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

Overview of attention for article published in BMC Pediatrics, March 2015
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Title
A method for reporting and classifying acute infectious diseases in a prospective study of young children: TEDDY
Published in
BMC Pediatrics, March 2015
DOI 10.1186/s12887-015-0333-8
Pubmed ID
Authors

Maria Lönnrot, Kristian Lynch, Helena Elding Larsson, Åke Lernmark, Marian Rewers, William Hagopian, Jin-Xiong She, Olli Simell, Anette-G Ziegler, Beena Akolkar, Jeffrey Krischer, Heikki Hyöty, The TEDDY study group

Abstract

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. 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. 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. 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.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 58 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Finland 1 2%
Unknown 57 98%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 13 22%
Student > Master 8 14%
Student > Bachelor 6 10%
Researcher 6 10%
Student > Doctoral Student 3 5%
Other 9 16%
Unknown 13 22%
Readers by discipline Count As %
Medicine and Dentistry 17 29%
Nursing and Health Professions 11 19%
Biochemistry, Genetics and Molecular Biology 4 7%
Psychology 3 5%
Agricultural and Biological Sciences 2 3%
Other 7 12%
Unknown 14 24%