Disease Burden of Diarrheal and Respiratory Disorders in Children: Hong Kong Perspectives
Diarrheal and respiratory infections are leading causes of pediatric hospital admission in Hong Kong. Since 1996, all Hong Kong government hospitals routinely collect computerize information on all admissions, enabling disease burden of diarrheal and respiratory disorders to be estimated. These data showed that, for the 2-year period 1 July 1997 to 30 June 1999, diarrheal diseases accounted for 11.5% of general pediatric admissions under 5 years and that respiratory disorders accounted for 37.5% of general pediatric admissions under 15 years. However linking these data to laboratory reports from one hospital showed significant discrepancies between actual diagnoses and the specific pathogens identified, emphasizing that there was significant under-reporting of diseases due to specific pathogens. An active sentinel surveillance study for rotavirus and diarrheal diseases, involving four hospitals from 1 April 2001 to 31 March 2003, confirmed these underestimates and highlighted the potential for establishing a sustainable surveillance system. Such a system would require one or more sentinel hospitals routinely collecting and testing specimens from all diarrheal and respiratory associated admissions for identification of specific viral and bacterial etiological agents. These laboratory data would then need to be linked to routinely collected passive surveillance hospital admission data and with government census data to provide reliable disease burden estimates. Such a system has the potential to meet the goals of the new WHO initiative known as the Global Framework for Immunization Monitoring and Surveillance, which aims to strengthen surveillance and program monitoring of vaccine preventable diseases.
KeywordsRespiratory Syncytial Virus Diarrheal Disease Stool Specimen Immigrant Child Vaccine Preventable Disease
List of Abbreviations:
Asian rotavirus surveillance network
clinical management system
global framework for immunization monitoring and surveillance
International Classification of Diseases
millennium development goals
program for appropriate technology in health
respiratory syncytial virus
United Nations Children's Fund
World Health Organization
The Statistics and Research Section, Hospital Authority provided the pediatric hospitals admission dataset, from the HA data warehouse, used in these analyses.
- Bresee J, Fang ZY, Wang B, Nelson EA, Tam J, Soenarto Y, Wilopo SA, Kilgore P, Kim JS, Kang JO, Lan WS, Gaik CL, Moe K, Chen KT, Jiraphongsa C, Ponguswanna Y, Nguyen VM, Phan VT, Le TL, Hummelman E, Gentsch JR, Glass R, Asian Rotavirus SN. (2004). Emerg Infect Dis. 10(6): 988–995.PubMedGoogle Scholar
- WHO. (2002). Generic Protocol for (i) Hospital-Based Surveillance to Estimate the Burden of Rotavirus Gastroenteritis in Children and (ii) A Community-Based Survey on Utilization of Health Care Services for Gastroenteritis in Children. Field test version (WHO/V&B/02.15). WHO publication, WHO/V&B/02.15.Google Scholar