Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study

Maryam Piram; Carla Maldini; Sandra Biscardi; Nathalie De Suremain; Christine Orzechowski; Emilie Georget; Delphine Regnard; Isabelle Koné-Paut; Alfred Mahr

doi:10.1093/rheumatology/kex158

Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study

Rheumatology (Oxford). 2017 Aug 1;56(8):1358-1366. doi: 10.1093/rheumatology/kex158.

Authors

Maryam Piram^{1

2}, Carla Maldini^{3

4}, Sandra Biscardi⁵, Nathalie De Suremain⁶, Christine Orzechowski⁷, Emilie Georget⁸, Delphine Regnard⁹, Isabelle Koné-Paut², Alfred Mahr^{3

4}

Affiliations

¹ CESP, INSERM, Université Paris-Saclay, Université Paris-Sud, UVSQ.
² Paediatric Rheumatology, CEREMAI, AP-HP, CHU de Bicêtre, Le Kremlin-Bicêtre.
³ ECSTRA, Université Paris 7-Diderot.
⁴ Internal Medicine, AP-HP, CHU Saint Louis, Paris.
⁵ Paediatrics, CHIC, Créteil.
⁶ Paediatrics, AP-HP, CHU Trousseau, Paris.
⁷ Paediatrics, CH Sainte Camille, Bry-sur-Marne.
⁸ Paediatrics, CHIV, Villeneuve Saint Georges.
⁹ Paediatrics, CHU de Bicêtre, Le Kremlin-Bicêtre, France.

PMID: 28444335
DOI: 10.1093/rheumatology/kex158

Abstract

Objectives: The aim was to describe the epidemiological characteristics of childhood IgA vasculitis (IgAV) defined by the EULAR/PRINTO/Paediatric Rheumatology European Society criteria in a population-based sample from France and ascertain its incidence over 3 years by a four-source capture-recapture analysis.

Methods: Cases were prospectively collected in Val de Marne county, a suburb of Paris, with 263 874 residents <15 years old. Children with incident IgAV living in this area from 2012 to 2014 were identified by four sources of case notification (emergency departments, paediatrics departments, private-practice paediatricians and general practitioners). Annual incidence was calculated, and a capture-recapture analysis was used with log-linear modelling to estimate case-finding completeness.

Results: We identified 147 incident cases [78 boys; mean age 6.5 (s.d.:2.6) years]. The annual incidence (95% CI) was 18.6 (13.6, 24.5)/100 000 children. Although only 10% of children were exclusively identified by non-hospital sources, the completeness of case finding was 62%, with an undercount-corrected annual incidence (95% CI) of 29.9 (23.7, 37.3)/100 000 children. The annual distribution of diagnoses consistently showed a trough in summer months; 72% of children had infectious symptoms (mainly upper respiratory tract) a few days before IgAV onset; and 23% had a North African background.

Conclusion: Our study supports secular and geospatial stability in childhood IgAV incidence and adds further indirect evidence for a possible role of a ubiquitous, non-emerging infectious trigger. Incidence studies from understudied areas are needed to disentangle the role of genetic factors better. Capture-recapture analysis suggests that a substantial portion of IgAV cases may remain unrecognized in epidemiological surveys.

Keywords: Henoch–Schönlein purpura; IgA vasculitis; capture–recapture; children; epidemiology; incidence.

MeSH terms

Adolescent
Child
Child, Preschool
Disease Notification
Female
France / epidemiology
Humans
IgA Vasculitis / epidemiology*
IgA Vasculitis / immunology
Immunoglobulin A*
Incidence
Linear Models
Male
Prospective Studies
Research Design
Surveys and Questionnaires

Substances

Immunoglobulin A