1
|
Mooney SJ, Rundle AG, Morrison CN. Registry Data in Injury Research: Study Designs and Interpretation. CURR EPIDEMIOL REP 2022; 9:263-272. [PMID: 36777794 PMCID: PMC9912303 DOI: 10.1007/s40471-022-00311-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/03/2022]
Abstract
Purpose of Review Injury data is frequently captured in registries that form a census of 100% of known cases that meet specified inclusion criteria. These data are routinely used in injury research with a variety of study designs. We reviewed study designs commonly used with data extracted from injury registries and evaluated the advantages and disadvantages of each design type. Recent Findings Registry data are suited to 5 major design types: (1) Description, (2) Ecologic (with Ecologic Cohort as a particularly informative sub-type), (3) Case-control (with location-based and culpability studies as salient subtypes), (4) Case-only (including case-case and case-crossover subtypes), and (5) Outcomes. Summary Registries are an important resource for injury research. Investigators considering use of a registry should be aware of the advantages and disadvantages of available study designs.
Collapse
Affiliation(s)
- Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, United States
| | - Andrew G Rundle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
- Center for Injury Science and Prevention, Columbia University, New York, NY, United States
| | - Christopher N Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
- Center for Injury Science and Prevention, Columbia University, New York, NY, United States
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC, Australia
| |
Collapse
|
2
|
Rundle AG, Bader MDM, Branas CC, Lovasi GS, Mooney SJ, Morrison CN, Neckerman KM. Causal Inference with Case-Only Studies in Injury Epidemiology Research. CURR EPIDEMIOL REP 2022; 9:223-232. [PMID: 37152190 PMCID: PMC10161782 DOI: 10.1007/s40471-022-00306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/03/2022]
Abstract
Purpose of Review We review the application and limitations of two implementations of the "case-only design" in injury epidemiology with example analyses of Fatality Analysis Reporting System data. Recent Findings The term "case-only design" covers a variety of epidemiologic designs; here, two implementations of the design are reviewed: (1) studies to uncover etiological heterogeneity and (2) studies to measure exposure effect modification. These two designs produce results that require different interpretations and rely upon different assumptions. The key assumption of case-only designs for exposure effect modification, the more commonly used of the two designs, does not commonly hold for injuries and so results from studies using this design cannot be interpreted. Case-only designs to identify etiological heterogeneity in injury risk are interpretable but only when the case-series is conceptualized as arising from an underlying cohort. Summary The results of studies using case-only designs are commonly misinterpreted in the injury literature.
Collapse
Affiliation(s)
- Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | | | - Charles C. Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | - Gina S. Lovasi
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
| | - Stephen J. Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| | - Kathryn M. Neckerman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 727, New York, NY 10032, USA
| |
Collapse
|
3
|
Spatial and space-time clustering and demographic characteristics of human nontyphoidal Salmonella infections with major serotypes in Toronto, Canada. PLoS One 2020; 15:e0235291. [PMID: 32609730 PMCID: PMC7329108 DOI: 10.1371/journal.pone.0235291] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/11/2020] [Indexed: 01/04/2023] Open
Abstract
Nontyphoidal Salmonella enterica (NTS) causes a substantial health burden to human populations in Canada and worldwide. Exposure sources and demographic factors vary by location and can therefore have a major impact on salmonellosis clustering. We evaluated major NTS serotypes: S. Enteritidis (n = 620), S. Typhimurium (n = 150), S. Thompson (n = 138), and S. Heidelberg (n = 136) reported in the city of Toronto, Canada, between January 1, 2015, and December 31, 2017. Cases were analyzed at the forward sortation area (FSA)—level (an area indicated by the first three characters of the postal code). Serotype-specific global and local clustering of infections were evaluated using the Moran's I method. Spatial and space-time clusters were investigated using Poisson and multinomial scan statistic models. Case-case analyses using a multinomial logistic regression model was conducted to compare seasonal and demographic factors among the different serotypes. High infection rate FSAs clustered in the central region of Toronto for S. Enteritidis, in the south-central region for S. Typhimurium, in north-west region for S. Thompson, and in the south-east region for S. Heidelberg. The relative risk ratio of S. Enteritidis infections was significantly higher in cases who reported travel outside of Ontario. The relative risk ratio of infections was significantly higher in summer for S. Typhimurium, and in fall for S. Thompson. The relative risk ratio of infection was highest for the 0–9 age group for S. Typhimurium, and the 20–39 age group for S. Heidelberg. Our study will aid public health stakeholders in designing serotype-specific geographically targeted disease prevention programs.
