scholarly journals Socioeconomic deprivation is inversely associated with measles incidence: a longitudinal small-area analysis, Germany, 2001 to 2017

2021 ◽  
Vol 26 (17) ◽  
Author(s):  
Sven Rohleder ◽  
Christian Stock ◽  
Kayvan Bozorgmehr
Keyword(s):  
High Risk ◽  
Small Area ◽  
Bayesian Regression ◽  
Socioeconomic Deprivation ◽  
World Health ◽  
Area Deprivation ◽  
Spatial And Temporal Patterns ◽  
Public Health Action ◽  
Small Area Analysis ◽  
Measles Incidence

Background Although measles is endemic throughout the World Health Organization European Region, few studies have analysed socioeconomic inequalities and spatiotemporal variations in the disease’s incidence. Aim To study the association between socioeconomic deprivation and measles incidence in Germany, while considering relevant demographic, spatial and temporal factors. Methods We conducted a longitudinal small-area analysis using nationally representative linked data in 401 districts (2001–2017). We used spatiotemporal Bayesian regression models to assess the potential effect of area deprivation on measles incidence, adjusted for demographic and geographical factors, as well as spatial and temporal effects. We estimated risk ratios (RR) for deprivation quintiles (Q1–Q5), and district-specific adjusted relative risks (ARR) to assess the area-level risk profile of measles in Germany. Results The risk of measles incidence in areas with lowest deprivation quintile (Q1) was 1.58 times higher (95% credible interval (CrI): 1.32–2.00) than in those with highest deprivation (Q5). Areas with medium-low (Q2), medium (Q3) and medium-high deprivation (Q4) had higher adjusted risks of measles relative to areas with highest deprivation (Q5) (RR: 1.23, 95%CrI: 0.99–1.51; 1.05, 95%CrI: 0.87–1.26 and 1.23, 95%CrI: 1.05–1.43, respectively). We identified 54 districts at medium-high risk for measles (ARR > 2) in Germany, of which 22 were at high risk (ARR > 3). Conclusion Socioeconomic deprivation in Germany, one of Europe’s most populated countries, is inversely associated with measles incidence. This association persists after demographic and spatiotemporal factors are considered. The social, spatial and temporal patterns of elevated risk require targeted public health action and policy to address the complexity underlying measles epidemiology.

scholarly journals Area deprivation is inversely associated with measles incidence: A spatiotemporal analysis in Germany

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rohleder ◽  
C Stock ◽  
K Bozorgmehr
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
High Risk ◽  
Disease Incidence ◽  
Socioeconomic Inequalities ◽  
Elevated Risk ◽  
Socioeconomic Deprivation ◽  
Area Deprivation ◽  
Geographical Factors ◽  
Measles Incidence

Abstract Background Although measles is endemic in all WHO European regions, very few studies have directly analysed socioeconomic inequalities in disease incidence of measles. We examined the spatiotemporal association between socioeconomic deprivation and measles incidence considering relevant demographic and geographical factors at district level. Methods We conducted a longitudinal small-area analysis using nationally representative data of 401 districts from 2001 to 2017. We used Bayesian spatiotemporal regression models to assess the potential effects of area deprivation on measles incidence, adjusted for relevant demographic (district population size, sex, age, and proportion of non-nationals) and geographical factors (north-south-west-east effect) as well as spatial and temporal effects. We computed risk ratios (RR) for deprivation quintiles (Q1 - Q5), and district-specific adjusted relative risks (ARR) to assess the area-level risk profile of measles in Germany. Results The risk of measles infection in areas with lowest deprivation quintile (Q1) was 1.58 times higher (95%-credible interval [CrI] 1.32-2.00) than in those with highest deprivation (Q5). Areas with medium-low (Q2), medium (Q3), and medium-high deprivation (Q4) had higher adjusted risks of measles relative to areas with highest deprivation (Q5) (RR: 1.23 (0.99-1.51), 1.05 (0.87-1.26), and 1.23 (1.05-1.43), respectively). We identified 22 areas at high risk and 56 at medium-high risk for measles infections, with highest area-level risks in south-western Germany. Conclusions Socioeconomic deprivation in Germany is inversely associated with measles incidence, with elevated risk for measles infections in areas with higher socioeconomic status. Our findings contribute to current global and national debates on measles elimination strategies, and demonstrate the importance of spatial modelling techniques in identifying socioeconomic inequalities and spatial risk patterns of measles for public health actions. Key messages Socioeconomic deprivation is inversely associated with measles incidence in Germany, with higher risk of infection in areas with highest socioeconomic status. The social, spatial, and temporal patterns of elevated risk of measles infection require targeted public health action and policy to address the complexity underlying measles epidemiology.

