Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008
Notice bibliographique
Résumé
BACKGROUND: Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections. METHODS: The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors. RESULTS: Significant (p≤0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of 'households in core need' (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased 'internal mobility' (population moving between communities), and also where the community's primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis. CONCLUSIONS: These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information (e.g. missing data). Given the cultural, socioeconomic, and nutritional benefits associated with traditional food practices, targeted community-based collaborative research is necessary to more fully investigate the statistical correlations identified in this exploratory research. This study demonstrates the value of examining the role of social determinants in the transmission and risk of infectious diseases.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».