Disparities in Shigellosis Incidence by Census Tract Poverty, Crowding, and Race/Ethnicity in the United States, FoodNet, 2004-2014.
Open Forum Infect Dis
; 7(2): ofaa030, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-32099844
ABSTRACT
BACKGROUND:
Shigella causes an estimated 500â 000 enteric illnesses in the United States annually, but the association with socioeconomic factors is unclear.METHODS:
We examined possible epidemiologic associations between shigellosis and poverty using 2004-2014 Foodborne Diseases Active Surveillance Network (FoodNet) data. Shigella cases (nâ =â 21â 246) were geocoded, linked to Census tract data from the American Community Survey, and categorized into 4 poverty and 4 crowding strata. For each stratum, we calculated incidence by sex, age, race/ethnicity, and FoodNet site. Using negative binomial regression, we estimated incidence rate ratios (IRRs) comparing the highest to lowest stratum.RESULTS:
Annual FoodNet Shigella incidence per 100â 000 population was higher among childrenâ <5 years old (19.0), blacks (7.2), and Hispanics (5.6) and was associated with Census tract poverty (incidence rate ratio [IRR], 3.6; 95% confidence interval [CI], 3.5-3.8) and household crowding (IRR, 1.8; 95% CI, 1.7-1.9). The association with poverty was strongest among children and persisted regardless of sex, race/ethnicity, or geographic location. After controlling for demographic variables, the association between shigellosis and poverty remained significant (IRR, 2.3; 95% CI, 2.0-2.6).CONCLUSIONS:
In the United States, Shigella infections are epidemiologically associated with poverty, and increased incidence rates are observed among young children, blacks, and Hispanics.
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MEDLINE
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Ano de publicação:
2020
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Article