Collapse
|
4
|
Paphitis K, Pearl DL, Berke O, McEwen SA, Trotz-Williams L. A case-case study comparing the individual risk factors and symptomatology of Salmonella Heidelberg and Salmonella Typhimurium in Ontario in 2015, following implementation of the Ontario Investigation Tools. Zoonoses Public Health 2020; 67:484-495. [PMID: 32364683 DOI: 10.1111/zph.12709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/03/2020] [Accepted: 04/03/2020] [Indexed: 11/26/2022]
Abstract
Salmonella Heidelberg and Salmonella Typhimurium are among the most common serotypes responsible for human salmonellosis in Ontario. Introduction of the Ontario Investigation Tools (OIT) in 2014 allowed for standardized case investigation and reporting. This study compared the risk factors and symptomatology for sporadic S. Heidelberg and S. Typhimurium cases reported in Ontario in 2015, following implementation of the OIT. Multilevel logistic regression models were applied to assess associations between serotype and individual-level demographic characteristics, exposures and symptoms for sporadic confirmed cases of S. Heidelberg and S. Typhimurium in Ontario in 2015. There were 476 sporadic cases of S. Typhimurium (n = 278) and S. Heidelberg (n = 198) reported in Ontario in 2015. There were significant associations between the odds of the isolate from a case being one of these serotypes, and travel, consumption of sprouts (any type), contact with reptiles and development of malaise, fever or bloody diarrhoea. The S. Typhimurium and S. Heidelberg cases differed in both symptom presentation and risk factors for illness. Case-case comparisons of Salmonella serotypes have some advantages over case-control studies in that these are less susceptible to selection and recall bias while allowing for rapid comparison of cases to identify potential high-risk exposures that are unique to one of the serotypes when compared to the other. Comparing cases of two different Salmonella serotypes can help to highlight risk factors that may be uniquely associated with one serotype, or more strongly associated with one serotype compared to another. This information may be useful for understanding relative source attribution between common serotypes of Salmonella.
Collapse
Affiliation(s)
- Katherine Paphitis
- Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada.,Infection Prevention and Control, Public Health Ontario, Toronto, ON, Canada
| | - David L Pearl
- Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada
| | - Olaf Berke
- Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada
| | - Scott A McEwen
- Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada
| | - Lise Trotz-Williams
- Department of Population Medicine, University of Guelph, Ontario Veterinary College, Guelph, ON, Canada.,Wellington-Dufferin-Guelph Public Health, Guelph, ON, Canada
| |
Collapse
|
5
|
Benedict KM, Collier SA, Marder EP, Hlavsa MC, Fullerton KE, Yoder JS. Case-case analyses of cryptosporidiosis and giardiasis using routine national surveillance data in the United States - 2005-2015. Epidemiol Infect 2019; 147:e178. [PMID: 31063098 PMCID: PMC6518830 DOI: 10.1017/s0950268819000645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Understanding endemic infectious disease risk factors through traditional epidemiological tools is challenging. Population-based case-control studies are costly and time-consuming. A case-case analyses using surveillance data addresses these limitations by using resources more efficiently. We conducted a case-case analyses using routine surveillance data reported by 16 U.S. states (2005-2015), wherein reported cases of salmonellosis were used as a comparison group to identify exposure associations with reported cases of cryptosporidiosis and giardiasis. Odds ratios adjusted for age and reporting state (aOR) and 95% confidence intervals (95% CI) were calculated. A total of 10 704 cryptosporidiosis cases, 17 544 giardiasis cases, and 106 351 salmonellosis cases were included in this analyses. When compared with cases of salmonellosis, exposure to treated recreational water (aOR 4.7, 95% CI 4.3-5.0) and livestock (aOR: 3.2; 95% CI: 2.9-3.5) were significantly associated with cryptosporidiosis and exposure to untreated drinking (aOR 4.1, 95% CI 3.6-4.7) and recreational water (aOR 4.1, 95% CI 3.7-4.5) were associated with giardiasis. Our analyses shows that routine surveillance data with standardised exposure information can be used to identify associations of interest for cryptosporidiosis and giardiasis.
