Household crowding a major risk factor for epidemic meningococcal disease in Auckland children
Household crowding a major risk factor for epidemic meningococcal disease in Auckland children
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DOI：
10.1097/00006454-200010000-00009
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发表时间：
2000-10-01
影响因子：
3.6
通讯作者：
Lennon, D
中科院分区：
文献类型：
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作者：
Baker, M;McNicholas, A;Lennon, D
背景新西兰是血清B群脑膜炎球菌病流行的第九个年头，年发病率高达每10万人16.9例。发病率最高的是奥克兰地区的毛利人和太平洋岛屿儿童。我们进行了一项病例对照研究，以确定这种疾病的潜在可改变的危险因素。对1997年5月至1999年3月在奥克兰招募的202例确诊和疑似脑膜炎球菌病的8岁以下儿童进行了病例对照研究。对照组（313例）采用整群抽样方法，在奥克兰地区随机分配起点。它们与脑膜炎球菌病病例中预期的年龄和种族分布频率相匹配。通过使用多变量模型并控制年龄、种族、季节和社会经济因素，疾病风险与过度拥挤密切相关，通过每个房间青少年和成年（10岁或以上）家庭成员的数量来衡量[比值比（OR），10.7; 95%置信区间（CI），3.9至29.5]。这将导致在一个6居室的房子里增加2个青少年或成年人的风险增加一倍。患病风险也与儿童使用止痛药有关，这被认为是近期患病的标志（OR 2.4，CI 1.5至4.0）;参加大型社交聚会的天数（10人或更多人> 4小时; OR 1.8，CI 1.2至2.6）;家庭吸烟人数（OR 1.4，CI 1.0至1.8）;分享食物、饮料或奶嘴（OR 1.6，CI 1.0 ~ 2.7）;和先前的呼吸道感染症状（咳嗽、“感冒或流感”、流鼻涕、打喷嚏）（OR 1.5，CI 1.0 - 2.5）。这些确定的脑膜炎球菌病风险因素中有一些是可以改变的。减少过度拥挤的措施可能对降低奥克兰儿童的发病率产生显著影响。
Background. New Zealand is in its ninth year of a serogroup B meningococcal disease epidemic with annual rates of up to 16.9 cases per 100 000. The highest incidence is in Maori and Pacific Island children in the Auckland region. We conducted a case-control study to identify potentially modifiable risk factors for this disease.Methods. A case-control study of 202 cases of confirmed and probable meningococcal disease in Auckland children younger than 8 years of age recruited from May, 1997, to March, 1999, was undertaken, Controls (313) were recruited door-to-door by a cluster sampling method based on starting points randomly distributed in the Auckland region. They were frequency matched with the expected distribution of age and ethnicity in the meningococcal disease cases.Results. With the use of a multivariate model and controlling for age, ethnicity, season and socioeconomic factors, risk of disease was strongly associated with overcrowding as measured by the number of adolescent and adult (10 years or older) household members per room [odds ratio (OR), 10.7; 95% confidence interval (CI), 3.9 to 29.5]. This would result in a doubling of risk with the addition of 2 adolescents or adults to a 6-room house. Risk of disease was also associated with analgesic use by the child, which was thought to be a marker of recent illness (OR 2.4, CI 1.5 to 4.0); number of days at substantial social gatherings (10 or more people for > 4 h; OR 1.8, CI 1.2 to 2.6); number of smokers in the household (OR 1.4, CI 1.0 to 1.8); sharing an item of food, drink or a pacifier (OR 1.6, CI 1.0 to 2.7); and preceding symptoms of a respiratory infection (cough, "cold or flu," runny nose, sneezing) in a household member (OR 1.5, CI 1.0 to 2.5).Conclusion. Some of these identified risk factors for meningococcal disease are modifiable. Measures to reduce overcrowding could have a marked effect on reducing the incidence of this disease in Auckland children.