Conurbation, Urban, and Rural Living as Determinants of Allergies and Infectious Diseases: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2016-2017.
Conurbation, Urban, and Rural Living as Determinants of Allergies and Infectious Diseases: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2016-2017.
复制标题
DOI：
10.2196/11354
复制
发表时间：
2018-11-26
影响因子：
8.5
通讯作者：
Rafi I
中科院分区：
文献类型：
--
作者：
de Lusignan S;McGee C;Webb R;Joy M;Byford R;Yonova I;Hriskova M;Matos Ferreira F;Elliot AJ;Smith G;Rafi I
生活在城市、城市或农村环境中是健康的一个重要决定因素。例如，城市和农村生活与呼吸道和过敏性疾病的增加有关，而农场或农村的教育被证明是防止这种情况的一个保护因素。这项研究的目的是评估暴露在大都市或城市生活中的人与农村环境中的人在过敏和传染病的一般实践表现上的差异。该人群是具有全国代表性的175家英国全科诊所的样本，涵盖了在哨兵网络全科诊所注册的160多万名患者。英国国家统计局报告了过敏性鼻炎、哮喘和传染病的全科医生报告率，这些疾病被英国国家统计局归类为上、下呼吸道感染、尿路感染和急性胃肠炎。我们使用多变量Logistic回归对年龄、性别、种族、剥夺、合并症和吸烟状况进行了调整，报告的优势比(OR)为95%。城市变应性鼻炎的OR值为1.13(95%可信区间1.04~1.23；P=0.003)，城市人群的OR值为1.29(95%可信区间1.19~1.41；P<；0.001)。便秘生活与哮喘(OR 0.70，95%CI 0.67~0.73；P<；.001)和下呼吸道感染(OR 0.94，95%CI 0.90~0.98；P=0.005)的低OR相关。与农村居民相比，城市居民上呼吸道感染的OR值较大(OR1.06，95%CI 1.03~1.08；P<；.001)，而城市居民上呼吸道感染的OR1.00，95%CI0.97~1.03；P=.93。急性胃肠炎遵循相同的模式：城市居民的OR为1.13(95%CI 1.01~1.25；P=.03)，城市居民的OR为1.04(95%CI 0.93~1.17；P=0.46)。城市居民尿路感染的OR值较低(OR0.94，95%CI为0.89~0.99；P=0.02)，而大都市区居民尿路感染的OR值较高(OR1.06，95%CI 1.00~1.13；P=0.04)。那些生活在城市或城市地区的人更有可能咨询过敏性鼻炎和上呼吸道感染的一般做法。城市和农村生活都与尿路感染的风险增加有关。居住在农村地区与哮喘和下呼吸道感染的风险增加有关。这些数据表明，生活环境可能会影响某些情况下的就诊率。对这些数据的纵向分析将有助于提供对重要决定因素的洞察。
Living in a conurbation, urban, or rural environment is an important determinant of health. For example, conurbation and rural living is associated with increased respiratory and allergic conditions, whereas a farm or rural upbringing has been shown to be a protective factor against this. The objective of the study was to assess differences in general practice presentations of allergic and infectious disease in those exposed to conurbation or urban living compared with rural environments. The population was a nationally representative sample of 175 English general practices covering a population of over 1.6 million patients registered with sentinel network general practices. General practice presentation rates per 100,000 population were reported for allergic rhinitis, asthma, and infectious conditions grouped into upper and lower respiratory tract infections, urinary tract infection, and acute gastroenteritis by the UK Office for National Statistics urban-rural category. We used multivariate logistic regression adjusting for age, sex, ethnicity, deprivation, comorbidities, and smoking status, reporting odds ratios (ORs) with 95% CIs. For allergic rhinitis, the OR was 1.13 (95% CI 1.04-1.23; P=.003) for urban and 1.29 (95% CI 1.19-1.41; P<.001) for conurbation compared with rural dwellers. Conurbation living was associated with a lower OR for both asthma (OR 0.70, 95% CI 0.67-0.73; P<.001) and lower respiratory tract infections (OR 0.94, 95% CI 0.90-0.98; P=.005). Compared with rural dwellers, the OR for upper respiratory tract infection was greater in urban (OR 1.06, 95% CI 1.03-1.08; P<.001) but no different in conurbation dwellers (OR 1.00, 95% CI 0.97-1.03; P=.93). Acute gastroenteritis followed the same pattern: the OR was 1.13 (95% CI 1.01-1.25; P=.03) for urban dwellers and 1.04 (95% CI 0.93-1.17; P=.46) for conurbation dwellers. The OR for urinary tract infection was lower for urban dwellers (OR 0.94, 95% CI 0.89-0.99; P=.02) but higher in conurbation dwellers (OR 1.06, 95% CI 1.00-1.13; P=.04). Those living in conurbations or urban areas were more likely to consult a general practice for allergic rhinitis and upper respiratory tract infection. Both conurbation and rural living were associated with an increased risk of urinary tract infection. Living in rural areas was associated with an increased risk of asthma and lower respiratory tract infections. The data suggest that living environment may affect rates of consultations for certain conditions. Longitudinal analyses of these data would be useful in providing insights into important determinants.
登录
查看更多内容
影响因子：
6.3
作者：
Fuertes E;Markevych I;von Berg A;Bauer CP;Berdel D;Koletzko S;Sugiri D;Heinrich J
通讯作者：
Heinrich J
影响因子：
10
作者：
Anderson, HR;de Leon, AP;Strachan, DP
通讯作者：
Strachan, DP
影响因子：
2.9
作者：
Correa A;Hinton W;McGovern A;van Vlymen J;Yonova I;Jones S;de Lusignan S
通讯作者：
de Lusignan S
影响因子：
3.6
作者：
Dodds, Julie P.;Johnson, Anne M.;Mercey, Danielle E.
通讯作者：
Mercey, Danielle E.
影响因子：
5.5
作者：
Casey, MM;Call, KT;Klingner, JM
通讯作者：
Klingner, JM