Collapse
Affiliation(s)
- K M Benedict
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - S A Collier
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - E P Marder
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - M C Hlavsa
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - K E Fullerton
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| | - J S Yoder
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases,National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention,Atlanta, GA,USA
| |
Collapse
|
6
|
Case-case analysis of Campylobacter and Salmonella - using surveillance data for outbreak investigations and monitoring routine risk factors. Epidemiol Infect 2018; 146:1916-1921. [PMID: 30092849 DOI: 10.1017/s0950268818002200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Utilising routine surveillance data, this study presents a method for generating a baseline comparison that can be used in future foodborne outbreak investigations following a case-case methodology. Salmonella and Campylobacter cases (2012-2015) from Maricopa County, AZ were compared to determine differences in risk factors, symptoms and demographics. For foods and other risk factors, adjusted odds ratios were developed using Campylobacter as the reference. Comparisons were also made for three major Salmonella subtypes, Typhimurium, Enteritidis and Poona as compared with Campylobacter. Salmonella cases were younger, while Campylobacter cases were more Hispanic and female. Campylobacter cases reported consuming peppers, sprouts, poultry, queso fresco, eggs and raw nuts more and reported contact with animal products, birds, visiting a farm or dairy, owning a pet, a sick pet, swimming in a river, lake or pond, or handling multiple raw meats more. Salmonella cases reported visiting a petting zoo and contact with a reptile more. There were significant variations by Salmonella subtype in both foods and exposures. We recommend departments conduct this analysis to generate a baseline comparison and a running average of relevant odds ratios allowing staff to focus on trace-back of contaminated food items earlier in the outbreak investigation process.
Collapse
|
7
|
Rattanaumpawan P, Boonyasiri A, Vong S, Thamlikitkul V. Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings. Am J Infect Control 2018; 46:139-146. [PMID: 29029814 DOI: 10.1016/j.ajic.2017.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/07/2017] [Accepted: 08/07/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings. METHODS We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians. RESULTS A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection. CONCLUSIONS This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases.
Collapse
Affiliation(s)
- Pinyo Rattanaumpawan
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Adhiratha Boonyasiri
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirenda Vong
- World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Visanu Thamlikitkul
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
8
|
Mandilara G, Mellou K, Karadimas K, Georgalis L, Polemis M, Georgakopoulou T, Vatopoulos A. An outbreak of a possibly new Salmonella enterica subspecies enterica serovar with the antigenic formula 11:z41:e,n,z15, Greece, March to May 2016: preliminary results. ACTA ACUST UNITED AC 2017; 21:30265. [PMID: 27363973 DOI: 10.2807/1560-7917.es.2016.21.25.30265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022]
Abstract
Eleven Salmonella spp. isolates with the antigenic type 11:z41:e,n,z15 - not referred to in the 9th edition of the White-Kauffman-Le Minor Scheme - were identified at the National Reference Laboratory for Salmonella in Greece. Their pulsed-field gel electrophoresis profiles were indistinguishable. No apparent epidemiological link has yet been identified; the results of a case-case study are pending.
