BACKGROUND: Despite significant progress in the epidemiology of chronic pain in adults, major gaps remain in our understanding of the epidemiology of chronic pain in children. In particular, the incidence, prevalence and sensory characteristics of many types of pain in Canadian children are unknown.OBJECTIVES: A study to obtain the lifetime and point prevalence of common acute pains, recurrent pain syndromes and chronic pains was conducted in a cohort of 495 school children, nine to 13 years of age, in eastern Ontario.METHODS: Children reported their pain experiences and described the intensity, affect and duration of the pains experienced over the previous month by completing the Pain Experience Interview –Short Form.RESULTS: The majority of children (96%) experienced some acute pain over the previous month, with headache (78%) being most frequently reported. Lifetime prevalence for certain acute pains differed significantly by sex (P<0.05). Fifty-seven per cent of children reported experiencing at least one recurrent pain, while 6% were identified as having had or currently having chronic pain.DISCUSSION: The prevalence of acute pain in this Canadian cohort is consistent with international estimates of acute pain experiences (ie, headache) and recurrent pain problems (ie, recurring headache, abdominal pain and growing pains). However, 6% of children reported chronic pain. The self-completed Pain Experience Interview – Short Form provides a feasible administration technique for obtaining population estimates of childhood pain, and for conducting longitudinal studies to identify risk and prognostic factors for chronic pain.
Objective:There is a paucity of information regarding the usefulness of non-traditional data streams for real-time syndromic surveillance systems. The objective of this paper is to examine the temporal relation between Ontario's emergency department (ED) visits and telephone health line (Telehealth) call volume for respiratory illnesses to test the feasibility of using Ontario's Telehealth system for real-time surveillance.Methods:Retrospective time-series data from the National Ambulatory Care Reporting System (NACRS) and the Telehealth Ontario program from June 1, 2004, to March 31, 2006, were analyzed. The added value of Telehealth Ontario data was determined by comparing it temporally with NACRS data, which uses the International Classification of Diseases (ICD) 10-Canadian Enhancement coding system for discharge diagnoses.Results:Telehealth Ontario had 216 105 calls for respiratory complaints, while 819 832 ICD-coded complaints from NACRS were identified with a comparable diagnosis of respiratory illness. Telehealth Ontario call volume was heavily weighted for the 0–4 years age group (49%), while the NACRS visits were mainly from those 18–64 years old (44%). The Spearman rank correlation coefficient was calculated to be 0.97, with the time-series analysis also resulting in significant correlations at lags (semi-monthly) 0 and 1, indicating that increases in Telehealth Ontario call volume correlate with increases in NACRS discharge diagnosis data for respiratory illnesses.Conclusion:Telehealth Ontario call volume fluctuation reflects directly on ED respiratory visit data on a provincial basis. These call complaints are a timely, useful and representative data stream that shows promise for integration into a real-time syndromic surveillance system.
These findings support the use of an Emergency Department Syndromic Surveillance system to track the incidence of respiratory viral disease in the community. These methods are efficient and can be performed using automated electronic data entry versus the inherent delays in the primary care sentinel surveillance system, and can aid the timely implementation of preventive and preparatory health interventions.
To validate the utility of a chief complaint–based emergency department surveillance system, we compared it with respiratory diagnostic data and calls to Telehealth Ontario about respiratory disease. This local syndromic surveillance system accurately monitored status of respiratory diseases in the community and contributed to early detection of respiratory disease outbreaks.
BACKGROUND: Despite increasing attention to the epidemiology of pain, relatively little is known about the association between pain and health in children. In particular, no studies have examined this relationship in the general population of children in Canada.OBJECTIVES: To assess the association between self-reported pain experiences and health in school children in southeastern Ontario. Health measures included perceived health status, psychological complaints and satisfaction with school.METHODS: A total of 495 nine-to 13-year-old school children completed the Pain Experience Interview – Short Form and health-related questions from the Health Behaviour in School-aged Children questionnaire.RESULTS: Of the 495 children in the present study, 8% rated their health as ‘fair’ to ‘poor’, 56% reported experiencing at least one of four psychological symptoms more than once a week and 24% said they disliked school. The strongest associations existed between headaches and poor self-rated health (OR=10.1; 95% CI 1.3 to 78.3), recurrent pain and psychological outcomes (OR=3.6; 95% CI 2.0 to 6.3), and recurrent pain and disliking school (OR=3.6; 95% CI 1.9 to 6.7).DISCUSSION: These findings indicate that common childhood pains are associated with childhood health. Further studies are needed to assess the causal relationship between pain and health in children, to obtain a more comprehensive understanding of the personal and economic impact of childhood pain, and to monitor changes in the lives of children living with chronic pain.
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