Small-Area Analysis: Targeting High-Risk Areas for Adolescent Pregnancy Prevention Programs

1998 ◽  
Vol 30 (4) ◽  
pp. 173 ◽  
Author(s):  
Jeffrey B. Gould ◽  
Beate Herrchen ◽  
Tanya Pham ◽  
Stephan Bera ◽  
Claire Brindis
Keyword(s):  
High Risk ◽  
Adolescent Pregnancy ◽  
Small Area ◽  
Prevention Programs ◽  
Pregnancy Prevention ◽  
Small Area Analysis ◽  
Adolescent Pregnancy Prevention ◽  
Risk Areas

scholarly journals Socioeconomic deprivation and the clinical management of self-harm: a small area analysis

2017 ◽  
Vol 52 (12) ◽  
pp. 1475-1481 ◽  
Author(s):  
Robert Carroll ◽  
Duleeka Knipe ◽  
Paul Moran ◽  
David Gunnell
Keyword(s):  
Clinical Management ◽  
Small Area ◽  
Socioeconomic Deprivation ◽  
Small Area Analysis ◽  
Self Harm

Data-informed targets for suicide prevention: a small-area analysis of high-risk suicide regions in Australia

2019 ◽  
Vol 54 (10) ◽  
pp. 1209-1218 ◽  
Author(s):  
Michelle Torok ◽  
F. Shand ◽  
M. Phillips ◽  
N. Meteoro ◽  
D. Martin ◽  
...  
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Small Area ◽  
Small Area Analysis ◽  
Data Informed

scholarly journals Evaluating equality in prescribing Novel Oral Anticoagulants (NOACs) in England: The protocol of a Bayesian small area analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246253
Author(s):  
Ehsan Rezaei-Darzi ◽  
Parinaz Mehdipour ◽  
Mariachiara Di Cesare ◽  
Farshad Farzadfar ◽  
Shadi Rahimzadeh ◽  
...  
Keyword(s):  
Small Area ◽  
Oral Anticoagulants ◽  
Demographic Data ◽  
Novel Oral Anticoagulants ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescription Data ◽  
Small Area Analysis ◽  
Space And Time ◽  
Over Time

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting about 1.6% of the population in England. Novel oral anticoagulants (NOACs) are approved AF treatments that reduce stroke risk. In this study, we estimate the equality in individual NOAC prescriptions with high spatial resolution in Clinical Commissioning Groups (CCGs) across England from 2014 to 2019. Methods A Bayesian spatio-temporal model will be used to estimate and predict the individual NOAC prescription trend on ‘prescription data’ as an indicator of health services utilisation, using a small area analysis methodology. The main dataset in this study is the “Practice Level Prescribing in England,” which contains four individual NOACs prescribed by all registered GP practices in England. We will use the defined daily dose (DDD) equivalent methodology, as recommended by the World Health Organization (WHO), to compare across space and time. Four licensed NOACs datasets will be summed per 1,000 patients at the CCG-level over time. We will also adjust for CCG-level covariates, such as demographic data, Multiple Deprivation Index, and rural-urban classification. We aim to employ the extended BYM2 model (space-time model) using the RStan package. Discussion This study suggests a new statistical modelling approach to link prescription and socioeconomic data to model pharmacoepidemiologic data. Quantifying space and time differences will allow for the evaluation of inequalities in the prescription of NOACs. The methodology will help develop geographically targeted public health interventions, campaigns, audits, or guidelines to improve areas of low prescription. This approach can be used for other medications, especially those used for chronic diseases that must be monitored over time.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