Collapse
Affiliation(s)
- Georgia Mandilara
- National Reference Centre for Salmonella and Shigella, National School of Public Health & Central Public Health Laboratory, Hellenic Centre of Disease Control and Prevention, Vari, Greece
| | | | | | | | | | | | | |
Collapse
|
9
|
Fonteneau L, Jourdan Da Silva N, Fabre L, Ashton P, Torpdahl M, Müller L, Bouchrif B, El Boulani A, Valkanou E, Mattheus W, Friesema I, Herrera Leon S, Varela Martínez C, Mossong J, Severi E, Grant K, Weill FX, Gossner CM, Bertrand S, Dallman T, Le Hello S. Multinational outbreak of travel-related Salmonella Chester infections in Europe, summers 2014 and 2015. Euro Surveill 2017; 22:30463. [PMID: 28230522 PMCID: PMC5322187 DOI: 10.2807/1560-7917.es.2017.22.7.30463] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 02/06/2017] [Indexed: 02/04/2023] Open
Abstract
Between 2014 and 2015, the European Centre for Disease Prevention and Control was informed of an increase in numbers of Salmonella enterica serotype Chester cases with travel to Morocco occurring in six European countries. Epidemiological and microbiological investigations were conducted. In addition to gathering information on the characteristics of cases from the different countries in 2014, the epidemiological investigation comprised a matched case-case study involving French patients with salmonellosis who travelled to Morocco that year. A univariate conditional logistic regression was performed to quantify associations. The microbiological study included a whole genome sequencing (WGS) analysis of clinical and non-human isolates of S. Chester of varied place and year of isolation. A total of 162 cases, mostly from France, followed by Belgium, the Netherlands, Spain, Denmark and Sweden were reported, including 86 (53%) women. The median age per country ranged from 3 to 38 years. Cases of S. Chester were more likely to have eaten in a restaurant and visited the coast of Morocco. The results of WGS showed five multilocus sequence types (ST), with 96 of 153 isolates analysed clustering into a tight group that corresponded to a novel ST, ST1954. Of these 96 isolates, 46 (48%) were derived from food or patients returning from Morocco and carried two types of plasmids containing either qnrS1 or qnrB19 genes. This European-wide outbreak associated with travel to Morocco was likely a multi-source outbreak with several food vehicles contaminated by multidrug-resistant S. Chester strains.
Collapse
Affiliation(s)
- Laure Fonteneau
- Santé publique France, the French national public health agency, Saint-Maurice, France
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Laetitia Fabre
- Institut Pasteur, French National Reference Center for E. coli, Shigella and Salmonella, Paris, France
| | - Philip Ashton
- Public Health England, Gastrointestinal Bacterial Reference Unit, London, England
| | | | | | - Brahim Bouchrif
- Institut Pasteur du Maroc, Sécurité alimentaire et environnement, Casablanca, Morocco
| | | | - Eleni Valkanou
- NRL Salmonella & AMR, Veterinary Laboratory of Chalkida, Greece
| | | | - Ingrid Friesema
- Netherlands National Institute for Public Health and the Environment (RIVM), the Netherlands
| | | | | | | | - Ettore Severi
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Kathie Grant
- Public Health England, Gastrointestinal Bacterial Reference Unit, London, England
| | - François-Xavier Weill
- Institut Pasteur, French National Reference Center for E. coli, Shigella and Salmonella, Paris, France
| | - Céline M Gossner
- European Centre for Disease Prevention and Control, Stockholm, Sweden
- School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | | | - Tim Dallman
- Public Health England, Gastrointestinal Bacterial Reference Unit, London, England
| | - Simon Le Hello
- Institut Pasteur, French National Reference Center for E. coli, Shigella and Salmonella, Paris, France
| |
Collapse
|
10
|
Jennings MC, Tilley DH, Ballard SB, Villanueva M, Costa FM, Lopez M, Steinberg HE, Luna CG, Meza R, Silva ME, Gilman RH, Simons MP, Maves RC, Cabada MM. Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru. Am J Trop Med Hyg 2017; 96:1097-1106. [PMID: 28167602 PMCID: PMC5417202 DOI: 10.4269/ajtmh.16-0633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AbstractIn Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case-case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk behaviors, and the clinical features of illness. Stool samples were tested for norovirus (NV), bacteria, and parasites using conventional methods. Data obtained were then analyzed using case-case methods. NV (14%), enterotoxigenic Escherichia coli (11%), and Campylobacter (9%), notably ciprofloxacin-resistant Campylobacter, were the most frequently identified pathogens among adults with TD. Coinfection with multiple enteropathogens occurred in 5% of cases. NV caused severe disease relative to other TD-associated pathogens identified, confining over 90% of infected individuals to bed. Destination-specific risk factors include consumption of the local beverage "chicha," which was associated with Cryptosporidium infection. Preventive interventions, such as vaccines, directed against these pathogens could significantly reduce the burden of TD.
