Gastro and Food Safety (One Health) Division, UK Health Security Agency, London, UK.
National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK.
Epidemiol Infect. 2023 Jun 14;151:e109. doi: 10.1017/S0950268823000869.
Infectious intestinal disease (IID) studies conducted at different levels of the surveillance pyramid have found heterogeneity in the association of socioeconomic deprivation with illness. The aim of this study was to analyse the association between socioeconomic deprivation and incidence of IID by certain gastrointestinal pathogens reported to UKHSA. Data were extracted from 2015 to 2018 for species, and norovirus. Rates were calculated per 100,000 person-years by the index of multiple deprivation quintile, and an ecological analysis was conducted using univariant and multvariable regression models for each pathogen. Incidence of species decreased with increasing deprivation. Conversely, the incidence of norovirus, non-typhoidal , /paratyphi species increased with increasing deprivation. Multivariable analysis results showed that higher deprivation was significantly associated with higher odds of higher number of cases for , norovirus /paratyphi. Infections most associated with deprivation were those transmitted by person-to-person spread, and least associated were those transmitted by zoonotic contamination of the environment. Person-to-person transmission can be contained by implementing policies targeting over-crowding and poor hygiene. This approach is likely to be the most effective solution for the reduction of IID.
在不同监测层级开展的传染性肠道疾病（IID）研究发现，社会经济剥夺与疾病的相关性存在异质性。本研究旨在通过向英国卫生安全局报告的某些胃肠道病原体分析社会经济剥夺与 IID 发病之间的关联。从 2015 年至 2018 年提取了有关物种和诺如病毒的数据。采用多因素剥夺五分位数指数计算了每 10 万人年的发病率，并针对每种病原体采用单变量和多变量回归模型进行了生态分析。物种的发病率随着剥夺程度的增加而降低。相反，诺如病毒、非伤寒型/副伤寒型血清型的发病率随着剥夺程度的增加而增加。多变量分析结果表明，较高的剥夺程度与更多病例和更高数量的病例显著相关，如、诺如病毒/副伤寒。与剥夺程度关联最密切的感染是通过人与人之间传播的感染，而与环境中动物源污染传播的感染关联最小。通过实施针对过度拥挤和不良卫生条件的政策可以控制人与人之间的传播。这种方法可能是减少 IID 的最有效解决方案。
