Agricultural, socioeconomic and environmental variables as risks for human verotoxigenic Escherichia coli (VTEC) infection in Finland.
Agricultural, socioeconomic and environmental variables as risks for human verotoxigenic Escherichia coli (VTEC) infection in Finland.
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DOI：
10.1186/1471-2334-11-275
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发表时间：
2011-10-18
影响因子：
3.7
通讯作者：
Kuusi M
中科院分区：
文献类型：
--
作者：
Jalava K;Ollgren J;Eklund M;Siitonen A;Kuusi M
产维罗毒素大肠杆菌（VTEC）是严重胃肠道感染的原因，特别是在婴儿中。芬兰每年向国家传染病登记处报告10至20例病例。本研究的目的是确定1997年至2006年间芬兰NIDR报告的VTEC感染的解释变量。我们应用了一个障碍模型，适用于具有超过零的数据集。我们从1997年至2006年的常规监测资料中纳入131例国内获得性VTEC的原发病例。对分离菌株进行了毒力型、血清组、噬菌体型和脉冲场凝胶电泳鉴定。通过将两部分贝叶斯障碍模型应用于传染病监测数据，我们能够创建一个模型，其中协变量与逻辑回归部分中病例发生的概率和泊松回归部分中病例发生的协变量变化幅度相关。该模型还包括邻近城市之间的空间相关性。根据向国家预防疾病研究所报告的病例，年平均发病率为每百万居民4.8例。131例中分离出VTEC O157菌株74株，非O157菌株58株（1例双重感染）。在芬兰416个城市中，有70个（17%）的城市中，人均公牛数量和受过高等教育的人口比例与人类VTEC感染的发生率和发病率增加有关。此外，单位面积淡水资源比例、单位面积耕地比例和有儿童的低收入家庭比例与VTEC感染发生率增加有关。通过障碍模型，我们能够区分疾病发生的风险因素和以超过零为特征的数据的疾病发病率。牛密度和高学历人口比例对该病的发生和发病率均有显著性影响，淡水、耕地和低收入有子女家庭比例对该病的发病率均有显著性影响。
Verotoxigenic E. coli (VTEC) is the cause of severe gastrointestinal infection especially among infants. Between 10 and 20 cases are reported annually to the National Infectious Disease Register (NIDR) in Finland. The aim of this study was to identify explanatory variables for VTEC infections reported to the NIDR in Finland between 1997 and 2006. We applied a hurdle model, applicable for a dataset with an excess of zeros. We enrolled 131 domestically acquired primary cases of VTEC between 1997 and 2006 from routine surveillance data. The isolated strains were characterized by virulence type, serogroup, phage type and pulsed-field gel electrophoresis. By applying a two-part Bayesian hurdle model to infectious disease surveillance data, we were able to create a model in which the covariates were associated with the probability for occurrence of the cases in the logistic regression part and the magnitude of covariate changes in the Poisson regression part if cases do occur. The model also included spatial correlations between neighbouring municipalities. The average annual incidence rate was 4.8 cases per million inhabitants based on the cases as reported to the NIDR. Of the 131 cases, 74 VTEC O157 and 58 non-O157 strains were isolated (one person had dual infections). The number of bulls per human population and the proportion of the population with a higher education were associated with an increased occurrence and incidence of human VTEC infections in 70 (17%) of 416 of Finnish municipalities. In addition, the proportion of fresh water per area, the proportion of cultivated land per area and the proportion of low income households with children were associated with increased incidence of VTEC infections. With hurdle models we were able to distinguish between risk factors for the occurrence of the disease and the incidence of the disease for data characterised by an excess of zeros. The density of bulls and the proportion of the population with higher education were significant both for occurrence and incidence, while the proportion of fresh water, cultivated land, and the proportion of low income households with children were significant for the incidence of the disease.
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影响因子：
2.1
作者：
Berrang-Ford, Lea;Berke, Olaf;Abdelrahman, Lubowa
通讯作者：
Abdelrahman, Lubowa
影响因子：
4.2
作者：
Innocent, GT;Mellor, DJ;Reid, SWJ
通讯作者：
Reid, SWJ
影响因子：
4.2
作者：
Eklund, M;Nuorti, JP;Siitonen, A
通讯作者：
Siitonen, A
影响因子：
6
作者：
Carrel, Margaret;Voss, Paul;Emch, Michael
通讯作者：
Emch, Michael
影响因子：
4.2
作者：
Chang, M.;Groseclose, S. L.;Braden, C. R.
通讯作者：
Braden, C. R.