Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008
Abstract Background Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake...
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ftbiomed:oai:biomedcentral.com:1471-2458-13-63 2023-05-15T17:46:40+02:00 Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 Pardhan-Ali, Aliya Wilson, Jeff Edge, Victoria L Furgal, Chris Reid-Smith, Richard Santos, Maria McEwen, Scott A 2013-01-22 http://www.biomedcentral.com/1471-2458/13/63 en eng BioMed Central Ltd. http://www.biomedcentral.com/1471-2458/13/63 Copyright 2013 Pardhan-Ali et al.; licensee BioMed Central Ltd. Ecology Risk factors Regression analysis Minority health Gastrointestinal diseases Research article 2013 ftbiomed 2013-03-03T01:07:48Z Abstract Background Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections. Methods The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors. Results Significant (p≤0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of ‘households in core need’ (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased ‘internal mobility’ (population moving between communities), and also where the community’s primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis. Conclusions These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information . Article in Journal/Newspaper Northwest Territories BioMed Central Canada Northwest Territories |
institution |
Open Polar |
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BioMed Central |
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ftbiomed |
language |
English |
topic |
Ecology Risk factors Regression analysis Minority health Gastrointestinal diseases |
spellingShingle |
Ecology Risk factors Regression analysis Minority health Gastrointestinal diseases Pardhan-Ali, Aliya Wilson, Jeff Edge, Victoria L Furgal, Chris Reid-Smith, Richard Santos, Maria McEwen, Scott A Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
topic_facet |
Ecology Risk factors Regression analysis Minority health Gastrointestinal diseases |
description |
Abstract Background Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections. Methods The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors. Results Significant (p≤0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of ‘households in core need’ (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased ‘internal mobility’ (population moving between communities), and also where the community’s primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis. Conclusions These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information . |
format |
Article in Journal/Newspaper |
author |
Pardhan-Ali, Aliya Wilson, Jeff Edge, Victoria L Furgal, Chris Reid-Smith, Richard Santos, Maria McEwen, Scott A |
author_facet |
Pardhan-Ali, Aliya Wilson, Jeff Edge, Victoria L Furgal, Chris Reid-Smith, Richard Santos, Maria McEwen, Scott A |
author_sort |
Pardhan-Ali, Aliya |
title |
Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
title_short |
Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
title_full |
Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
title_fullStr |
Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
title_full_unstemmed |
Community-level risk factors for notifiable gastrointestinal illness in the Northwest Territories, Canada, 1991-2008 |
title_sort |
community-level risk factors for notifiable gastrointestinal illness in the northwest territories, canada, 1991-2008 |
publisher |
BioMed Central Ltd. |
publishDate |
2013 |
url |
http://www.biomedcentral.com/1471-2458/13/63 |
geographic |
Canada Northwest Territories |
geographic_facet |
Canada Northwest Territories |
genre |
Northwest Territories |
genre_facet |
Northwest Territories |
op_relation |
http://www.biomedcentral.com/1471-2458/13/63 |
op_rights |
Copyright 2013 Pardhan-Ali et al.; licensee BioMed Central Ltd. |
_version_ |
1766150457320800256 |