Baker M, McNicholas A, Garrett N, Jones N, Stewart J, Koberstein V, Lennon D
Institute of Environmental Science and Research, Wellington, New Zealand.
Pediatr Infect Dis J. 2000 Oct;19(10):983-90. doi: 10.1097/00006454-200010000-00009.
New Zealand is in its ninth year of a serogroup B meningococcal disease epidemic with annual rates of up to 16.9 cases per 100,000. The highest incidence is in Maori and Pacific Island children in the Auckland region. We conducted a case-control study to identify potentially modifiable risk factors for this disease.
A case-control study of 202 cases of confirmed and probable meningococcal disease in Auckland children younger than 8 years of age recruited from May, 1997, to March, 1999, was undertaken. Controls (313) were recruited door-to-door by a cluster sampling method based on starting points randomly distributed in the Auckland region. They were frequency matched with the expected distribution of age and ethnicity in the meningococcal disease cases.
With the use of a multivariate model and controlling for age, ethnicity, season and socioeconomic factors, risk of disease was strongly associated with overcrowding as measured by the number of adolescent and adult (10 years or older) household members per room [odds ratio (OR), 10.7; 95% confidence interval (CI), 3.9 to 29.5]. This would result in a doubling of risk with the addition of 2 adolescents or adults to a 6-room house. Risk of disease was also associated with analgesic use by the child, which was thought to be a marker of recent illness (OR 2.4, CI 1.5 to 4.0); number of days at substantial social gatherings (10 or more people for > 4 h; OR 1.8, CI 1.2 to 2.6); number of smokers in the household (OR 1.4, CI 1.0 to 1.8); sharing an item of food, drink or a pacifier (OR 1.6, CI 1.0 to 2.7); and preceding symptoms of a respiratory infection (cough, "cold or flu," runny nose, sneezing) in a household member (OR 1.5, CI 1.0 to 2.5).
Some of these identified risk factors for meningococcal disease are modifiable. Measures to reduce overcrowding could have a marked effect on reducing the incidence of this disease in Auckland children.
新西兰正处于B群脑膜炎球菌病流行的第九个年头，年发病率高达每10万人16.9例。发病率最高的是奥克兰地区的毛利族和太平洋岛屿儿童。我们进行了一项病例对照研究，以确定这种疾病潜在的可改变风险因素。
对1997年5月至1999年3月招募的202例确诊和疑似脑膜炎球菌病的8岁以下奥克兰儿童进行了病例对照研究。通过基于奥克兰地区随机分布的起始点的整群抽样方法挨家挨户招募对照（313名）。他们在年龄和种族方面与脑膜炎球菌病病例的预期分布进行了频率匹配。
在使用多变量模型并控制年龄、种族、季节和社会经济因素后，疾病风险与拥挤程度密切相关，拥挤程度通过每间房青少年和成人（10岁及以上）家庭成员数量来衡量[比值比（OR），10.7；95%置信区间（CI），3.9至29.5]。在一间有6个房间的房子里增加2名青少年或成人会使风险加倍。疾病风险还与儿童使用镇痛药有关，这被认为是近期患病的一个指标（OR 2.4，CI 1.5至4.0）；参加大型社交聚会的天数（10人或更多，持续超过4小时；OR 1.8，CI 1.2至2.6）；家庭中吸烟者的数量（OR 1.4，CI 1.0至1.8）；共用食物、饮料或安抚奶嘴（OR 1.6，CI 1.0至2.7）；以及家庭成员出现呼吸道感染的前驱症状（咳嗽、“感冒或流感”、流鼻涕、打喷嚏）（OR 1.5，CI 1.0至2.5）。
这些确定的脑膜炎球菌病风险因素中的一些是可以改变的。减少拥挤的措施可能对降低奥克兰儿童这种疾病的发病率有显著效果。
