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1.
BMC Infect Dis ; 21(1): 744, 2021 Aug 03.
Article in English | MEDLINE | ID: mdl-34344304

ABSTRACT

BACKGROUND: Syndromic surveillance systems are an essential component of public health surveillance and can provide timely detection of infectious disease cases and outbreaks. Whilst surveillance systems are generally embedded within healthcare, there is increasing interest in novel data sources for monitoring trends in illness, such as over-the-counter purchases, internet-based health searches and worker absenteeism. This systematic review considers the utility of school attendance registers in the surveillance of infectious disease outbreaks and occurrences amongst children. METHODS: We searched eight databases using key words related to school absence, infectious disease and syndromic surveillance. Studies were limited to those published after 1st January 1995. Studies based in nursery schools or higher education settings were excluded. Article screening was undertaken by two independent reviewers using agreed eligibility criteria. Data extraction was performed using a standardised data extraction form. Outcomes included estimates of absenteeism, correlation with existing surveillance systems and associated lead or lag times. RESULTS: Fifteen studies met the inclusion criteria, all of which were concerned with the surveillance of influenza. The specificity of absence data varied between all-cause absence, illness absence and syndrome-specific absence. Systems differed in terms of the frequency of data submissions from schools and the level of aggregation of the data. Baseline rates of illness absence varied between 2.3-3.7%, with peak absences ranging between 4.1-9.8%. Syndrome-specific absenteeism had the strongest correlation with other surveillance systems (r = 0.92), with illness absenteeism generating mixed results and all-cause absenteeism performing the least well. A similar pattern of results emerged in terms of lead and lag times, with influenza-like illness (ILI)-specific absence providing a 1-2 week lead time, compared to lag times reported for all-cause absence data and inconsistent results for illness absence data. CONCLUSION: Syndrome-specific school absences have potential utility in the syndromic surveillance of influenza, demonstrating good correlation with healthcare surveillance data and a lead time of 1-2 weeks ahead of existing surveillance measures. Further research should consider the utility of school attendance registers for conditions other than influenza, to broaden our understanding of the potential application of this data for infectious disease surveillance in children. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2019 CRD42019119737.


Subject(s)
Influenza, Human , Population Surveillance , Absenteeism , Child , Disease Outbreaks , Humans , Influenza, Human/epidemiology , Schools
2.
BMC Public Health ; 21(1): 1245, 2021 06 28.
Article in English | MEDLINE | ID: mdl-34182979

ABSTRACT

BACKGROUND: Norovirus has a higher level of under-reporting in England compared to other intestinal infectious agents such as Campylobacter or Salmonella, despite being recognised as the most common cause of gastroenteritis globally. In England, this under-reporting is a consequence of the frequently mild/self-limiting nature of the disease, combined with the passive surveillance system for infectious diseases reporting. We investigated heterogeneity in passive surveillance system in order to improve understanding of differences in reporting and laboratory testing practices of norovirus in England. METHODS: The reporting patterns of norovirus relating to age and geographical region of England were investigated using a multivariate negative binomial model. Multiple model formulations were compared, and the best performing model was determined by proper scoring rules based on one-week-ahead predictions. The reporting patterns are represented by epidemic and endemic random intercepts; values close to one and less than one imply a lower number of reports than expected in the given region and age-group. RESULTS: The best performing model highlighted atypically large and small amounts of reporting by comparison with the average in England. Endemic random intercept varied from the lowest in East Midlands in those in the under 5 year age-group (0.36, CI 0.18-0.72) to the highest in the same age group in South West (3.00, CI 1.68-5.35) and Yorkshire & the Humber (2.93, CI 1.74-4.94). Reporting by age groups showed the highest variability in young children. CONCLUSION: We identified substantial variability in reporting patterns of norovirus by age and by region of England. Our findings highlight the importance of considering uncertainty in the design of forecasting tools for norovirus, and to inform the development of more targeted risk management approaches for norovirus disease.