Progression to and Prevention of Diabetes: Disparity of Impaired Fasting Glucose and Impaired Glucose Tolerance - Review Article

2020 ◽  
Vol 103 (8) ◽  
pp. 829-836
Keyword(s):  
High Risk ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Lifestyle Intervention ◽  
Impaired Fasting Glucose ◽  
Diabetes Prevention ◽  
Lifestyle Modification ◽  
Fasting Glucose ◽  
World Health ◽  
Risk Of Progression

It is well established that individuals who have prediabetes either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) have high risk to develop diabetes. However, it is unclear whether the rate of progression to diabetes is different between these two categories. Lifestyle modification has been recommended for diabetes prevention in these high-risk groups. However, given the differences in their pathophysiology, it is possible that these subtypes of prediabetes condition may have different responses to lifestyle modification. The present review was to summarize the risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention in individuals who have isolated IGT or isolated IFG or combined. The risk of progression to diabetes is highest in combined IFG and IGT subtype. Individuals who have isolated IFG by the American Diabetes Association criteria (100 to 125 mg/dl) has lower risk of progression to diabetes than those with World Health Organization criteria (110 to 125 mg/dl) and the latter has similar or higher risk of incident diabetes than those with isolated IGT. Lifestyle modification is most effective in individuals with IGT (with or without IFG) but is less effective in those with isolated IFG. In conclusion, The risk of progression to diabetes and the effectiveness of lifestyle intervention for diabetes prevention are disparate between prediabetes subtypes. Given the paucity of diabetes prevention data in individuals with isolated IFG, more studies dedicated to this subtype is required. Keywords: Impaired fasting glucose, Impaired glucose tolerance, Prediabetes, Type 2 diabetes, Lifestyle intervention, Diabetes prevention

scholarly journals Comparison of the ColiPlate™ Kit with Two Common E. coli Enumeration Methods for Water

Water ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 1804
Author(s):  
Cassi J. Gibson ◽  
Abraham K. Maritim ◽  
Jason W. Marion
Keyword(s):  
High Risk ◽  
Natural Water ◽  
Membrane Filtration ◽  
Fecal Contamination ◽  
Reference Method ◽  
World Health ◽  
Risk Levels ◽  
E Coli ◽  
Field Samples ◽  
Very High

Quantitatively assessing fecal indicator bacteria in drinking water from limited resource settings (e.g., disasters, remote areas) can inform public health strategies for reducing waterborne illnesses. This study aimed to compare two common approaches for quantifying Escherichia coli (E. coli) density in natural water versus the ColiPlate™ kit approach. For comparing methods, 41 field samples from natural water sources in Kentucky (USA) were collected. E. coli densities were then determined by (1) membrane filtration in conjunction with modified membrane-thermotolerant E. coli (mTEC) agar, (2) Idexx Quanti-Tray® 2000 with the Colilert® substrate, and (3) the Bluewater Biosciences ColiPlate kit. Significant correlations were observed between E. coli density data for all three methods (p < 0.001). Paired t-test results showed no difference in E. coli densities determined by all the methods (p > 0.05). Upon assigning modified mTEC as the reference method for determining the World Health Organization-assigned “very high-risk” levels of fecal contamination (> 100 E. coli CFU/100 mL), both ColiPlate and Colilert exhibited excellent discrimination for screening very high-risk levels according to the area under the receiver operating characteristic curve (~89%). These data suggest ColiPlate continues to be an effective monitoring tool for quantifying E. coli density and characterizing fecal contamination risks from water.

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