Children under five are associated with household transmission of acute gastroenteritis: database studies of a primary care sentinel network
PHE ePoster Library. de Lusignan S. 09/12/19; 274474; 36
Prof. Simon de Lusignan
Prof. Simon de Lusignan
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Abstract
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Abstract Introduction
Acute gastroenteritis (AGE) is highly transmissible and contributes significantly to the burden of infectious disease. We investigated the incidence of AGE over 25 years and household transmission since 2013.
Methods
25-year repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network, using negative binomial model, and a retrospective cohort analysis, using a shared gamma frailty model. Both studies looked at the impact of child <5 years, household size, socioeconomic status (index of multiple deprivation (IMD) score quintiles), and rurality affecting household transmission. We have also included gender, ethnicity, more age-bands, and NHS region in our retrospective study.
Results
The cross-sectional study reports 2013 as a maximum change point in incidence of AGE. The incidence rate ratio (IRR) of households transmission (n=4,346) with a child <5years was 12.24 (95%CI 10.15-14.87, p<0.05); for each rise in IMD quintile the RR falls 0.91 (95%CI -0.83-0.90, p<0.001).The cohort study (n=3,976) found the hazard ratio of household transmission in the <5years age-band was 11.77 (95%CI 10.52-13.18, p<0.001). We saw similar associations with deprivation (HR 0.86 (95%CI o82-0.90, p<0.0001) and town and city compared with conurbations. Additionally we saw a lower association with male gender and white ethnicity, but an increased association with household size, and outside London.
Conclusion
Household transmission rates is influenced by the presence of pre-school children, larger households, Asian ethnicity and living in London. Male gender, higher economic status and conurbation were associated with lower rates. External funding details
Abstract Introduction
Acute gastroenteritis (AGE) is highly transmissible and contributes significantly to the burden of infectious disease. We investigated the incidence of AGE over 25 years and household transmission since 2013.
Methods
25-year repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network, using negative binomial model, and a retrospective cohort analysis, using a shared gamma frailty model. Both studies looked at the impact of child <5 years, household size, socioeconomic status (index of multiple deprivation (IMD) score quintiles), and rurality affecting household transmission. We have also included gender, ethnicity, more age-bands, and NHS region in our retrospective study.
Results
The cross-sectional study reports 2013 as a maximum change point in incidence of AGE. The incidence rate ratio (IRR) of households transmission (n=4,346) with a child <5years was 12.24 (95%CI 10.15-14.87, p<0.05); for each rise in IMD quintile the RR falls 0.91 (95%CI -0.83-0.90, p<0.001).The cohort study (n=3,976) found the hazard ratio of household transmission in the <5years age-band was 11.77 (95%CI 10.52-13.18, p<0.001). We saw similar associations with deprivation (HR 0.86 (95%CI o82-0.90, p<0.0001) and town and city compared with conurbations. Additionally we saw a lower association with male gender and white ethnicity, but an increased association with household size, and outside London.
Conclusion
Household transmission rates is influenced by the presence of pre-school children, larger households, Asian ethnicity and living in London. Male gender, higher economic status and conurbation were associated with lower rates. External funding details
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