Subject(s)
Caliciviridae Infections , Gastroenteritis , Norovirus , Caliciviridae Infections/epidemiology , Child , Child, Preschool , Disease Outbreaks , England/epidemiology , Gastroenteritis/epidemiology , Humans
3.
Epidemiol Infect ; 148: e287, 2020 11 18.
Article in English | MEDLINE | ID: mdl-33203492

ABSTRACT

Children are important transmitters of infection. Within schools they encounter large numbers of contacts and infections can spread easily causing outbreaks. However, not all schools are affected equally. We conducted a retrospective analysis of school outbreaks to identify factors associated with the risk of gastroenteritis, influenza, rash or other outbreaks. Data on reported school outbreaks in England were obtained from Public Health England and linked with data from the Department for Education and the Office for Standards in Education, Children's Services and Skills (Ofsted). Primary and all-through schools were found to be at increased risk of outbreaks, compared with secondary schools (odds ratio (OR) 5.82, 95% confidence interval (CI) 4.50-7.58 and OR 4.66, 95% CI 3.27-6.61, respectively). School size was also significantly associated with the risk of outbreaks, with higher odds associated with larger schools. Attack rates were higher in gastroenteritis and influenza outbreaks, with lower attack rates associated with rashes (relative risk 0.17, 95% CI 0.15-0.20). Deprivation and Ofsted rating were not associated with either outbreak occurrence or the subsequent attack rate. This study identifies primary and all-through schools as key settings for health protection interventions. Public health teams need to work closely with these schools to encourage early identification and reporting of outbreaks.


Subject(s)
Communicable Diseases/epidemiology , Disease Outbreaks , Seasons , Adolescent , Child , Child, Preschool , England/epidemiology , Humans , Risk Factors
4.
Epidemiol Infect ; 147: e99, 2019 01.
Article in English | MEDLINE | ID: mdl-30869040

ABSTRACT

Current methods of control recruitment for case-control studies can be slow (a particular issue for outbreak investigations), resource-intensive and subject to a range of biases. Commercial market panels are a potential source of rapidly recruited controls. Our study evaluated food exposure data from these panel controls, compared with an established reference dataset. Market panel data were collected from two companies using retrospective internet-based surveys; these were compared with reference data from the National Diet and Nutrition Survey (NDNS). We used logistic regression to calculate adjusted odds ratios to compare exposure to each of the 71 food items between the market panel and NDNS participants. We compared 2103 panel controls with 2696 reference participants. Adjusted for socio-demographic factors, exposure to 90% of foods was statistically different between both panels and the reference data. However, these differences were likely to be of limited practical importance for 89% of Panel A foods and 79% of Panel B foods. Market panel food exposures were comparable with reference data for common food exposures but more likely to be different for uncommon exposures. This approach should be considered for outbreak investigation, in conjunction with other considerations such as population at risk, timeliness of response and study resources.


Subject(s)
Disease Outbreaks/statistics & numerical data , Food Contamination/statistics & numerical data , Foodborne Diseases/epidemiology , Hazard Analysis and Critical Control Points/methods , Adolescent , Adult , Aged , Aged, 80 and over , England/epidemiology , Female , Foodborne Diseases/etiology , Humans , Male , Middle Aged , Retrospective Studies , Young Adult
5.
Epidemiol Infect ; 146(4): 458-464, 2018 03.
Article in English | MEDLINE | ID: mdl-29332618

ABSTRACT

Established methods of recruiting population controls for case-control studies to investigate gastrointestinal disease outbreaks can be time consuming, resulting in delays in identifying the source or vehicle of infection. After an initial evaluation of using online market research panel members as controls in a case-control study to investigate a Salmonella outbreak in 2013, this method was applied in four further studies in the UK between 2014 and 2016. We used data from all five studies and interviews with members of each outbreak control team and market research panel provider to review operational issues, evaluate risk of bias in this approach and consider methods to reduce confounding and bias. The investigators of each outbreak reported likely time and cost savings from using market research controls. There were systematic differences between case and control groups in some studies but no evidence that conclusions on the likely source or vehicle of infection were incorrect. Potential selection biases introduced by using this sampling frame and the low response rate are unclear. Methods that might reduce confounding and some bias should be balanced with concerns for overmatching. Further evaluation of this approach using comparisons with traditional methods and population-based exposure survey data is recommended.


