Dataset Information

Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992-2017): cross-sectional and retrospective cohort study protocol.

ABSTRACT: INTRODUCTION:Acute gastroenteritis (AGE) is a highly transmissible condition. Determining characteristics of household transmission will facilitate development of prevention strategies and reduce the burden of this disease.We are carrying out this study to describe household transmission of medically attended AGE, and explore whether there is an increased incidence in households with young children. METHODS AND ANALYSIS:This study used the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, comprising data from 1 750 167 registered patients (August 2017 database). We conducted a novel analysis using a 'household key', to identify patients within the same household (n=811 027, mean 2.16 people). A 25-year repeated cross-sectional study will explore the incidence of medically attended AGE overall and then a 5-year retrospective cohort study will describe household transmission of AGE. The cross-sectional study will include clinical data for a 25-year period-1 January 1992 until the 31 December 2017. We will describe the incidence of AGE by age-band and gender, and trends in incidence. The 5-year study will use Poisson and quasi-Poisson regression to identify characteristics of individuals and households to predict medically attended AGE transmitted in the household. This will include whether the household contained a child under 5 years and the age category of the first index case (whether adult or child under 5 years). If there is overdispersion and zero-inflation we will compare results with negative binomial to handle these issues. ETHICS AND DISSEMINATION:All RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. The protocol follows STrengthening the Reporting of OBservational studies in Epidemiology guidelines (STROBE). The study results will be published in a peer-review journal, the dataset will be available to other researchers.

SUBMITTER: de Lusignan S

PROVIDER: S-EPMC6112382 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992-2017): cross-sectional and retrospective cohort study protocol.

de Lusignan Simon S Konstantara Emmanouela E Joy Mark M Sherlock Julian J Hoang Uy U Coyle Rachel R Ferreira Filipa F Jones Simon S O'Brien Sarah J SJ

BMJ open 20180823 8

<h4>Introduction</h4>Acute gastroenteritis (AGE) is a highly transmissible condition. Determining characteristics of household transmission will facilitate development of prevention strategies and reduce the burden of this disease.We are carrying out this study to describe household transmission of medically attended AGE, and explore whether there is an increased incidence in households with young children.<h4>Methods and analysis</h4>This study used the Royal College of General Practitioners (R ...[more]

PMID: 30139907

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Project description:IntroductionNew HIV infection during pre-conception and pregnancy is a significant contributor of mother-to-child transmission of HIV in South Africa. This study estimated HIV incidence (defined as new infection within the last one year from the time of the survey which included both new infections occurred during pregnancy or just before pregnancy) among pregnant women and described the characteristics of recently infected pregnant women at national level.MethodsBetween 1 October and 15 November 2017, we conducted a national cross-sectional survey among pregnant women aged 15-49 years old attending antenatal care at 1,595 public facilities. Blood specimens were collected from pregnant women and tested for HIV in a centralised laboratory. Plasma viral load and Limiting Antigen Avidity Enzyme Immunosorbent Assay (LAg) tests were further performed on HIV positive specimens to differentiate between recent and long-term infections. Recent infection was defined as infection that occurred within one year from the date of collection of blood specimen for the survey. Data on age, age of partner, and marital status were collected through interviews. Women whose specimens were classified as recent by LAg assay and with viral loads >1,000 copies/mL were considered as recently infected. The calculated proportion of HIV positive women with recent infection was adjusted for assay-specific parameters to estimate annual incidence. Survey multinomial logistic regression was used to examine factors associated with being recently infected using HIV negative women as a reference group. Age-disparate relationship was defined as having a partner 5 or more years older.ResultsOf 10,049 HIV positive participants with LAg and viral load data, 1.4% (136) were identified as recently infected. The annual HIV incidence was 1.5% (95% confidence interval (CI): 1.2-1.7). In multivariable analyses, being single (adjusted odds ratio, aOR: 3.4, 95% CI: 1.8-6.2) or cohabiting (aOR: 3.8, 95% CI: 1.8-7.7), compared to being married as well as being in an age-disparate relationship among young women (aOR: 3.1, 95% CI: 2.0-4.7; reference group: young women (15-24years) whose partners were not 5 years or more older) were associated with higher odds of recent infection.ConclusionsCompared to previous studies among pregnant women, the incidence estimated in this study was substantially lower. However, the UNAIDS target to reduce incidence by 75% by 2020 (which is equivalent to reducing incidence to <1%) has not been met. The implementation of HIV prevention and treatment interventions should be intensified, targeting young women engaged in age-disparate relationship and unmarried women to fast track progress towards the UNAIDS target.

