title: Epidemiology of childhood type 1 diabetes mellitus in Nile Delta, northern Egypt - a retrospective study.
abstract: OBJECTIVE
  The geographical incidence of type 1 diabetes mellitus (T1DM) varies widely worldwide. Both genetic and environmental factors have been implicated, although environmental factors are still speculative and elusive. More epidemiological studies are needed to uncover such factors. To date, there are no reported studies on the epidemiology of childhood T1DM in Nile Delta, Egypt. We aimed to define the incidence, prevalence and demographic characteristics of T1DM in children (0-18 years) living in the Nile Delta region, one of the most densely populated areas in Egypt.
  
  
  METHODS
  The study included all T1DM patients aged 0-18 years who lived in the Nile Delta region of Egypt and who were either diagnosed at or referred to Mansoura University Children's Hospital (MUCH) between 1 January 1994 and 31 December 2011. The hospital files of the patients were reviewed. General population data on the 0-18 year age group in the Nile Delta governorates were also presented.
  
  
  RESULTS
  From a total of 1600 T1DM patients, 891 (55.7%) were females (p=0.000) and 935 (58.4%) were from rural areas (p=0.000). Calculated age-adjusted incidence of T1DM in 1996, 2006 and 2011 were 0.7, 2.0 and 3.1/10(5)/year, respectively, while calculated age-adjusted prevalence of T1DM in the same years were 1.9, 15.5 and 26.8/10(5)/year, respectively. Patients presented most frequently in the 5-10 year age group (p<0.000) and in winter months (p=0.009).
  
  
  CONCLUSIONS
  In this first childhood T1DM epidemiology study in the Nile Delta region of Egypt, T1DM incidence and prevalence were found to show an increase over the past 18 years (1994-2011). Incidence and prevalence were higher in females and more cases were found to originate from rural areas.
authors.affiliation: Mansoura University Children's Hospital, Pediatric Endocrinology and Diabetes Unit, Mansoura, Egypt. E-ma-il: prof.magdy.2013@gmail.com.
authors.forename: Magdy Abd El-Monem
authors.initials: MA
authors.lastname: El-Ziny
authors.forename: Nanees Abdel-Badie
authors.initials: NA
authors.lastname: Salem
authors.forename: Amany Kamal
authors.initials: AK
authors.lastname: El-Hawary
authors.forename: Nehad Mohamed
authors.initials: NM
authors.lastname: Chalaby
authors.forename: Ashraf Abd-Elmoneim
authors.initials: AA
authors.lastname: Elsharkawy
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012621:Seasons