Subject(s)
Case-Control Studies , Disease Outbreaks , Gastrointestinal Diseases/epidemiology , Marketing , Female , Humans , Internet , Interviews as Topic , Male , United Kingdom/epidemiology
6.
Epidemiol Infect ; 145(2): 289-298, 2017 01.
Article in English | MEDLINE | ID: mdl-27780484

ABSTRACT

Since April 2015, whole genome sequencing (WGS) has been the routine test for Salmonella identification, surveillance and outbreak investigation at the national reference laboratory in England and Wales. In May 2015, an outbreak of Salmonella Enteritidis cases was detected using WGS data and investigated. UK cases were interviewed to obtain a food history and links between suppliers were mapped to produce a food chain network for chicken eggs. The association between the food chain network and the phylogeny was explored using a network comparison approach. Food and environmental samples were taken from premises linked to cases and tested for Salmonella. Within the outbreak single nucleotide polymorphism defined cluster, 136 cases were identified in the UK and 18 in Spain. One isolate from a food containing chicken eggs was within the outbreak cluster. There was a significant association between the chicken egg food chain of UK cases and phylogeny of outbreak isolates. This is the first published Salmonella outbreak to be prospectively detected using WGS. This outbreak in the UK was linked with contemporaneous cases in Spain by WGS. We conclude that UK and Spanish cases were exposed to a common source of Salmonella-contaminated chicken eggs.


Subject(s)
Disease Outbreaks , Foodborne Diseases/epidemiology , Genome, Bacterial , High-Throughput Nucleotide Sequencing , Salmonella Infections/epidemiology , Salmonella enteritidis/classification , Salmonella enteritidis/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Chickens , Child , Child, Preschool , Cluster Analysis , Eggs/microbiology , Female , Foodborne Diseases/microbiology , Humans , Infant , Male , Meat/microbiology , Middle Aged , Molecular Epidemiology , Polymorphism, Single Nucleotide , Salmonella Infections/microbiology , Salmonella enteritidis/isolation & purification , Spain/epidemiology , Surveys and Questionnaires , United Kingdom/epidemiology , Young Adult
7.
Epidemiol Infect ; 144(6): 1201-11, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26542197

ABSTRACT

Suboptimal uptake of the measles, mumps and rubella (MMR) vaccine by certain socioeconomic groups may have contributed to recent large measles outbreaks in the UK. We investigated whether socioeconomic deprivation was associated with MMR vaccine uptake over 16 years. Using immunization data for 72,351 children born between 1995 and 2012 in Liverpool, UK, we examined trends in vaccination uptake. Generalized linear models were constructed to examine the relative effect of socioeconomic deprivation and year of birth on MMR uptake. Uptake of MMR1 by age 24 months ranged between 82·5% in 2003 [95% confidence interval (CI) 81·2-83·7] and 93·4% in 2012 (95% CI 92·7-94·2). Uptake of MMR2 by age 60 months ranged between 65·3% (95% CI 64·4-67·4) in 2006 and 90·3% (95% CI 89·4-91·2) in 2012. In analysis adjusted for year of birth and sex, children in the most deprived communities were at significantly greater risk of not receiving MMR1 [risk ratio (RR) 1·70, 95% CI 1·45-1·99] and MMR2 (RR 1·36, 95% CI 1·22-1·52). Higher unemployment and lower household income were significantly associated with low uptake. Contrary to concerns about lower MMR uptake in affluent families, over 16 years, children from the most socioeconomically deprived communities have consistently had the lowest MMR uptake. Targeted catch-up campaigns and strategies to improve routine immunization uptake in deprived areas are needed to minimize the risk of future measles outbreaks.


