from outpatient departments. The second independent source of information was from all hospitals where the diabetic patients were hospitalized. The completeness of ascertainment was based on the capture-recapture procedure. RESULTS: The completeness of the ascertainment was 95%. In 1992, the annual incidence rate of IDDM (per 100,000) in the 0- to 14 year-old age-group was 8.92 for both sexes (7.95 for boys and 9.93 for girls). In the youngest age-group, an increase in the incidence rates from 2.89 in 1985 to 6.54 in 1992 was observed. Seasonality, with a higher incidence in autumn and winter, was observed in children older than 4 years. The prevalence rates of IDDM (per 1,000) were 0.28-0.50% in the 8-year period. CONCLUSIONS: The incidence of IDDM in Slovak children (0-14 years) is similar to what has been found in other Central European countries. In children younger than 4 years of age, in the last 2 years (1991 and 1992) more patients with diabetes were found than in any period during the preceding 6 years. The recent conspicuous increase in the incidence of IDDM among the younger children in Slovakia urges us to study its mechanisms, so far unknown, and to search for possible means of prevention.

[Incidence of rheumatic fever in Slovakia during the last 20 years]. / Výskyt febris rheumatica na Slovensku za ostatných 20 rokov.

The incidence of rheumatic fever has a declining trend in Slovakia. In 1972 there were 26.7 primary attacks and 8.7 relapses per 100,000 children aged 0-14 years, in 1990 there are 0.5 primary attacks and 0.4 relapses and in 1991 0.4 primary attacks and no relapses. The interregional (former regions) distribution was to the disadvantage of eastern parts but gradually this was evened out. Rheumatic fever occurs in girls and boys, in the majority mild arthritis forms are involved with unequivocal regression of carditic-arthritic forms. The decline can be ascribed to the rising socio-economic standard and health care.

An Algerian experiment: short chemotherapy for tuberculosis.

PIP: 427 Algerian children aged up to 15 years were treated at the Pediatric Clinic of the Beni-Messour University Hospital Centre, Algiers, between July 1979-January 1985 with a 6-month multi-drug course for tuberculosis (TB). TB was diagnoses by clinical and x-ray findings in 56% and confirmed bacteriologically in the rest. Those with pulmonary, meningeal, osteoarticular, or renal TB received isoniazid and rifampicin daily for 6 months with streptomycin and pyrazinamide for the first 2 months. Those with primary TB, regional lymphadenitis, pleural, peritoneal, or other localized TB received the same drug regimen without initial streptomycin. 372 children completed the course, and, of these, all were cured, 99% definitely so. There were 3 relapses. Children who did not complete the drug treatment included 7 who died due to TB, 4 of them pulmonary and 3 meningeal; 1 who had drug toxicity; 17 who stopped treatment and were lost to follow-up; 30 who were lost to follow-up after completion of treatment and 5 who died of unrelated causes. The only adverse reactions were transient elevated liver transaminase in 4.6, and 1 case of jaundice in a child who received an accidental overdose. Besides its effectiveness, this short course treatment was considered beneficial because only 4% discontinued and were lost to follow-up, compared to 15% of a prior group given a 12-month treatment course.^ieng

[Registration of patients with chronic diseases]. / Registrácia chorých s chronickými chorobami.

The authors describe registers of chronic diseases, provisions regarding their contents and organizational aspects. They make the reader familiar with the collection, storage and evaluation of data and some problems with their safeguarding. They report their experience with recommended questionnaires and the structure of forms. They describe the activities of the doctor completing the forms as well as the activities associated with recording in the centre. The authors demonstrate possible types of outputs and whom they serve. They illustrate the results of their work on the example of data from the register for diabetes mellitus of the juvenile type I and rheumatic fever. They discuss the role of registers in the health services, their role in ensuring the health status of the population, planning and management of the health services. In the conclusion they mention new technical possibilities.

[Infant and neonatal mortality and its forecasting]. / Dojcenská a novorodenecká úmrtnost' a predpovedanie ich vývoja.