Collapse
Affiliation(s)
- Mary Carol Jennings
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Preventive Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Drake H Tilley
- Bacteriology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Sarah-Blythe Ballard
- Parasitology Department, Naval Medical Research Unit No. 6, Lima, Peru.,Asociación Benéfica PRISMA, Lima, Peru.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Miguel Villanueva
- Hematology Department, Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Martha Lopez
- Collaborative Research Center, Universidad Peruana Cayetano Heredia, Cusco, Peru.,Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Hannah E Steinberg
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - C Giannina Luna
- Virology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Rina Meza
- Bacteriology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Maria E Silva
- Virology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mark P Simons
- Bacteriology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Ryan C Maves
- Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California.,Bacteriology Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Miguel M Cabada
- Collaborative Research Center, Universidad Peruana Cayetano Heredia, Cusco, Peru.,Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
11
|
Colombara DV, Faruque ASG, Cowgill KD, Mayer JD. Risk factors for diarrhea hospitalization in Bangladesh, 2000-2008: a case-case study of cholera and shigellosis. BMC Infect Dis 2014; 14:440. [PMID: 25127553 PMCID: PMC4141120 DOI: 10.1186/1471-2334-14-440] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 08/12/2014] [Indexed: 02/05/2023] Open
Abstract
Background Cholera and shigellosis are endemic on the Indian subcontinent. Our objective was to identify cholera-specific risk factors distinct from shigellosis risk factors. Methods We conducted a case-case study among hospitalized diarrheal patients, comparing those with cholera and shigellosis in International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) hospitals in Matlab (rural) and Dhaka (urban) between January 1, 2000 and December 31, 2008. Results Multivariable Poisson regression models revealed that having more than nine years of education, compared to no education, was associated with a 39% (adjusted Risk Ratio [aRR] = 0.61, 95% confidence interval [CI]: 0.40-0.93) decreased risk for cholera hospitalization in Matlab and a 16% (aRR = 0.84, 95% CI: 0.75-0.94) decreased risk in Dhaka. Having a family member with diarrhea in the past seven days increased cholera hospitalization risk by 17% (aRR = 1.17, 95% CI: 1.09-1.26) in Matlab. Conclusions Further studies are needed to elucidate the pathway through which education impacts cholera risk in order to create targeted interventions in cholera-endemic areas. Interventions seeking to reduce transmission and facilitate hygienic practices among family members of index cases with diarrhea should be considered, especially in rural cholera endemic settings.
Collapse
Affiliation(s)
- Danny V Colombara
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | | | | | | |
Collapse
|
12
|
Zenner D, Zöllner J, Charlett A, Marmairis W, Lane C, Chow JY. Till receipts - a new approach for investigating outbreaks? Evaluation during a large Salmonella Enteritidis phage type 14b outbreak in a north west London takeaway restaurant, September 2009. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.27.20848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
Collapse
Affiliation(s)
- D Zenner
- Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, United Kingdom
- University College London, United Kingdom
| | - J Zöllner
- Imperial College London, United Kingdom
| | - A Charlett
- Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, United Kingdom
| | - W Marmairis
- North West London Health Protection Team, Public Health England, United Kingdom
| | - C Lane
- Centre for Infectious Disease Surveillance and Control (CIDSC), Public Health England, United Kingdom
| | - J Y Chow
- North West London Health Protection Team, Public Health England, United Kingdom
| |
Collapse
|
13
|
|
14
|
Gaulin C, Gravel G, Bekal S, Currie A, Ramsay D, Roy S. Challenges in Listeriosis Cluster and Outbreak Investigations, Province of Quebec, 1997–2011. Foodborne Pathog Dis 2014; 11:1-7. [DOI: 10.1089/fpd.2013.1574] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Colette Gaulin
- Ministère de la Santé et des Services Sociaux, Québec, Québec, Canada
| | - Geneviève Gravel
- Ministère de la Santé et des Services Sociaux, Montréal, Québec, Canada
| | - Sadjia Bekal
- Laboratoire de Santé Publique du Québec, Québec, Canada
| | - Andrea Currie
- Public Health Agency of Canada, Outbreak Management Division, Centre for Food-borne, Environmental, and Zoonotic Infectious Diseases, Infectious Disease and Emergency Preparedness Branch, Guelph, Ontario, Canada
