Epidemiology and Health

Original Article

Estimation of the size of the iatrogenic Creutzfeldt-Jakob disease outbreak associated with cadaveric dura mater grafts in Korea: Byoung-Hak Jeon, Jinseob Kim, Ganghyun Kim, Soochul Park, SangYun Kim, Hae-Kwan Cheong; Epidemiol Health. 2016;38:e2016059. Published online December 19, 2016; DOI: https://doi.org/10.4178/epih.e2016059

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Abstract

OBJECTIVES
This study estimated the overall incidence of iatrogenic Creutzfeldt-Jakob disease (iCJD) based on dura graft cases in Korea using a mathematical model.

METHODS

We estimated the number of annual dura grafts performed between 1980 and 1995 by applying the proportion of dura grafts recorded by the Health Insurance Review Agency claim dataset in Korea to the number of nationwide neurosurgery cases. The distribution of the incubation period was assumed to fall under a Weibull distribution with density function or a log-logistic distribution with density function.

RESULTS

The total number of neurosurgery procedures performed from 1980 to 1995 was estimated to be 263,945, and among those operations, 37% used dura graft products. Between the years of 1980 and 2020, our model predicted that the total number of iCJD cases would be between 14.9 and 33.2 (95% confidence interval [CI], 13.4 to 50.9). Notably, we estimated that the cumulative number of iCJD cases caused by dura grafts between 1980 and 2011 was approximately 13.3 to 27.3 (95% CI, 12.2 to 40.6).

CONCLUSIONS

Based on our model, we postulate that the incidence of iCJD will sharply decline from 2012 to 2020. However, additional new cases are still expected, which necessitates a strong national surveillance system.

Summary

Korean summary
국내 경막유래 의인성 크로이츠펠트-증후군 환자의 발생규모 추정 본 연구는 국내 가용한 모든 자료원을 활용하여 국내 의인성 CJD 위험인구를 추산하고 이를기반으로 발생 가능한 의인성 CJD 환자의 규모를 수학적 모형을 통해 추산하는 것을 목적으로 시행하였으며, 예측모형 결과 2020년까지 가파르게 감소할것으로 보이나, 추가 발생에 대비한 국가감시체계의 강화가 필요할것으로 사료된다.

Citations

Citations to this article as recorded by

Interventions to reduce the risk of surgically transmitted Creutzfeldt–Jakob disease: a cost-effective modelling review
Matt Stevenson, Lesley Uttley, Jeremy E Oakley, Christopher Carroll, Stephen E Chick, Ruth Wong
Health Technology Assessment.2020; 24(11): 1. CrossRef

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