The authors draw attention to some trends in the development of important indicators of health care in the SR, i.e. infant and neonatal mortality. Using the method of simple analysis of trends mortality, they processed time series of data from all districts in Slovakia. They included in the analysis mortality data from 1972 to 1989. Based on the mentioned data they calculated the extrapolated trend for each district and present estimates for 1995 and 2005. They draw attention to differences between districts and discuss possible causes of this state of affairs. They draw attention of readers to the interpretation of results and warn against their absolutization.

[Congenital heart defects in children born 1981-1987 in the Bratislava District and surrounding countryside]. / Vrodené chyby srdca u detí narodených v rokov 1981-1987 v okresoch Bratislava a Bratislava-vidiek.

In 1981-1987 of 61,420 liveborn children in the districts Bratislava-town and Bratislava-country 480 infants with inborn heart disease were born of whom 135 died. The mean incidence of congenital heart disease is 7.81% and the mean mortality 2.22%. During first week 42% of the 135 infants with congenital heart disease died. From an analysis of the deceased, operated and living candidate for operation the authors estimated 273 cardiological surgical operations for 216 children from the total of 480 with congenital heart disease. The results may serve as a basis for therapeutic and preventive care within the framework of the cardiovascular programme for children.

[The central register for diabetes mellitus in children in Slovakia]. / Centrálny register diabetes mellitus u detí v SSR.

The central register of diabetes mellitus in the SSR keeps records of patients from birth to the age of 14 and 18 years resp. The health institution reports patients on special forms. At the end of the first half of 1988 574 patients from the entire SSR were on record. The incidence of diabetes mellitus in the last years is 6 per 100,000 children and has a slightly rising trend. The prevalence is (to the date of June 30, 1988) 34 in children under 14 years and by age groups it is 6 in children under 4 years, 29 in children under 9 years and 67 in children under 14 years per 100,000 children of the respective age group. This indicates increasing numbers of sick children with advancing age. The register records data from the family-history (incidence of diabetes, risk factors), from the patient's history at the time of the manifestation of the disease and during the period of data collection. The present state is evaluated on the basis of biochemical and clinical results. The state of compensation and quality of cooperation with the patient and parents are interlinked. In 284 families diabetes was present in another or several members (total 413) (genetic predisposition). Before the onset of diabetes mellitus 240 children an acute illness was recorded with a time interval of six weeks (infection and possible damage of islets). In addition to providing basic data for research of the disease, the register helps with dispensarization, statistical work, reports to doctors, inviting patients and planning the needs of sick children.

Pediatrical case histories analyzed by means of a computer.

The authors present their first version of the formation of anamnestic case histories (family, personal, epidemiological, and social) by means of a conversation between the physician and the computer. During the recording a set of the means of expression is used, this allows for an exhaustive compilation and recording of various types of case histories. The means of expression called variables make up the questionnaire sentence. The case histories- conversations about them, are presented by the algorithm of the questionnaire in logical sequences which permit suprabound jumps off to other linkages. The created complexes-sentences are verified as a whole and then recorded. Portions of different types of case histories are demonstrated in this paper together with their possible side jumps. The possibilities of computer analysis lie in repeated recording, corrections, in the formation of statistical analyses of various data and, in the future, also in the formation of differential diagnostic considerations with the assistance of computers.

Incidence of congenital heart disease among children in a selected population sample.

The incidence of congenital heart disease [CHD] among infants and children has been studied since 1976. The sample represents more than one third of all infants born annually during the years under review. In 1976, 354 of all newborns had a CHD, confirmed by autopsy in 105, as compared with 285 newborns with CHD in 1977, confirmed by autopsy in 62, the incidence in 1976 and 1977 thus being 9.48% and 7.67%, respectively. The most common diseases were ventricular septal defect (38.7% and 39.65%), atrial septal defect (9.04% and 7.72%) and left-to-right shunt (8.47 and 11.23%). The incidence of the remaining CHD was less than 5%. During the two years under review and unspecified heart diseases represented 12.15% (1976) and 7.72% (1977). Mortality within the first month of birth in 1976 and 1977 was 62.8% and 51.6%, respectively. The difference shows that the incidence of CHD in 1976 was higher than in 1977.