Geographic determinants of reported human Campylobacter infections in Scotland

Abstract
Campylobacteriosis is the leading cause of bacterial gastroenteritis in most developed countries. People are exposed to infection from contaminated food and environmental sources. However, the translation of these exposures into infection in the human population remains incompletely understood. This relationship is further complicated by differences in the presentation of cases, their investigation, identification, and reporting; thus, the actual differences in risk must be separated from the artefactual differences. This paper describes a Generalised Linear Model (GLM) of Campylobacter case reporting rates within Scotland. Using data on 34,193 confirmed Campylobacter infections in mainland Scotland between 2000 and 2006 (inclusive) a number of risk factors were tested. Social deprivation (measured by the Carstairs index) was protective (p<0.001) whilst a greater number of private water supplies per person was associated with increased case rates (p<0.001). Once these factors were taken into account significant differences remain in reported infection rates between certain NHS Boards and the expectation; this suggests that either the levels of ascertainment between NHS Boards in Scotland are not uniform or there are determinants of infection which have not been included in the model. Following stratification by age group, population density had a significant protective effect for those under 15 but not for those aged 15 and older, demonstrating that rural children are at greater risk than their urban counterparts. This model demonstrates that the less deprived and children living in rural areas and areas with a large number of private water supplies are at the greatest risk of being reported as cases of Campylobacter infection.
Year
2010
Category
Refereed journal