Current status of radiological Kashin-Beck disease among school-aged children in Chamdo City, Tibet
10.3760/cma.j.cn121113-20230523-00297
- VernacularTitle:西藏自治区昌都市学龄儿童大骨节病X线阳性病例的现况分析
- Author:
Jiaxiang GAO
1
;
Hu LI
;
Liyi ZHANG
;
Zihao HE
;
Ziyi YANG
;
Zhichang LI
;
Kai WANG
;
Yan KE
;
Qiang LIU
;
Shu ZHANG
;
Xiaobo CHENG
;
Shuai CHAI
;
Zhaoyang MENG
;
Lipeng SUN
;
Qunwei LI
;
Hongqiang GONG
;
Jianhao LIN
Author Information
1. 北京大学人民医院骨关节科（北京大学关节病研究所），北京 100044
- Keywords:
Tibet;
Child;
Kashin-Beck disease;
Epidemiologic studies
- From:
Chinese Journal of Orthopaedics
2024;44(1):33-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to explore the status of radiological Kashin-Beck disease (KBD) among school-aged children in Chamdo City, Tibet, through a 3-year monitoring survey, providing epidemiological evidence for prevention and control strategies.Methods:The target areas for this study were Luolong, Bianba, and Basu counties in Chamdo City, Tibet Autonomous Region, identified as having the most severe historical cases of KBD. Children aged 7-12 years attending school were enrolled as study subjects. Anteroposterior X-ray films of the right-hand were taken, and radiological diagnoses were made based on the "Diagnosis of Kashin-Beck Disease" criteria (WS/T 207-2010). Two experienced researchers independently reviewed the X-rays, and intra- and inter-group consistency were assessed using weighted Kappa values and percentage agreement. Cross-sectional surveys were conducted in 2017 and 2020 to describe the X-ray detection rates of KBD, and logistic regression analysis was employed to construct a predictive model of risk factors for radiological KBD cases.Results:In 2017, a total of 5,711 children aged 7-12 years in Chamdo City, Tibet, participated in the baseline cross-sectional survey (average age 9.2 years, 48.0% female), with 28 cases of radiological KBD. The age- and gender-standardized prevalence rate was 0.527%. In 2020, 6,771 participants (average age 9.3 years, 49.5% female) underwent a second cross-sectional survey, with 9 cases of radiological KBD and a standardized prevalence rate of 0.134%. Logistic regression analysis indicated that older age [ OR=2.439, 95% CI(1.299, 4.580), P=0.006] and female gender [ OR=8.157, 95% CI(1.016, 65.528), P=0.048] were independent risk factors for radiological KBD cases. Conversely, higher residential altitude, under the premise of Tibet's high altitude, was a protective factor [ OR=0.995, 95% CI(0.990, 0.999), P=0.032). Conclusion:The radiographically positive detection rate of KBD among school-aged children in Chamdo City, Tibet Autonomous Region, is at an extremely low level and showing a declining trend, reaching the historical standard in 2020. Considering the absence of positive signs in affected children, it suggests that local KBD has been effectively eliminated.
