Tuberculosis associated with household crowding in a developed country
Tuberculosis associated with household crowding in a developed country
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DOI：
10.1136/jech.2007.063610
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发表时间：
2008-08-01
影响因子：
6.3
通讯作者：
Howden-Chapman, P.
中科院分区：
文献类型：
--
作者：
Baker, M.;Das, D.;Howden-Chapman, P.
背景资料：结核病（TB）仍然是新西兰和全球的一种重要传染病，但对传播的风险因素仍然知之甚少。本研究旨在确定是否家庭拥挤有助于结核病在NZ.Methods的传播：本生态研究采用结核病监测和人口普查数据来计算结核病发病率的人口普查区单位（CAU）。普查数据用于确定CAU特征，包括家庭拥挤的比例（一个或多个卧室的赤字），出生在结核病高发国家的移民人口比例，家庭收入中位数和贫困水平。一个负二项回归模型被用来估计结核病发病率和家庭crowding.Results之间的关联：分析包括1898通知结核病病例2000-4期间。单变量分析显示，在CAU水平的结核病发病率与家庭拥挤，总人口和所有种族和年龄组。在调整了家庭收入、现有结核病负担和来自结核病高发国家的移民比例等协变量后，多变量分析显示结核病发病率与家庭拥挤之间存在统计学显著相关。发病率比（IRR）在总人口中为1.05（95%CI 1.02 ~ 1.08），在新西兰出生的< 40岁人群中为1.08（95%CI 1.04 ~ 1.12）。一项基于个人的研究（E。G.病例-对照），以补充这些发现。减少或消除家庭拥挤可以降低新西兰和全球的结核病发病率。
Background: Tuberculosis ( TB) remains an important infectious disease in New Zealand ( NZ) and globally, but risk factors for transmission are still poorly understood. This research aimed to identify whether household crowding contributes to TB transmission in NZ.Methods: This ecological study used TB surveillance and census data to calculate TB incidence rates by census area unit (CAU). Census data were used to determine CAU characteristics including proportion of household crowding ( a bedroom deficit of one or more), proportion of population who are migrants born in high-TB-incidence countries, median household income, and deprivation level. A negative binomial regression model was used to estimate the association between TB incidence and household crowding.Results: The analysis included 1898 notified TB cases for the 2000-4 period. Univariate analysis showed TB incidence at the CAU level was associated with household crowding, for the total population and for all ethnic and age groups. After adjusting for the covariates of household income, existing TB burden, and proportion of migrants from high-TB-incidence countries, multivariate analysis showed statistically significant associations between TB incidence and household crowding. The incidence rate ratio (IRR) was 1.05 ( 95% CI 1.02 to 1.08) in the total population and 1.08 ( 95% CI 1.04 to 1.12) for NZ-born people < 40 years.Conclusion: At the CAU level, TB incidence in NZ is associated with household crowding. An individual-based study ( e. g. case-control) in recently infected cases ( detected by molecular epidemiology techniques) is suggested to complement these findings. Reducing or eliminating household crowding could decrease TB incidence in NZ and globally.