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Household presentation of acute gastroenteritis in a primary care sentinel network: retrospective database studies.
BMC Public Health ( IF 3.5 ) Pub Date : 2020-04-05 , DOI: 10.1186/s12889-020-08525-8
Simon de Lusignan 1, 2, 3 , Julian Sherlock 1, 2 , Filipa Ferreira 1, 2 , Sarah O'Brien 4 , Mark Joy 1, 2
Affiliation  

BACKGROUND Acute gastroenteritis (AGE) is a highly transmissible condition spreading rapidly between individuals and within households. Rotavirus vaccination was introduced in the UK in 2013. The study objectives were to investigate how acute gastroenteritis incidence changed over 25 years and household incidence of AGE since 2013. METHODS Repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network. We used a negative binomial model to report incidence rate ratio (IRR) using the last 5 years data. We also conducted a retrospective cohort analysis, using a shared gamma frailty model (2013-2017). We explored the impact of child under 5- years, household size, socioeconomic status quintile, and rurality. RESULTS In the cross-sectional analysis, the IRR of AGE in households with a child of under 5 years was 12.20 (95%CI 11.08-13.45-, p < 0.001) compared with households without; the IRR fell across IMD quintiles, for example there is a 37% decrease in incidence comparing IMD quintile 1 to quintile 5 (95%CI -0.52-0.76, p < 0.001), The cohort study revealed that the presence of an under 5 in the household was associated with a higher risk of household presentation (HR = 6.29, 95% CI 5.61-7.06, p < 0.001). In addition, we observe a reduction in risk of presentation from the most to the least deprived socioeconomic quintile (second quintile: HR = 0.74 (95%CI 0.59-0.92), to least deprived quintile, HR = 0.55 (95%CI 0.41-0.74). We saw a lower association with male gender, white ethnicity and living outside London, but an increased association with increasing household size. CONCLUSIONS The incidence of AGE has changed over time: pre-school children, larger households, and living in London were associated with higher rates, and male gender and higher economic status associated with lower rates.

中文翻译:

初级保健前哨网络中家庭急性胃肠炎的表现:回顾性数据库研究。

背景技术急性胃肠炎(AGE)是高度传播的疾病,其在个体之间和家庭内部迅速传播。轮状病毒疫苗于2013年在英国引入。研究目标是调查25年以来急性胃肠炎的发病率如何变化以及自2013年以来家庭的AGE发病率。方法皇家全科医生研究与监视中心网络的重复横断面研究。我们使用负二项式模型使用最近5年的数据报告发病率比率(IRR)。我们还使用共享的伽玛脆弱模型(2013-2017)进行了回顾性队列分析。我们探讨了5岁以下儿童,家庭规模,五分之一的社会经济地位和农村地区的影响。结果在横截面分析中,与没有孩子的家庭相比,有5岁以下孩子的家庭的AGE IRR为12.20(95%CI 11.08-13.45-,p <0.001);IMD五分位数的IRR下降,例如,与IMD五分位数1和5分位数相比,发生率降低了37%(95%CI -0.52-0.76,p <0.001)。队列研究显示,家庭的家庭出勤风险较高(HR = 6.29,95%CI 5.61-7.06,p <0.001)。此外,我们观察到呈现风险从社会经济最高的五分位数减少到最少的五分位数(第二个五分位数:HR = 0.74(95%CI 0.59-0.92),最小的五分位数HR = 0.55(95%CI 0.41- 0.74)。我们发现,与男性,白人和伦敦以外地区生活的关联度较低,但与家庭人数增加的关联度较高。
更新日期:2020-04-06
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