Acute encephalopathy and seizure rates in children under age two years in Oregon and Washington state.
A surveillance network was established in Oregon and Washington state to identify cases of certain neurologic illnesses during a one-year period (August 1, 1987 to July 31, 1988) among children 1-24 months of age. Reported here are the observed case occurrence rates and findings from capture-recapture analyses used to predict rates that would have been observed had ascertainment been complete. The network consisted of a hospital component involving 98% of all eligible facilities, a provider component involving 93% of all eligible pediatricians and neurologists, and a research staff component of record abstractors. Of 3,876 potential cases reported, 626 met the study criteria. The observed rates for the primary diagnostic groups were: encephalopathies, 16 per 100,000 children; infantile spasms, 10 per 100,000 children; afebrile seizures, 159 per 100,000 children; and complex febrile seizures, 101 per 100,000 children. Of the 626 qualifying cases, 41% were reported by two or more surveillance components. Capture-recapture analyses with log-linear modeling to control for source dependence suggested 80% of all study cases were detected. Comparable percentages for the four illness groups were: encephalopathies, 82%; infantile spasms, 94%; afebrile seizures, 69%; and complex febrile seizures, 91%. The predicted rate for afebrile seizures, corrected for under-ascertainment, exceeded the upper 95% confidence interval bound around the observed rate. For all other conditions, predicted rates fell within the 95% confidence intervals around the observed rates. These findings suggest capture-recapture analyses should be applied to the full sample of cases and to relevant disease substrata.
Bobo
J K
JK
Department of Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha 68198-4350.
Thapa
P B
PB
Anderson
J R
JR
Gale
J L
JL
D000208:Acute Disease; D000367:Age Factors; D015982:Bias; D001927:Brain Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002675:Child, Preschool; D003195:Computer Communication Networks; D016001:Confidence Intervals; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D009922:Oregon / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D011237:Predictive Value of Tests; D012640:Seizures / Q000453:epidemiology*; D013036:Spasms, Infantile / Q000453:epidemiology*; D014861:Washington / Q000453:epidemiology