Subject(s)
Immunization Programs , Measles-Mumps-Rubella Vaccine , Vaccination , Child, Preschool , England , Female , Humans , Immunization Programs/statistics & numerical data , Infant , Longitudinal Studies , Male , Socioeconomic Factors , Vaccination/statistics & numerical data
8.
J Public Health (Oxf) ; 38(3): 585-590, 2016 09.
Article in English | MEDLINE | ID: mdl-26045472

ABSTRACT

BACKGROUND: The burden of disease relating to undiagnosed HIV infection is significant in the UK. BHIVA (British HIV Association) recommends population screening in high prevalence areas, expanding outside traditional antenatal/GUM settings. METHODS: RUClear 2011-12 piloted expanding HIV testing outside traditional settings using home-sampling kits (dry-blood-spot testing) ordered online. Greater Manchester residents (≥age 16) could request testing via an established, online chlamydia testing service (www.ruclear.co.uk). Participant attitudes towards this new service were assessed. Qualitative methods (thematic analysis) were used to analyse free-text data submitted by participants via hard copy questionnaires issued in all testing kits. RESULTS: 79.9% (2447/3062) participants completed questionnaires, of which 30.9% (756/2447) provided free-text data. Participants overwhelmingly supported the service, valuing particularly accessibility and convenience, allowing individuals to order tests any time of day and self-sample comfortably at home; avoiding the invasive nature of venipuncture and avoiding the need for face-to-face interaction with health services. The pilot was also clinically and cost-effective. CONCLUSION: Testing via home-sampling kits ordered online (dry-blood-spot testing) was felt to be an acceptable and convenient method for accessing a HIV test. Many individuals undertook HIV testing where they would otherwise not have been tested at all. Expansion of similar services may increase the uptake of HIV testing.


Subject(s)
Attitude to Health , HIV Infections/diagnosis , Self Care/psychology , Adolescent , Adult , Aged , Dried Blood Spot Testing/methods , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , United Kingdom , Young Adult
10.
Public Health ; 127(1): 53-7, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23127519

ABSTRACT

OBJECTIVE: To quantify the effectiveness of school-based sexual education on risky sexual behaviour and sexually transmitted infection (STI) acquisition in adulthood. STUDY DESIGN: Online survey of sexual attitudes and behaviours. METHODS: Students at a British university were surveyed regarding where they learnt most about sex at 14 years of age, how easy they found talking about sexual issues with their parents and age at first intercourse. The effects of these factors were modelled on risk of recent unprotected intercourse and self-reported STIs in adulthood. RESULTS: Seventy-eight of 711 (11%) students reported unprotected intercourse in the 4 weeks before the survey, and 44 (6.2%) students had ever been diagnosed with an STI. Both age at first intercourse (risk reduced by 11% per year of delayed intercourse, 95% confidence interval (CI) 3-19%) and learning about sex from lessons at school (66% reduction in risk compared with learning from one's mother, 95% CI 5-88%) were associated with reductions in risk of unprotected intercourse. Factors associated with fewer STIs were age at first intercourse (17% reduction per year of delayed intercourse, 95% CI 5-28%); and learning about sex from lessons at school (85% reduction, 95% CI 32-97%), from friends of the same age (54% reduction, CI 7-77%) and from first boy/girlfriend (85% reduction, 95% CI 35-97%) compared with learning from one's mother. CONCLUSION: School-based sexual education is effective at reducing the risk of unprotected intercourse and STIs in early adulthood. Influence from friends in adolescence may also have a positive effect on the risk of STIs in later life.


Subject(s)
Risk Reduction Behavior , Schools , Sex Education , Sexual Behavior/psychology , Sexually Transmitted Diseases/prevention & control , Adolescent , Adult , Coitus , Female , Humans , Male , Sexual Behavior/statistics & numerical data , United Kingdom , Universities , Young Adult
11.
Euro Surveill ; 17(29)2012 Jul 19.
Article in English | MEDLINE | ID: mdl-22835470

ABSTRACT

From 1 January to 30 June 2012, 359 confirmed and 157 probable cases of measles were reported in Merseyside, England. The most affected age groups were children under five years and young adults from 15 years of age. Most cases have been sporadic. There have been few outbreaks in nurseries; however, no outbreaks have been reported in schools. Of the cases eligible for vaccination, only 3% of the confirmed cases were fully immunised.


