Rose Tanith C, Adams Natalie L, Barr Benjamin, Hawker Jeremy, O'Brien Sarah J, Violato Mara, Whitehead Margaret, Taylor-Robinson David C
NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.
Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
BMC Infect Dis. 2017 Jun 23;17(1):447. doi: 10.1186/s12879-017-2551-1.
The burden of infectious intestinal disease (IID) in the UK is substantial. Negative consequences including sickness absence are common, but little is known about the social patterning of these outcomes, or the extent to which they relate to disease severity.
We performed a cross-sectional analysis using IID cases identified from a large population-based survey, to explore the association between socioeconomic status (SES) and symptom severity and sickness absence; and to assess the role of symptom severity on the relationship between SES and absence. Regression modelling was used to investigate these associations, whilst controlling for potential confounders such as age, sex and ethnicity.
Among 1164 cases, those of lower SES versus high had twice the odds of experiencing severe symptoms (OR 2.2, 95%CI;1.66-2.87). Lower SES was associated with higher odds of sickness absence (OR 1.8, 95%CI;1.26-2.69), however this association was attenuated after adjusting for symptom severity (OR 1.4, 95%CI;0.92-2.07).
In a large sample of IID cases, those of low SES versus high were more likely to report severe symptoms, and sickness absence; with greater severity largely explaining the higher absence. Public health interventions are needed to address the unequal consequences of IID identified.
在英国,感染性肠道疾病(IID)的负担相当大。包括因病缺勤在内的负面后果很常见,但对于这些后果的社会模式,或者它们与疾病严重程度的关联程度,人们知之甚少。
我们利用从一项大型基于人群的调查中识别出的IID病例进行了横断面分析,以探讨社会经济地位(SES)与症状严重程度和因病缺勤之间的关联;并评估症状严重程度在SES与缺勤关系中的作用。使用回归模型来研究这些关联,同时控制年龄、性别和种族等潜在混杂因素。
在1164例病例中,社会经济地位较低者与较高者相比,出现严重症状的几率是后者的两倍(比值比2.2,95%置信区间;1.66 - 2.87)。社会经济地位较低与因病缺勤的几率较高相关(比值比1.8,95%置信区间;1.26 - 2.69),然而在调整症状严重程度后,这种关联减弱(比值比1.4,95%置信区间;0.92 - 2.07)。
在大量IID病例样本中,社会经济地位低者与高者相比,更有可能报告严重症状和因病缺勤;症状严重程度更高在很大程度上解释了缺勤率更高的原因。需要采取公共卫生干预措施来应对已发现的IID带来的不平等后果。