Perthes' disease in the UK: Geographic and temporal trends in incidence reflecting deprivation inequalities in childhood.


Perry, DC; Bruce, CE; Pope, D; Dangerfield, P; Platt, MJ; Hall, AJ; (2011) Perthes' disease in the UK: Geographic and temporal trends in incidence reflecting deprivation inequalities in childhood. Arthritis and rheumatism. ISSN 0004-3591 DOI: 10.1002/art.34316

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Abstract

: OBJECTIVE: Perthes' disease is a common childhood precursor to osteoarthritis of the hip, of which little is known. We analysed the UK incidence of disease, with respect to geographic and temporal trends over a 19-year period. METHODS: The General Practice Research database was analysed between 1990 and 2008 to identify incident cases in children aged 0-14 years old. Incidence rates were calculated by year and region, and the association with regional markers of deprivation examined. RESULTS: Over the 19-year period there was a dramatic decline in incidence with annual rates falling from 12·2 to 5·7 cases/100,000 children 0-14 years old (p< 0·001). There was also marked geographic variation with incidence rates in Scotland more than twice those in London (10·39 (95% CI 8·05 - 13·2) vs. 4·6 (95% CI 3·4 - 6·1) per 100,000 0-14 year olds). A more rapid decline in incidence was apparent in the Northern regions compared to Southern regions. The most deprived quintile had the highest disease incidence (rate ratio 1·49 (95% CI 1·10 - 2·04)) and, with the exception of London, regional incidence showed a strong linear relationship to regional deprivation score (p<0·01). CONCLUSION: The incidence of Perthes' disease has a strong North-South divide, with a greater disease incidence within the Northern regions of the UK. There is a marked decline in incidence over the study period, which is more marked in Northern areas. The declining incidence, along with the geographic variation, suggests that a major aetiological determinant in Perthes' disease is environmental, which is closely linked to childhood deprivation.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
PubMed ID: 22143958
Web of Science ID: 303239000041
URI: http://researchonline.lshtm.ac.uk/id/eprint/61433

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