Subject(s)
Disease Outbreaks , Measles virus/isolation & purification , Measles/diagnosis , Measles/epidemiology , Adolescent , Adult , Age Distribution , Child , Child, Preschool , England/epidemiology , Female , Genotype , Humans , Immunization , Infant , Male , Measles/prevention & control , Measles/virology , Measles virus/genetics , Measles-Mumps-Rubella Vaccine/administration & dosage , Polymerase Chain Reaction , Population Surveillance , Post-Exposure Prophylaxis , Sex Distribution , Vaccination/statistics & numerical data , Young Adult
12.
AIDS Care ; 23(5): 542-9, 2011 May.
Article in English | MEDLINE | ID: mdl-21287419

ABSTRACT

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.


Subject(s)
Community Health Services/statistics & numerical data , HIV Infections/prevention & control , Health Services Accessibility/statistics & numerical data , Vulnerable Populations/statistics & numerical data , Acquired Immunodeficiency Syndrome/epidemiology , Adolescent , Adult , Black or African American , Analysis of Variance , Child , Child, Preschool , England/epidemiology , Female , HIV Infections/epidemiology , HIV Infections/ethnology , Homosexuality, Male , Humans , Infant , Infant, Newborn , Logistic Models , Male , Middle Aged , Population Surveillance , Transients and Migrants/statistics & numerical data , Young Adult
13.
J Hosp Infect ; 111: 89-95, 2021 May.
Article in English | MEDLINE | ID: mdl-33453349

ABSTRACT

BACKGROUND: COVID-19 care home outbreaks represent a significant proportion of COVID-19 morbidity and mortality in the UK. National testing initially focused on symptomatic care home residents, before extending to asymptomatic cohorts. AIM: The aim was to describe the epidemiology and transmission of COVID-19 in outbreak free care homes. METHODS: A two-point prevalence survey of COVID-19, in 34 Liverpool care homes, was performed in April and May 2020. Changes in prevalence were analysed. Associations between care home characteristics, reported infection, prevention and control interventions, and COVID-19 status were described and analysed. FINDINGS: No resident developed COVID-19 symptoms during the study. There was no significant difference between: the number of care homes containing at least one test positive resident between the first (17.6%, 95% confidence interval (CI) 6.8-34.5) and second round (14.7%, 95% CI 5.0-31.1) of testing (p>0.99); and the number of residents testing positive between the first (2.1%, 95% CI 1.2-3.4) and second round (1.0%, 95% CI 0.5-2.1) of testing (P=0.11). Care homes providing nursing care (risk ratio (RR) 7.99, 95% CI 1.1-57.3) and employing agency staff (RR 8.4, 95% CI 1.2-60.8) were more likely to contain test positive residents. Closing residents shared space was not associated with residents testing positive (RR 2.63, 95% CI 0.4-18.5). CONCLUSIONS: Asymptomatic COVID-19 care homes showed no evidence of disease transmission or development of outbreaks; suggesting that current infection prevention and control measures are effective in preventing transmission. Repeat testing at two to three weeks had limited or no public health benefits over regular daily monitoring of staff and residents for symptoms. These results should inform policies calling for regular testing of asymptomatic residents.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/prevention & control , COVID-19/transmission , Carrier State/diagnosis , Disease Outbreaks/prevention & control , Homes for the Aged/statistics & numerical data , Nursing Homes/statistics & numerical data , Adult , Aged , Aged, 80 and over , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Symptom Assessment , United Kingdom/epidemiology
14.
Int J STD AIDS ; 21(1): 46-51, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19933205

ABSTRACT

We conducted a prospective cohort study to assess sexual behaviour of students at a British University during the summer break, to explore the role of foreign travel as a risk factor of sexually transmitted infections acquisition and to determine characteristics associated with casual sex. We found that those who travelled abroad were more likely to use alcohol (RR 1.59, 95% CI 1.17-2.16) and cannabis (RR 1.35, 95% CI 1.13-1.62) and to have casual sex during holidays. They also reported more sexual relationships after holidays (RR 1.26, 95% CI 1.09-1.53). New partnerships during holidays were associated with being single, foreign travel, drinking alcohol and having previously had large number of sexual partners. The adjusted relative risk of developing new sexual partnerships with foreign travel was 2.70 (95% CI 1.11-6.61). People who travel abroad during holidays are more likely to engage in risk taking behaviour and have casual sex. They are also more sexually active after holidays.