| | - Danielle Ramsay
- Ministère de l'Agriculture, des Pêcheries, et de l'Alimentation du Québec, Québec, Canada
| | - Sophie Roy
- Ministère de l'Agriculture, des Pêcheries, et de l'Alimentation du Québec, Direction des Laboratoires d'Expertises, Québec, Canada
| |
Collapse
|
15
|
ZENNER D, JANMOHAMED K, LANE C, LITTLE C, CHARLETT A, ADAK GK, MORGAN D. The serotype case-case design: a direct comparison of a novel methodology with a case-control study in a national Salmonella Enteritidis PT14b outbreak in England and Wales. Epidemiol Infect 2013; 141:2346-53. [PMID: 23324254 PMCID: PMC9151425 DOI: 10.1017/s0950268812002968] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 10/24/2012] [Accepted: 12/03/2012] [Indexed: 11/05/2022] Open
Abstract
Societal and technological changes render traditional study designs less feasible for investigation of outbreaks. We compared results obtained from case-case and case-control designs during the investigation of a Salmonella Enteritidis PT14b (SE14b) outbreak in Britain to provide support for validation of this approach. Exposures of cases were compared to concurrent non-Enteritidis Salmonella cases and population controls recruited through systematic digit phone dialling. Infection with SE14b was associated with eating in oriental restaurants [odds ratio (OR) 35·8, 95% confidence interval (CI) 4·4-290·9] and consuming eggs away from home (OR 13·8, 95% CI 1·5-124·5) in the case-case study and was confirmed through a concurrent case-control study with similar effect estimates and microbiological findings of SE14b in eggs from a specific chicken flock on a Spanish farm. We found that the case-case design was feasible, quick and inexpensive, potentially minimized recall bias and made use of already interviewed cases with subtyping results. This approach has potential for use in future investigations.
Collapse
Affiliation(s)
- D. ZENNER
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - K. JANMOHAMED
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - C. LANE
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - C. LITTLE
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - A. CHARLETT
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - G. K. ADAK
- Health Protection Services Colindale, Health Protection Agency, London, UK
| | - D. MORGAN
- Health Protection Services Colindale, Health Protection Agency, London, UK
| |
Collapse
|
16
|
Varga C, Middleton D, Walton R, Savage R, Tighe MK, Allen V, Ahmed R, Rosella L. Evaluating risk factors for endemic human Salmonella Enteritidis infections with different phage types in Ontario, Canada using multinomial logistic regression and a case-case study approach. BMC Public Health 2012; 12:866. [PMID: 23057531 PMCID: PMC3538573 DOI: 10.1186/1471-2458-12-866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
Abstract
Background Identifying risk factors for Salmonella Enteritidis (SE) infections in Ontario will assist public health authorities to design effective control and prevention programs to reduce the burden of SE infections. Our research objective was to identify risk factors for acquiring SE infections with various phage types (PT) in Ontario, Canada. We hypothesized that certain PTs (e.g., PT8 and PT13a) have specific risk factors for infection. Methods Our study included endemic SE cases with various PTs whose isolates were submitted to the Public Health Laboratory-Toronto from January 20th to August 12th, 2011. Cases were interviewed using a standardized questionnaire that included questions pertaining to demographics, travel history, clinical symptoms, contact with animals, and food exposures. A multinomial logistic regression method using the Generalized Linear Latent and Mixed Model procedure and a case-case study design were used to identify risk factors for acquiring SE infections with various PTs in Ontario, Canada. In the multinomial logistic regression model, the outcome variable had three categories representing human infections caused by SE PT8, PT13a, and all other SE PTs (i.e., non-PT8/non-PT13a) as a referent category to which the other two categories were compared. Results In the multivariable model, SE PT8 was positively associated with contact with dogs (OR=2.17, 95% CI 1.01-4.68) and negatively associated with pepper consumption (OR=0.35, 95% CI 0.13-0.94), after adjusting for age categories and gender, and using exposure periods and health regions as random effects to account for clustering. Conclusions Our study findings offer interesting hypotheses about the role of phage type-specific risk factors. Multinomial logistic regression analysis and the case-case study approach are novel methodologies to evaluate associations among SE infections with different PTs and various risk factors.
