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加拿大温尼伯市中心区衣原体和淋病新发感染的流行病学及人群归因分数

Epidemiology of incident chlamydia and gonorrhoea infections and population attributable fractions associated with living in the inner-core of Winnipeg, Canada.

作者信息

Shaw Souradet Y, Nowicki Deborah L, Schillberg Erin, Green Christopher G, Ross Craig P, Reimer Joss, Plourde Pierre J, Elliott Lawrence J

机构信息

1 Population Health Surveillance, Population and Public Health Program, Winnipeg Regional Health Authority, Canada.

2 Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Canada.

出版信息

Int J STD AIDS. 2017 May;28(6):550-557. doi: 10.1177/0956462415614168. Epub 2016 Jul 10.

Abstract

Population attributable fractions help to convey public health significance of differential disease risk for chlamydia and gonorrhoea. Geographical residence serves as a useful proxy for complex processes creating ill health. Using population-based data, Poisson regression models were used to examine factors associated with chlamydia and gonorrhoea incidence. Population attributable fractions due to residency in the Winnipeg Health Region's inner-core were determined for chlamydia/gonorrhoea infections among 15-59-year olds (2005-2013), stratified by age group. For both chlamydia and gonorrhoea, it was found that the 15-24-year old age group had the highest incidence rates. There was also a stronger association between residency in the inner-core and incidence for gonorrhoea, compared to chlamydia. Overall, 24% (95% CI: 12-34%) of chlamydia infections were attributable to residency in the inner-core, compared to 46% (95% CI: 35-54%) for gonorrhoea ( p < .05). Within chlamydia/gonorrhoea, no statistically significant differences in population attributable fraction were observed by age group. The conclusion was that a concentration of efforts towards inner-core residents with gonorrhoea infections may result in a relatively larger decrease in incidence.

摘要

人群归因分数有助于传达衣原体和淋病疾病风险差异的公共卫生意义。地理居住情况可作为造成健康不良的复杂过程的有用替代指标。利用基于人群的数据,采用泊松回归模型来研究与衣原体和淋病发病率相关的因素。针对温尼伯健康区域内核心区居民,确定了2005年至2013年15至59岁人群衣原体/淋病感染的人群归因分数,并按年龄组进行分层。对于衣原体和淋病,均发现15至24岁年龄组的发病率最高。与衣原体相比,内核心区居住情况与淋病发病率之间的关联也更强。总体而言,24%(95%置信区间:12 - 34%)的衣原体感染可归因于内核心区居住情况,而淋病这一比例为46%(95%置信区间:35 - 54%)(p < 0.05)。在衣原体/淋病范围内,各年龄组在人群归因分数方面未观察到统计学上的显著差异。结论是,针对感染淋病的内核心区居民集中开展防治工作可能会使发病率相对大幅下降。

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