Subject(s)
Alcohol Drinking , Risk-Taking , Sexual Behavior/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Substance-Related Disorders , Travel/statistics & numerical data , Adolescent , Adult , Cannabis , Female , Humans , Illicit Drugs , Male , Middle Aged , Prospective Studies , United Kingdom/epidemiology
15.
Int J STD AIDS ; 20(9): 619-22, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19710334

ABSTRACT

The aim of the study was to determine whether international students have greater risk-taking behaviours that could lead to importing novel and resistant strains of sexually transmitted infections (STIs). We conducted a cross-sectional web-based survey of university students' sexual behaviour, alcohol and drug use, and self-reported diagnosis of STIs and compared these between British and international students. In all, 827 students completed the survey, of whom 123 (15%) were international students. International students were less likely to have ever drunk alcohol (95.4% versus 87.8%, P = 0.002) and used drugs (56.4% versus 41.5%, P = 0.002). International students were on average almost two years older at first intercourse (18.7 versus 17 years; P < 0.001). There were no differences in the number of sexual partners between national and international students. On a discriminant analysis model, international students were characterized by being older and from a non-white background, less likely to use cocaine, they drank alcohol less frequently and were more likely to have had unprotected intercourse with two or more partners in the previous year. In conclusion, international students tend to drink more moderately and use fewer recreational drugs than British students. However, they exhibit higher sexual risk behaviours that could lead to importing novel and resistant strains of STIs.


Subject(s)
Alcohol Drinking/epidemiology , Sexual Behavior , Sexually Transmitted Diseases/transmission , Substance-Related Disorders/epidemiology , Travel , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , Risk-Taking , Students , United Kingdom , Universities
16.
Public Health ; 123(10): 645-9, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19875140

ABSTRACT

OBJECTIVES: To establish uptake of influenza vaccine amongst care home clinical staff in Greater Nottingham, and to investigate what could be done to improve vaccine uptake in this group. STUDY DESIGN: Postal questionnaire surveys were used. In the first instance, a total sample survey was used. In the second instance, a sample of care home staff was surveyed, randomized at the care home level. METHODS: A postal questionnaire completed by care home matrons was used to obtain a preliminary estimate of staff vaccine uptake. Individual staff questionnaires were then used to validate this finding, and measure attitudes, beliefs and behaviours associated with vaccination. RESULTS: Vaccine uptake among those working in care homes with nursing was found to be low. Vaccine uptake was higher in homes with a policy recommending vaccination of staff. Most respondents who had received vaccination reported that they had done so because of an existing medical condition, rather than because of being a healthcare worker. A statistically significant relationship (P=0.02) was found between individuals' reported beliefs on how well they could resist influenza and their vaccination status. CONCLUSIONS: All care homes for the elderly should have a vaccination policy which recommends staff vaccination. Educational campaigns, vaccination in the workplace and free provision of the influenza vaccine may help to improve vaccine uptake in this group.


Subject(s)
Allied Health Personnel/psychology , Attitude of Health Personnel , Homes for the Aged , Influenza Vaccines/administration & dosage , Nursing Homes , Health Knowledge, Attitudes, Practice , Humans , Infection Control/methods , Influenza, Human/prevention & control , Influenza, Human/transmission , Odds Ratio , Organizational Policy , Random Allocation , Sampling Studies , Surveys and Questionnaires , United Kingdom
17.
Int J STD AIDS ; 19(6): 370-7, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18595873

