[Estimated prevalence of cerebral neoplasm of childhood from the capture-recapture method]. / Estimativa da prevalência de neoplasia cerebral na faixa etária pediátrica pelo método de captura-recaptura.

The aim of the study was to estimate the prevalence and fatality rate of primary cerebral neoplasms among children between 1 and 15 years old, State of Bahia, Brazil, 1995. It was a cross-sectional study which includes all cases of brain tumors diagnosed by several sources. From these cases the capture-recapture method was used to estimate the probable number of cases and measure the prevalence and confidence intervals at 95%. By this method it was estimated the existence of 87 cases (CI = 64; 111) of brain tumors in the State, being 72 (CI = 54; 91) in the capital. The estimated prevalence was 1.85/100,000 for children between 1 to 15 years old (CI = 1.36; 2.36/100,000) for the State, and 10.1/100,000 (CI = 7.58; 12.77/100,000) for the capital. The fatality rate was 5.4 percent (CI = 4%; 8%), and 8.9% (CI = 7%; 13%) for the capital and the State respectively. The capture-recapture method showed high precision to estimate the total number of cases. Possible causes of no diagnostic nor treatment of cerebral neoplasms are discussed.

[Clinical epidemiological aspects of cerebral neoplasms in childhood in the State of Bahia, Brazil]. / Aspectos clínico-epidemiológicos das neoplasias cerebrais na faixa etária pediátrica no estado da Bahia, Brasil.

The aim of this study is to describe the relevant aspects of the medical treatment and epidemiology of brain tumors in children between 1 and 15 years old in the State of Bahia, Brazil, first semester of 1995. A cross-sectional design was used for the survey of all new cases and preexisting cases of brain tumors diagnosed through neuroimage among all the children who completed these examinations. Forty eight out of 2,128 were diagnosed as brain tumors, 19 of which being incident cases. In the clinical epidemiological study, the prevalence was 2.3 percent, and the incidence was 0.9 percent. In the prevalent cases, males predominated (1.4:1), and the average age of 10-15 years old (65%). Among the 1-4 years old group predominated incident cases. The astrocytoma was the most frequent brain tumor (41%), and the supratentorial localization predominated by 52%. The ataxia and/or paralysis of cranial nerve and the endocrine and/or visual disturbance symptomatic groups were the most prevalent (82% and 43%, respectively). We discuss the supratentorial localization and the adolescent group predomination in cerebral neoplasms in childhood.

[Association of signs and symptoms with cerebral neoplasms in infancy] / Associação de sinais e sintomas com neoplasias cerebrais na infância.

OBJECTIVE: To validate groups of cerebral neoplasia symptoms/signs capable of performing diagnosis of children with neoplasia, with a higher reliability. METHODS: Cross-sectional survey, clinical-epidemiological, and double-blind survey for cerebral neoplasia diagnosis based on data from encephalic and cranial computered tomography scanning (ECCT) and/or magnetic resonance imaging (MRI) services in the state of Bahia, first semester of 1995. A total of 753 children from 1 to 15 years of age, with exams and information regarding symptoms/signs were included. These were classified in 4 groups (1 to 4), according to location of the cerebral tumor. The ECCT and/or MRI were the gold standard and independent evaluation for each group. Basic calculation: sensibility, specificity, negative and positive predictive values (PPV), accuracy, pretest prevalence, and confidence interval (CI) at 95%. Complementary: Bias, odd ratio (OR), prevalence ratio (PR) and Kappa (k) with qualification of validation. RESULTS: 34 cases of tumors were detected, with the loss of one; prevalence of 4,4%. Evaluation results >/= 90% for group 2 symptoms/signs (ataxia and/or cranial nerves palsy), except PPV = 82%; elevated k, and "optimal" evaluation. It was the best tumor predictive group. The prevalence CI was significant, with small amplitudes. Group 3 (endocrine/visual dysfunction), was optimal for k, but with a lower PPV. CONCLUSION: Symptoms/signs of group 2 are important for cerebral tumor diagnosis, followed by group 3. A complete anamneses and neurological examination of children with cephalea and/or seizures are important for screening and reference to bioimaging services. High number of normal exams increases assistance costs, becoming a negative factor for children who really need the exams.