A Nation-wide estimation of the cumulative incidence and disease burden of the rotavirus gastroenteritis

(1)估计日本儿童轮状病毒胃肠炎的年发病率、年龄别发病率和累积风险。轮状病毒胃肠炎是一种常见的儿童感染，但该疾病的确切发病率在日本并未得到很好的描述。我们的目的是评估发病率指标以确定轮状病毒胃肠炎的严重程度。轮状病毒胃肠炎所属的各种原因的急性感染性胃肠炎的估计数，自1999年颁布《预防传染病和传染病患者医疗法》以来就有了。使用这个估计值和另一个对门诊急性感染性胃肠炎患者中轮状病毒检测比例的估计值，我们计算了轮状病毒胃肠炎的年发病率、特定年龄的年发病率和6岁前的累积风险。后一项估计是通过对四个独立的…进行荟萃分析而获得的之前在日本进行的更多Denten研究。据我们估计，日本约有80万名6岁以下儿童因轮状病毒胃肠炎而去儿科或医院门诊部就诊，每年有11例/100人，每两名儿童中就有一人在上小学前去看儿科医生。此类儿科医生就诊最频繁的年龄为1岁(27例/100人/年)。因此，轮状病毒病在日本儿童中的负担是巨大的。(2)一家哨兵医院在25年期间(1978-2002年)研究了日本肠套叠的高发病率。第二代轮状病毒疫苗的开发需要在疫苗引入之前了解婴儿肠套叠的基线发病率。为了获得这样的估计，我们查阅了一家医院的临床记录，该医院是日本北部当地社区儿科床位的主要提供者。在这25年间(1978-2002)，有91名5岁以下儿童因放射学确诊的肠套叠住院，其中45%是1岁以下儿童。假设该地区所有患有肠套叠的儿童都住进了这家医院，1岁和5岁的儿童平均每100000人年分别住院185次和78次。肠套叠的发生率在不同时期之间存在差异，没有长期的长期趋势。日本的发病率是迄今为止报告的最高之一，这为地理变异提供了进一步的证据。较少

(1)Estimation of annual incidence, age-specific incidence rate, and the cumulative risk of rotavirus gastroenteritis among children in Japan.Rotavirus gastroenteritis is a common childhood infection, but the exact morbidity of the disease is not well described in Japan. We aimed at estimating morbidity measures to determine the magnitude of rotavirus gastroenteritis. An estimate for acute infectious gastroenteritis of all causes, to which rotavirus gastroenteritis belongs, has been available since the enactment in 1999 of the Law concerning the Prevention of Infectious Diseases and Medical Care of Patients with Infectious Diseases. Using this estimate and another estimate for the detection proportion of rotavirus among outpatients with acute infectious gastroenteritis, we calculated the annual incidence, the age-specific annual incidence rate, and the cumulative risk by the age of 6 years for rotavirus gastroenteritis. The latter estimate was obtained by a meta-analysis of four indepen … More dent studies previously performed in Japan. According to our estimates, approximately 800,000 children in Japan under the age of 6 years visit pediatric practices or the outpatient department of hospitals because of rotavirus gastroenteritis at a rate of 11 cases/100 persons/year, and one in two children will visit pediatricians before they go to primary school. Such pediatrician visits most frequently occur at the age of 1 year (27 cases/100 persons/year). Thus, the magnitude of the burden of rotavirus disease among Japanese children is substantial.(2)A high incidence of intussusception in Japan as studied in a sentinel hospital over a 25-year period (1978-2002).The development of second-generation rotavirus vaccines requires knowledge of baseline incidence rates for intussusception in infants prior to vaccine introduction. To obtain such estimates we reviewed clinical records in a hospital that served as the major provider of paediatric beds in a local community in the northern part of Japan. During the 25-year period (1978-2002), there were 91 hospitalizations due to radiologically confirmed intussusception in children <5 years of age, of which 45% were <1 year of age. Assuming that all children with intussusception in the area had been admitted to this hospital, there were an average of 185 and 78 hospitalizations per 100000 person-years for children <1 year old and 5 years old respectively. There was period-to-period variability with no long-term secular trend in the incidence of intussusception. The incidence rate in Japan was among the highest thus far reported, providing further evidence of geographic variability. Less