Project description:BackgroundDirect observation of the household spread of influenza and respiratory infections is limited; much of our understanding comes from mathematical models. The study aims to determine household incidence of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections within a primary care routine data and identify factors associated with the diseases' incidence.MethodsWe conducted two five-year retrospective analyses of influenza-like illness (ILI), lower (LRTI) and upper (URTI) respiratory infections using the England Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network database; a cross-sectional study reporting incident rate ratio (IRR) from a negative binomial model and a retrospective cohort study, using a shared gamma frailty survival model, reporting hazard ratios (HR). We reported the following household characteristics: children < 5 years old, each extra household member, gender, ethnicity (reference white), chronic disease, pregnancy, and rurality.ResultsThe IRR where there was a child < 5 years were 1·62 (1·38-1·89, p < 0·0001), 2·40 (2.04-2.83, p < 0·0001) and 4·46 (3.79-5.255, p < 0·0001) for ILI, LRTI and URTI respectively. IRR also increased with household size, rurality and presentations and by female gender, compared to male. Household incidence of URTI and LRTI changed little between years whereas influenza did and were greater in years with lower vaccine effectiveness. The HR where there was a child < 5 years were 2·34 (95%CI 1·88-2·90, p < 0·0001), 2·97 (95%CI 2·76-3·2, p < 0·0001) and 10·32 (95%CI 10.04-10.62, p < 0·0001) for ILI, LRTI and URTI respectively. HR were increased with female gender, rurality, and increasing household size.ConclusionsPatterns of household incidence can be measured from routine data and may provide insights for the modelling of disease transmission and public health policy.

Project description:ImportanceColorectal cancer (CRC) incidence rates among individuals younger than 50 years have been increasing in many countries, including Canada. Whether changes in CRC incidence rates over time are uniform across income and age groups remains unknown.ObjectiveTo examine time trends in CRC incidence rates in Canada by area-level average household income by age group from 1992 to 2016.Design, setting, and participantsA population-based, retrospective cohort study was conducted including individuals aged 20 years or older diagnosed with CRC in Canada (excluding Québec) from 1992 to 2016. Data analysis was performed from February 27 to September 28, 2020.ExposuresAverage household income was determined by linking an individual's postal code at diagnosis from the Canadian Cancer Registry to Canadian Census data. Average household income was then categorized into quintiles from Q1, the lowest income group, to Q5, the highest income group.Main outcomes and measuresCanadian Cancer Registry data were used to determine CRC incidence rates from 1992 to 2016.ResultsThere were 340 790 cases of CRC diagnosed from 1992 to 2016; 11 790 cases (3.5%) were diagnosed in individuals aged 20 to 44 years. Colorectal cancer incidence rates for individuals aged 20 to 44 years increased for all income quintiles, with higher incidence rates in the lower income quintiles. The ratio between the maximum and minimum CRC incidence rates was highest among the 20- to 29-year age group from 1992 to 1996 (ratio, 2.67; 95% CI, 1.47-4.83) and 2012 to 2016 (ratio, 2.00; 95% CI, 1.29-3.10). For individuals aged 45 to 49 years, CRC incidence rates increased only for individuals in the lower income quintiles (eg, incidence in Q1, 1992-1996 vs 2012-2016: 4.54 per 100 000 [95% CI, 4.05-5.03] vs 5.37 per 100 000 [95% CI, 4.91-5.83]), with higher incidence rates in the high income quintiles (eg, incidence rate for Q5 in 1992-1996: 5.92 per 100 000 [95% CI, 5.36-6.48]). For those aged 50 to 54 years, CRC incidence rates were stable for all income quintiles, with less variability between income quintiles. For individuals aged 55 to 74 years, CRC incidence rates were stable or decreased for all income quintiles (eg, incidence rate for age 55-59 years in Q5, 1992-1992 vs 2012-2016: 17.97 per 100 000 [95% CI, 16.76-19.18] vs 14.56 per 100 000 [95% CI, 13.80-15.32]), and there was less variability in the rates by income quintile, particularly from 2012 to 2016. After age 75 years, CRC incidence rates were stable or decreased (eg, incidence rate for age 75-79 years, 1992-1996 vs 2012-2016: 66.43 per 100 000 [65.00-67.87] vs 57.34 per 100 000 [56.24-58.45]), were highest for the lower income quintiles, and variability between income quintiles increased relative to younger age groups.Conclusions and relevanceIn this cohort study, trends in CRC incidence rates in Canada differed by age group and income quintile. These results suggest that, although population-based screening can reduce income disparities, targeted interventions and further research are needed to address the increasing CRC incidence rate among younger individuals in Canada, particularly in the lower income quintiles.

Dataset Information

Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992-2017): cross-sectional and retrospective cohort study protocol.

Publications

Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992-2017): cross-sectional and retrospective cohort study protocol.

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