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Incidence of type 1 diabetes mellitus in children in Tuzla Canton between 1995 and 2004

2006; Springer Science+Business Media; Volume: 166; Issue: 2 Linguagem: Inglês

10.1007/s00431-006-0353-3

1432-1076

Husref Tahirović, Alma Toromanović,

Diabetes, Cardiovascular Risks, and Lipoproteins

The aim of this study is to report the main results of a descriptive epidemiology of type 1 diabetes among children from Tuzla Canton, Bosnia and Herzegovina, in the 0–14 years age group between 1995 and 2004, the ten-year period after the war. The Tuzla Canton area is situated in the north-eastern part of Bosnia and Herzegovina, with an area of 2,649 km and a population of 502,418, including 85,526 children in the 0–14 years age group (on 31 December 2004) [2]. The criteria for inclusion in this study were as recommended by the WHO Diamond Project Group [5]: all children with onset of type 1 diabetes below 15 years of age between 1 January 1995 and 31 December 2004 who were residents of the Tuzla Canton area at the time of the first insulin injection. Primary case identification was based on data from the central register of diabetic patients aged 0–14 years. Secondary independent sources were data from the register of prescription data of 13 public health centers in the Tuzla Canton area. The estimated completeness of ascertainment based on the capture–recapture method [4] was 100%. The average incidence rate was calculated as the number of newly diagnosed type 1 diabetes patients per 100,000 person/years for the 0 to 4, 5 to 9, and 10 to 14 years age groups. The mid-year populations were used as the denominator (aged 14 years and under). Seasonal variability was investigated assuming a sinusoidal pattern over the year. Variations were tested with the c test. Trends in incidence during the 1995–2004 period were estimated by Poisson regression to give an annual percentage increase [3]. Between 1995 and 2004, 71 new cases of type 1 diabetes were registered in the 0–14 age group in Tuzla Canton. Of this group, 31 were female (44%) and 40 were male (56%). The overall crude incidence during the observed period was 7.1/100,000 (95% CI: 5.5–8.9) for both sexes (7.7 for boys and 6.4 for girls), and the incidence standardized to the world population was 6.9 (95% CI: 5.2–8.7) (Table 1). The median age at diagnosis was 8.1 years (range: 1.0–14.0). There was no significant difference in the age at diagnosis in boys (7.5) and girls (8.9) (t-test: t=151, df=69, p=0.14). The highest number of new cases was detected in December, with a nadir in May and June (Fig. 1) (Edwards seasonality test x=15.86, Eur J Pediatr (2007) 166:491–492 DOI 10.1007/s00431-006-0257-2