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Geographic correlation between deprivation and risk of meningococcal disease: an ecological study.

Williams CJ, Willocks LJ, Lake IR, Hunter PR - BMC Public Health (2004)

Bottom Line: An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.Two-thirds of the increased incidence was due to cases in the under fives.The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.

View Article: PubMed Central - HTML - PubMed

Affiliation: East & North Hertfordshire Health Protection Unit, Welwyn Garden City, Hertfordshire AL8 6JL, United Kingdom. kitwilliams@nhs.net

ABSTRACT

Background: Meningitis caused by Neisseria meningitidis is a serious infection which is most common in young children and adolescents. This study investigated the relationships between the incidence and age distribution of meningococcal disease, and socioeconomic environment.

Methods: An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.

Results: Incidence of meningococcal disease was highest in the most deprived wards, with a relative risk of 1.97 (1.55 - 2.51). Mapping revealed geographical coincidence of deprivation and meningococcal disease, particularly in urban areas. Two-thirds of the increased incidence was due to cases in the under fives.

Conclusions: The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.

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Related in: MedlinePlus

Age-specific incidence rates*: Comparison of cases in each Townsend score group (thirds, 1151 wards) *Sources Cases: Confirmed and probable cases of invasive meningococcal disease included in analysis, enhanced surveillance data from CDSC eastern Denominator: 1999 population estimates, compendium of clinical and health indicators 2001, adjusted from synthetic wards (see methods) Map files : 1991 Census digitised boundary data Townsend scores: 1991 Census area statistics
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Figure 2: Age-specific incidence rates*: Comparison of cases in each Townsend score group (thirds, 1151 wards) *Sources Cases: Confirmed and probable cases of invasive meningococcal disease included in analysis, enhanced surveillance data from CDSC eastern Denominator: 1999 population estimates, compendium of clinical and health indicators 2001, adjusted from synthetic wards (see methods) Map files : 1991 Census digitised boundary data Townsend scores: 1991 Census area statistics

Mentions: The age-specific incidence rates are shown in figure 2. The most striking feature is the large excess of cases in the under ones and one to fours in the most deprived wards. The incidence is 1.9 times higher for the most deprived under fives (under one and one to four groups combined). The increased incidence in the under five age group accounts for 68% of the difference in overall incidence between the most and least deprived wards. The incidences in the 16 age groups used varied significantly between the three deprivation groups (Friedman test, p < 0.0001).


Geographic correlation between deprivation and risk of meningococcal disease: an ecological study.

Williams CJ, Willocks LJ, Lake IR, Hunter PR - BMC Public Health (2004)

Age-specific incidence rates*: Comparison of cases in each Townsend score group (thirds, 1151 wards) *Sources Cases: Confirmed and probable cases of invasive meningococcal disease included in analysis, enhanced surveillance data from CDSC eastern Denominator: 1999 population estimates, compendium of clinical and health indicators 2001, adjusted from synthetic wards (see methods) Map files : 1991 Census digitised boundary data Townsend scores: 1991 Census area statistics
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC503390&req=5

Figure 2: Age-specific incidence rates*: Comparison of cases in each Townsend score group (thirds, 1151 wards) *Sources Cases: Confirmed and probable cases of invasive meningococcal disease included in analysis, enhanced surveillance data from CDSC eastern Denominator: 1999 population estimates, compendium of clinical and health indicators 2001, adjusted from synthetic wards (see methods) Map files : 1991 Census digitised boundary data Townsend scores: 1991 Census area statistics
Mentions: The age-specific incidence rates are shown in figure 2. The most striking feature is the large excess of cases in the under ones and one to fours in the most deprived wards. The incidence is 1.9 times higher for the most deprived under fives (under one and one to four groups combined). The increased incidence in the under five age group accounts for 68% of the difference in overall incidence between the most and least deprived wards. The incidences in the 16 age groups used varied significantly between the three deprivation groups (Friedman test, p < 0.0001).

Bottom Line: An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.Two-thirds of the increased incidence was due to cases in the under fives.The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.

View Article: PubMed Central - HTML - PubMed

Affiliation: East & North Hertfordshire Health Protection Unit, Welwyn Garden City, Hertfordshire AL8 6JL, United Kingdom. kitwilliams@nhs.net

ABSTRACT

Background: Meningitis caused by Neisseria meningitidis is a serious infection which is most common in young children and adolescents. This study investigated the relationships between the incidence and age distribution of meningococcal disease, and socioeconomic environment.

Methods: An ecological design was used, including mapping using a Geographical Information System (GIS) at census ward level.

Results: Incidence of meningococcal disease was highest in the most deprived wards, with a relative risk of 1.97 (1.55 - 2.51). Mapping revealed geographical coincidence of deprivation and meningococcal disease, particularly in urban areas. Two-thirds of the increased incidence was due to cases in the under fives.

Conclusions: The results suggest that area deprivation is a risk factor for meningococcal disease, and that its effects are seen most in young children.

Show MeSH
Related in: MedlinePlus