Low N, Sterne J A, Barlow D
Department of Social Medicine, University of Bristol, UK.
Sex Transm Infect. 2001 Feb;77(1):15-20. doi: 10.1136/sti.77.1.15.
To examine differences in population based rates of gonorrhoea and chlamydia between black ethnic groups in Lambeth, Southwark and Lewisham Health Authority.
Episodes of gonorrhoea or chlamydia recorded among attenders at 11 genitourinary clinics in south and central London from 1 January 1994 to 31 December 1995 were retrieved. Complete data on chlamydia were only available for women. Ethnic group was assigned according to census categories--white, black Caribbean, black African, black other, Asian, or other. We calculated yearly incidence rates for episodes of gonorrhoea and chlamydia in residents of Lambeth, Southwark and Lewisham Health Authority. Random effects Poisson regression models were used to examine associations between infection rates and age, ethnic group, and material deprivation.
During the study period there were 1996 episodes of gonorrhoea in men and women and 1376 episodes of chlamydia in women with complete data. For both infections rates among individuals from black Caribbean and black other ethnic groups were markedly higher than among black Africans. In men, the gonorrhoea rate among black Caribbean 20-24 year olds was 2348 (95% CI 1965 to 2831) episodes per 100,000 compared with 931 (95% CI 690 to 1288) in black African men and 111 (95% CI 100 to 124) per 100,000 in white men of the same age. Among women gonorrhoea rates were highest in black Caribbean 15-19 year olds (2612, 95% CI 2161 to 3190 per 100,000). In contrast, rates in black African women of the same age (331, 95% CI 154 to 846 per 100,000) were similar to those of white women (222, 95% CI 163 to 312). Chlamydia rates were also highest in black Caribbean 15-19 year old women (4579, 95% CI 3966 to 5314 per 100,000), compared with 1286 (95% CI 907 to 1888) in black African and 433 (95% CI 349 to 544) per 100,000 white women. Controlling for material deprivation and age only attenuated differences in rates between ethnic groups slightly.
There are marked differences in rates of gonorrhoea and chlamydia between different black ethnic groups, with higher rates in black Caribbeans than black Africans. This study supports the hypothesis that assortative sexual mixing patterns can restrict epidemics of sexually transmitted infections within ethnic groups. Differences in disease occurrence between black ethnic groups should be explored before combining data, even when numbers of episodes are small.
研究伦敦南部兰贝斯区、南华克区和刘易舍姆区黑人族裔人群中淋病和衣原体感染率的差异。
检索1994年1月1日至1995年12月31日期间伦敦市中心和南部11家泌尿生殖科诊所就诊者中记录的淋病或衣原体感染病例。仅获得了女性衣原体感染的完整数据。根据人口普查类别划分种族——白人、加勒比黑人、非洲黑人、其他黑人、亚洲人或其他种族。我们计算了兰贝斯区、南华克区和刘易舍姆区居民淋病和衣原体感染病例的年发病率。采用随机效应泊松回归模型研究感染率与年龄、种族和物质匮乏之间的关联。
研究期间，男性和女性共有1996例淋病病例，有完整数据的女性衣原体感染病例有1376例。加勒比黑人和其他黑人种族个体的两种感染率均明显高于非洲黑人。在男性中，20 - 24岁加勒比黑人的淋病发病率为每10万人2348例（95%可信区间1965至2831），而同年龄非洲黑人男性为931例（95%可信区间690至1288），白人男性为每10万人111例（95%可信区间100至124）。在女性中，15 - 19岁加勒比黑人的淋病发病率最高（每10万人2612例，95%可信区间2161至3190）。相比之下，同年龄非洲黑人女性的发病率（每10万人331例，95%可信区间154至846）与白人女性（222例，95%可信区间163至312）相似。衣原体感染率在15 - 19岁加勒比黑人女性中也最高（每10万人4579例，95%可信区间3966至5314），而非洲黑人女性为1286例（95%可信区间907至1888），白人女性为每10万人433例（95%可信区间349至544）。仅对物质匮乏和年龄进行控制，种族间感染率的差异仅略有减弱。
不同黑人种族之间淋病和衣原体感染率存在显著差异，加勒比黑人的感染率高于非洲黑人。本研究支持选择性性混合模式可限制族裔内部性传播感染流行的假说。在合并数据之前，即使病例数较少，也应探究黑人种族间疾病发生率的差异。