Collapse
Affiliation(s)
- Csaba Varga
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Gillespie IA, Mook P, Adak GK, O'Brien SJ, McCarthy ND. The "case-chaos study" as an adjunct or alternative to conventional case-control study methodology. Am J Epidemiol 2012; 176:497-505. [PMID: 22875753 DOI: 10.1093/aje/kws034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Case-control studies are important in infectious disease epidemiology for rapidly identifying and controlling risks, but challenges, including the need for speed, can place practical restrictions on control selection and recruitment. The biased comparisons that result can hamper or, worse, mislead investigators. Following a 2009 outbreak of Shiga-like toxin-producing Escherichia coli O157 infection associated with a petting farm in southeast England, it was hypothesized that case behavior alone could be used to identify risks. Case-patients' exposures were randomized on a case-by-case basis, and the resulting permuted data were compared with the actual events preceding illness by conditional logistic regression analysis. There was good agreement between the risks identified by using our new method and the risks elicited in the original outbreak case-control studies. This was also the case in analysis of 2 further historical outbreaks. These initial findings suggest that the technique, which we have called the "case-chaos" technique, appeared to be useful in this setting. Analysis of simulated data supports this view. Circumventing the need for traditional control data has the potential to reduce outbreak investigation lead times, leading to earlier interventions and reduced morbidity and mortality. However, further validation is necessary, coupled with an awareness of limitations of the method.
Collapse
Affiliation(s)
- Iain A Gillespie
- Health Protection Services: Colindale, Health Protection Agency, London, United Kingdom.
| | | | | | | | | |
Collapse
|
18
|
GAULIN COLETTE, LEVAC ERIC, RAMSAY DANIELLE, DION RÉJEAN, ISMAÏL JOHANNE, GINGRAS SUZANNE, LACROIX CHRISTINE. Escherichia coli O157:H7 Outbreak Linked to Raw Milk Cheese in Quebec, Canada: Use of Exact Probability Calculation and Case-Case Study Approaches to Foodborne Outbreak Investigation. J Food Prot 2012; 75:812-8. [DOI: 10.4315/0362-028x.jfp-11-385] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The analytical studies used to investigate foodborne outbreak are mostly case-control or retrospective cohort studies. However, these studies can be complex to perform and susceptible to biases. This article addresses basic principles of epidemiology, probability, and the use of case-case design to identify the source of an Escherichia coli O157:H7 outbreak linked to raw milk cheese consumption in Quebec, Canada; a small number of cases with the same pulsed-field gel electrophoresis (PFGE) profile were involved. Between 4 December 2008 and 15 January 2009, a cumulative total of 16 E. coli O157:H7 cases with the same PFGE profile were reported to Quebec public health authorities. Among the first six cases reported, three had consumed raw milk cheese from the same producer (cheese A). Raw milk cheese is consumed by about 2% of the Quebec population. By using the exact probability calculation, it was found that a significantly higher proportion of E. coli O157:H7 cases (with the specific PFGE profile) than expected had consumed cheese A (P < 0.001). These computations were updated during the course of the investigation to include subsequent cases and gave the same results. A case-case study corroborated this result. This article considers alternative statistical and epidemiological approaches to investigate a foodborne outbreak—in particular with an exact probability calculation and case-case comparisons. This approach could offer a fast and inexpensive alternative to regular case-control studies to target public health actions, particularly during a foodborne outbreak.
Collapse
Affiliation(s)
- COLETTE GAULIN
- 1Ministère de la Santé et des Services sociaux, 1075 chemin Ste-Foy, Québec, Province de Québec, Canada G1S 2M1
| | - ERIC LEVAC
- 2Agence de la santé et des Services sociaux de la Montérégie, 1255 rue Beauregard, Longueuil, Province de Québec, Canada J4K 2M3
| | - DANIELLE RAMSAY
- 3Ministère de l'Agriculture, des Pêcheries et de l'Alimentation du Québec, 200 chemin Ste-Foy, Québec, Province de Québec, Canada G1R 4X6
| | - RÉJEAN DION
- 4Laboratoire de santé publique du Québec 20045 Chemin Sainte-Marie, Sainte-Anne de Bellevue, Québec, Canada H9X 3R5
| | - JOHANNE ISMAÏL
- 4Laboratoire de santé publique du Québec 20045 Chemin Sainte-Marie, Sainte-Anne de Bellevue, Québec, Canada H9X 3R5
| | - SUZANNE GINGRAS
- 5Institut national de santé publique du Québec, 1000, route de l'Église, Québec, Canada G1V 3V9
| | - CHRISTINE LACROIX
- 2Agence de la santé et des Services sociaux de la Montérégie, 1255 rue Beauregard, Longueuil, Province de Québec, Canada J4K 2M3
