A method for reporting and classifying acute infectious diseases in a prospective study of young children: TEDDY.

BMC Pediatr 2015 Mar 20;15:24. Epub 2015 Mar 20.

University of Tampere, Tampere, Finland.

Background: Early childhood environmental exposures, possibly infections, may be responsible for triggering islet autoimmunity and progression to type 1 diabetes (T1D). The Environmental Determinants of Diabetes in the Young (TEDDY) follows children with increased HLA-related genetic risk for future T1D. TEDDY asks parents to prospectively record the child's infections using a diary book. The present paper shows how these large amounts of partially structured data were reduced into quantitative data-sets and further categorized into system-specific infectious disease episodes. The numbers and frequencies of acute infections and infectious episodes are shown.

Methods: Study subjects (n = 3463) included children who had attended study visits every three months from age 3 months to 4 years, without missing two or more consecutive visits during the follow-up. Parents recorded illnesses prospectively in a TEDDY Book at home. The data were entered into the study database during study visits using ICD-10 codes by a research nurse. TEDDY investigators grouped ICD-10 codes and fever reports into infectious disease entities and further arranged them into four main categories of infectious episodes: respiratory, gastrointestinal, other, and unknown febrile episodes. Incidence rate of infections was modeled as function of gender, HLA-DQ genetic risk group and study center using the Poisson regression.

Results: A total of 113,884 ICD-10 code reports for infectious diseases recorded in the database were reduced to 71,578 infectious episodes, including 74.0% respiratory, 13.1% gastrointestinal, 5.7% other infectious episodes and 7.2% febrile episodes. Respiratory and gastrointestinal infectious episodes were more frequent during winter. Infectious episode rates peaked at 6 months and began declining after 18 months of age. The overall infectious episode rate was 5.2 episodes per person-year and varied significantly by country of residence, sex and HLA genotype.

Conclusions: The data reduction and categorization process developed by TEDDY enables analysis of single infectious agents as well as larger arrays of infectious agents or clinical disease entities. The preliminary descriptive analyses of the incidence of infections among TEDDY participants younger than 4 years fits well with general knowledge of infectious disease epidemiology. This protocol can be used as a template in forthcoming time-dependent TEDDY analyses and in other epidemiological studies.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12887-015-0333-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377063PMC
March 2015
18 Reads

Publication Analysis

Top Keywords

infectious episodes
20
infectious
14
infectious disease
12
episodes
9
respiratory gastrointestinal
8
infectious episode
8
febrile episodes
8
study visits
8
episodes respiratory
8
infectious agents
8
disease entities
8
icd-10 codes
8
teddy
8
genetic risk
8
reports infectious
8
months age
8
infectious diseases
8
study
6
infections
5
data reduction
4

References

(Supplied by CrossRef)

TEDDY Study Group et al.
Immunology of Diabetes V: Ann NY Acad Sci 2008

A Mitra et al.
Prim Health Care Res Dev 2011

ER Wal et al.
Pediatrics 1991

The TEDDY Study Group et al.
Pediatr Diabetes 2007

K Wang et al.
Cochrane Database Syst Rev 2012

PA Tähtinen et al.
Pediatrics 2013

FF Bodor et al.
Semin Pediatr Infect Dis 1998

MH Sawyer et al.
Curr Opin Pediatr 2001

A Beyerlein et al.
JAMA Pediatr 2013

AS Monto et al.
Epidemiol Infect 1993

BJ Law et al.
Respir Med 2002

Similar Publications