ab226015

Prevalence of pediatric systemic lupus erythematosus and juvenile chronic arthritis in a Chinese population: A nation-wide prospective population-based study in Taiwan

J.-L. Huang¹, T.-C. Yao^1,2, L.-C. See³

¹Department of Pediatrics, ²Graduate Institute of Clinical Medical Science, ³Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

ABSTRACT
Objective
To estimate the national prevalence of systemic lupus erythematosus (SLE) and juvenile chronic arthritis (JCA) in Chinese children in Taiwan.

Methods
A nationwide prospective population based epidemiologic study for the prevalence of pediatric SLE and JCA was undertaken in Taiwan (23 million inhabitants). The population at risk was identified as children under the age of 16 living in Taiwan (5.78 million). All citizens have been obligated to participate in Taiwan's National Health Insurance program since 1995. This gave us access to nationwide case data from the Major Illness/Injury registry and enabled us to calculate population prevalence. The population data were derived from the 1999 Taiwan census.

Results
Three hundred sixty-five and 218 prevalent cases of pediatric SLE and JCA were identified, respectively. The prevalence of pediatric SLE was 6.3 per 100,000 (95% CI: 5.7-7.0). The prevalence in girls (11.2 per 100,000, 95% CI: 10.0-12.5) was 6.2 times higher than that in boys (1.8 per 100,000, 95% CI: 1.4-2.4). The prevalence of SLE substantially increased in children over the age of seven, especially in girls. The prevalence of JCA was 3.8 per 100,000 (95% CI: 3.3-4.3). The figures were similar for boys (3.5 per 100,000, 95% CI: 2.9-4.2) and girls (4.1 per 100,000, 95% CI: 3.3-4.9).

Conclusion
In this first population based epidemiologic survey of pediatric SLE and JCA in Taiwan, we provided a good starting point in our understanding of the epidemiology of these serious conditions in the Chinese population. The discrepancies between our prevalence figures and those reported from Western countries are possibly the results from true differences pertaining to ethnicity, geography or both. Future studies are necessary to elucidate the implications suggested by these data.

Key words
Systemic lupus erythematosus, juvenile chronic arthritis, prevalence, Chinese, children, epidemiology.

Abbreviations:
SLE: systemic lupus erythematosus
JCA: juvenile chronic arthritis
MII: Major Illness/Injury
NHI: National Health Insurance
BNHI: Bureau of National Health Insurance
ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification
CI: confidence interval

Please address correspondence and reprint requests to: Dr. Jing-Long Huang, Department of Pediatrics, Chang Gung Children's Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan, Taiwan.
E-mail: long@adm.cgmh.org.tw

or Dr. Lai-Chu See, Department of Public Health, College of Medicine, Chang Gung University, No. 259, Wen Hwa 1st Road, Kweishan, Taoyuan, Taiwan.
E-mail: lichu@mail.cgu.edu.tw