- 6Université de Sherbrooke, Département des sciences de la santé communautaire, 2500 rue de l'Université, Sherbrooke, Province de Québec, Canada J1K 2R1
| |
Collapse
|
19
|
Ravel A, Smolina E, Sargeant JM, Cook A, Marshall B, Fleury MD, Pollari F. Seasonality in human salmonellosis: assessment of human activities and chicken contamination as driving factors. Foodborne Pathog Dis 2010; 7:785-94. [PMID: 20184452 DOI: 10.1089/fpd.2009.0460] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study used integrated surveillance data to assess the seasonality in retail chicken contamination and of human activities and their role on the seasonality of human endemic salmonellosis. From June 2005 to May 2008, reported cases of salmonellosis were followed-up comprehensively using a standardized questionnaire, and 616 retail chicken breasts were systematically tested for Salmonella, in one Canadian community. Poisson regression was used to model seasonality of human cases, Salmonella in retail chicken, and to assess the relationship between these and selected meteorological variables. The case-case approach was used to compare the activities of salmonellosis cases that occurred during the summer peak to the other cases. There were 216 human endemic salmonellosis cases (incidence rate: 14.7 cases/100,000 person-years), predominantly of Typhimurium and Enteritidis serotypes (28.4% and 20.8%, respectively). The monthly distribution of cases was associated with ambient temperature (p < 0.001) with a significant seasonal peak in June (p = 0.03) and July (p = 0.0005), but it was not associated with precipitation (p = 0.38). Several activities reported by cases tended to be more frequent during summer. Particularly, attending a barbeque and gardening within the 3 days before the disease onset were two significant risk factors for salmonellosis in June or July compared with the salmonellosis cases that occurred in the other months. Out of all chicken samples, 185 (30%) tested positive for Salmonella spp., Kentucky being the dominant serotype (44.3% of positive samples). The monthly proportion of positive chicken samples showed no seasonal variations (p = 0.30) and was not associated with the monthly count of human cases (p = 0.99). In conclusion, even though evidence generally supports chicken as a primary vehicle of Salmonella to humans, the contamination of retail chicken was not driving the seasonality in human salmonellosis. Attending a barbeque or gardening during the hotter months of the year should be further assessed for their risk.
Collapse
Affiliation(s)
- André Ravel
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada.
| | | | | | | | | | | | | |
Collapse
|
20
|
Wilson N, Baker M, Edwards R, Simmons G. Case-case analysis of enteric diseases with routine surveillance data: Potential use and example results. EPIDEMIOLOGIC PERSPECTIVES & INNOVATIONS : EP+I 2008; 5:6. [PMID: 18976484 PMCID: PMC2584622 DOI: 10.1186/1742-5573-5-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 10/31/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND Case-control studies and outbreak investigations are the major epidemiological tools for providing detailed information on enteric disease sources and risk factors, but these investigations can be constrained by cost and logistics. METHODS We explored the advantages and disadvantages of comparing risk factors for enteric diseases using the case-case method. The main issues are illustrated with an analysis of routine notification data on enteric diseases for 2006 collected by New Zealand's national surveillance system. RESULTS Our analyses of aggregated New Zealand surveillance data found that the associations (crude odds ratios) for risk factors of enteric disease were fairly consistent with findings from local case-control studies and outbreak investigations, adding support for the use of the case-case analytical approach. Despite various inherent limitations, such an approach has the potential to contribute to the monitoring of risk factor trends for enteric diseases. Nevertheless, using the case-case method for analysis of routine surveillance data may need to be accompanied by: (i) reduction of potential selection and information biases by improving the quality of the surveillance data; and (ii) reduction of confounding by conducting more sophisticated analyses based on individual-level data. CONCLUSION Case-case analyses of enteric diseases using routine surveillance data might be a useful low-cost means to study trends in enteric disease sources and inform control measures. If used, it should probably supplement rather than replace outbreak investigations and case-control studies. Furthermore, it could be enhanced by utilising high quality individual-level data provided by nationally-representative sentinel sites for enteric disease surveillance.
Collapse
Affiliation(s)
- Nick Wilson
- Departament of Public Health, University of Otago, Wellington, New Zealand.
| | | | | | | |
Collapse
|