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The second study of infectious intestinal disease (IID2): increased rates of recurrent diarrhoea in individuals aged 65 years and above.

Tam CC, Viviani L, Rodrigues LC, O'Brien SJ - BMC Public Health (2013)

Bottom Line: We used Cox models to investigate factors associated with recurrent illness.Elderly populations have a high propensity for recurrent IID.More detailed studies are needed to identify vulnerable subgroups and susceptibility factors, and inform adequate control policies among the elderly.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. clarence.tam@lshtm.ac.uk.

ABSTRACT

Background: Infectious intestinal disease (IID) is a major health and economic burden in high-income countries. In the UK, there are an estimated 17 million IID cases annually, of which 6 million are caused by the 12 most common pathogens. Host factors that influence risk of IID are not well understood.

Methods: We analyzed data from the IID2 Study, a UK cohort that measured IID incidence, to investigate factors associated with recurrent IID. We calculated rates of IID by age group, sex, previous episodes experienced, and socioecomic indicators. We used Cox models to investigate factors associated with recurrent illness.

Results: The rate of IID was five times higher among infants than those aged 65 years and above (hazard ratio, HR = 5.0, 95% CI: 3.1 - 8.0). However, the association between previous IID and a subsequent IID episode was stronger in the elderly. Among those aged 65 years and above, each additional IID episode increased the rate of subsequent IID three-fold (HR = 3.1, 95% CI: 2.5 - 3.7). Among infants, the corresponding increase was 1.7-fold (HR = 1.7, 95% CI: 1.3 - 2.3).

Conclusions: Elderly populations have a high propensity for recurrent IID. More detailed studies are needed to identify vulnerable subgroups and susceptibility factors, and inform adequate control policies among the elderly.

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Sensitivity analysis investigating the influence of varying lengths of follow-up on model-estimated hazard ratios and 95% CIs for the main effects of age and the interaction between age group and a linear effect of previous episodes. Dark squares: all cohort participants; Light squares: participants with >12 weeks of follow-up; Dark circles: participants with >26 weeks of follow-up; Light circles: participants with >39 weeks of follow-up.
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Figure 1: Sensitivity analysis investigating the influence of varying lengths of follow-up on model-estimated hazard ratios and 95% CIs for the main effects of age and the interaction between age group and a linear effect of previous episodes. Dark squares: all cohort participants; Light squares: participants with >12 weeks of follow-up; Dark circles: participants with >26 weeks of follow-up; Light circles: participants with >39 weeks of follow-up.

Mentions: In the sensitivity analysis, excluding individuals with fewer than 27 weeks of follow-up had little effect on the results (Figure 1). When only individuals with >39 weeks of follow-up were included in the model, the effect of previous episodes on IID rate was markedly decreased in all age groups, although the main effect for age remained unchanged. This was likely the result of a loss of statistical power to investigate interaction effects, as there were no individuals with more than two episodes among those with >39 weeks of follow-up. The effect of previous episodes among the 65+ age group, however, was still apparent.


The second study of infectious intestinal disease (IID2): increased rates of recurrent diarrhoea in individuals aged 65 years and above.

Tam CC, Viviani L, Rodrigues LC, O'Brien SJ - BMC Public Health (2013)

Sensitivity analysis investigating the influence of varying lengths of follow-up on model-estimated hazard ratios and 95% CIs for the main effects of age and the interaction between age group and a linear effect of previous episodes. Dark squares: all cohort participants; Light squares: participants with >12 weeks of follow-up; Dark circles: participants with >26 weeks of follow-up; Light circles: participants with >39 weeks of follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750603&req=5

Figure 1: Sensitivity analysis investigating the influence of varying lengths of follow-up on model-estimated hazard ratios and 95% CIs for the main effects of age and the interaction between age group and a linear effect of previous episodes. Dark squares: all cohort participants; Light squares: participants with >12 weeks of follow-up; Dark circles: participants with >26 weeks of follow-up; Light circles: participants with >39 weeks of follow-up.
Mentions: In the sensitivity analysis, excluding individuals with fewer than 27 weeks of follow-up had little effect on the results (Figure 1). When only individuals with >39 weeks of follow-up were included in the model, the effect of previous episodes on IID rate was markedly decreased in all age groups, although the main effect for age remained unchanged. This was likely the result of a loss of statistical power to investigate interaction effects, as there were no individuals with more than two episodes among those with >39 weeks of follow-up. The effect of previous episodes among the 65+ age group, however, was still apparent.

Bottom Line: We used Cox models to investigate factors associated with recurrent illness.Elderly populations have a high propensity for recurrent IID.More detailed studies are needed to identify vulnerable subgroups and susceptibility factors, and inform adequate control policies among the elderly.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. clarence.tam@lshtm.ac.uk.

ABSTRACT

Background: Infectious intestinal disease (IID) is a major health and economic burden in high-income countries. In the UK, there are an estimated 17 million IID cases annually, of which 6 million are caused by the 12 most common pathogens. Host factors that influence risk of IID are not well understood.

Methods: We analyzed data from the IID2 Study, a UK cohort that measured IID incidence, to investigate factors associated with recurrent IID. We calculated rates of IID by age group, sex, previous episodes experienced, and socioecomic indicators. We used Cox models to investigate factors associated with recurrent illness.

Results: The rate of IID was five times higher among infants than those aged 65 years and above (hazard ratio, HR = 5.0, 95% CI: 3.1 - 8.0). However, the association between previous IID and a subsequent IID episode was stronger in the elderly. Among those aged 65 years and above, each additional IID episode increased the rate of subsequent IID three-fold (HR = 3.1, 95% CI: 2.5 - 3.7). Among infants, the corresponding increase was 1.7-fold (HR = 1.7, 95% CI: 1.3 - 2.3).

Conclusions: Elderly populations have a high propensity for recurrent IID. More detailed studies are needed to identify vulnerable subgroups and susceptibility factors, and inform adequate control policies among the elderly.

Show MeSH
Related in: MedlinePlus