ABSTRACT

Understanding predisposing factors for sexually transmitted infections (STIs) in young adults may identify targets for public health interventions. We conducted a cross-sectional web-based survey of university students' sexual attitudes, behaviours and lifestyles and self-reported rates of STI. A total of 827 students responded, 22.4% had two or more sexual partners in the previous year with inconsistent condom use and the lifetime prevalence of STIs was 9.6%. Factors associated with a diagnosis of STI were increasing age and number of sexual partners ever, female gender (adjusted odds ratio [AOR] 2.70, 95% confidence interval [CI] 1.31, 5.56) and use of crack (AOR 10.45, 95% CI 1.46, 75.16). For female students, these were increasing age and number of partners ever, whereas for male students having sex with other men (bisexual AOR 4.8, 95% CI 1.02, 22.595, homosexual AOR 17.66, 95% CI 3.03, 103.04) and use of crack (AOR 32.24, 95% CI 3.33, 312.08). Multiple partners and recreational drug use may predict incidence of STI. Prevention strategies need to aim at reducing risk behaviour across various activities.


Subject(s)
Condoms/statistics & numerical data , Sexual Behavior , Sexual Partners , Sexually Transmitted Diseases/epidemiology , Adult , Crack Cocaine , Cross-Sectional Studies , Female , Humans , Male , Risk-Taking , Sex , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/ethnology , White People/statistics & numerical data
19.
Trop Doct ; 38(2): 93-5, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18453497

ABSTRACT

Community reproductive health workers play a valuable role in family planning counselling and the distribution of contraceptive methods in rural communities. However, they face stigma, misconceptions and a lack of support. Regular supervision by health workers and support from community leaders can help address these issues.


Subject(s)
Attitude to Health , Community Health Workers , Family Planning Services/statistics & numerical data , Health Personnel , Needs Assessment , Reproductive Medicine , Community Health Workers/education , Community Health Workers/psychology , Health Knowledge, Attitudes, Practice , Health Personnel/education , Health Personnel/psychology , Humans , Reproductive Medicine/education , Surveys and Questionnaires , Uganda
20.
Int J STD AIDS ; 29(4): 350-356, 2018 03.
Article in English | MEDLINE | ID: mdl-28835196

ABSTRACT

Recreational drug use (RDU) has been reported to be disproportionately higher in men who have sex with men (MSM) when compared to their heterosexual counterparts. To identify RDU, links to risky sexual practices and infections for MSM attending three sexual health clinics across Manchester, United Kingdom, a retrospective case note review was conducted using a random powered sample of service users attending three sites during 2014. Three hundred and fifty-seven case notes were reviewed across three sites. Eighteen per cent of service users reported any type of RDU. Use of at least one of the three drugs associated with chemsex (crystal methamphetamine, mephedrone, gamma hydroxybutyrate/gamma butyrolactone) was reported by 3.6%. A statistically significant difference was identified between non-drug users and any-drug users reporting: group sex (odds ratio [OR] 5.88, p = 0.013), condomless receptive anal intercourse (CRAI) (OR 2.77, p = 0.003) and condomless oral intercourse (OR 2.52, p = 0.016). A statistically significant difference was identified between chemsex-related drug user and non-drug user groups reporting: group sex (OR 13.05, p = 0.023), CRAI (OR 3.69, p = 0.029) and condomless insertive anal intercourse (OR 1.27, p = 0.039). There was also a statistically higher incidence of gonorrhoea infection in chemsex-related drug use compared with those not using drugs (p = 0.002, OR 6.88). This study identifies that substance use is common in MSM attending sexual health clinics in Manchester. High-risk sexual practices and certain sexually transmitted infections are more common in MSM reporting RDU.


Subject(s)
Homosexuality, Male , Risk-Taking , Sexually Transmitted Diseases/epidemiology , Substance-Related Disorders/epidemiology , Adult , Humans , Illicit Drugs , Male , Middle Aged , Prevalence , Retrospective Studies , Sexual Behavior/statistics & numerical data , Sexual Health , Surveys and Questionnaires , United Kingdom/epidemiology , Unsafe Sex/statistics & numerical data , Young Adult
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