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Socioeconomic status linked to Campylobacteriosis risk
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In Connecticut, higher socioeconomic status was correlated with increased prevalence of campylobacteriosis, according to recent findings.
However, the reverse association was seen in children aged younger than 10 years, who had a higher incidence of campylobacteriosis when living in neighborhoods of lower socioeconomic status.
In the study, researchers geocoded the residences of 5,708 patients reported to have campylobacteriosis in Connecticut between 1999 and 2009, representing 95.9% of cases reported in the state during that time. They used census tract-level poverty as a measure of socioeconomic status for analysis. Patient residences were categorized into four groups, based on the percentage of residents in the census tract who lived below the federal poverty level: 0%-5%, 5%-10%, 10%-20%, and >20%. The investigators then calculated the average annual age-adjusted prevalence for each of the four socioeconomic categories for all years combined, and also for three time periods (1999-2002, 2003-2005 and 2006-2009). Age group-specific rates were also calculated for case patients in the four socioeconomic categories.
The researchers found that the average annual campylobacteriosis crude incidence rate was 15.9 per 100,000 population. The average age-specific incidence rate ranged from 9.4 per 100,000 population in the 10-19 years age group to 18.1 per 100,000 population in the >50 years age group.
There was a strong dose-response relationship between higher campylobacteriosis incidence and higher neighborhood socioeconomic status, according to the researchers. The average annual age-adjusted prevalence was 10.1 (95% CI, 9.1-11.1) per 100,000 population for the lowest socioeconomic level (≥20% below federal poverty level); 11.9 (95% CI, 11-12.9) for the 10%-20% group; 14.8 (95% CI, 14-15.7) for the 5%-10% group; and 16.9 (95% CI, 16.3-17.4) per 100,000 for the highest socioeconomic group (P<0.001). Additionally, there was a strongly consistent and significant socioeconomic gradient (P<0.001) for each of the three time periods.
For all age groups >10 years, campylobacteriosis cases increased in proportion to increases in socioeconomic status (P<0.001). However, this trend reversed among children aged 0 to 10 years, where the prevalence of campylobacteriosis increased as neighborhood socioeconomic status decreased (P<0.001).
According to the researchers, the results could be explained by the fact that campylobacteriosis cases of higher socioeconomic status may be more likely to seek health care and have an organism-specific diagnosis made. However, it is more likely that there is a greater prevalence of campylobacteriosis risk factors in higher socioeconomic settings — including international travel and eating out at restaurants.
The finding that children aged younger than 10 years living in poorer census tracts were at higher risk for infection may “reflect a higher rate of exposure to Campylobacterspecies in the home,” the researchers wrote. “However, this hypothesis needs verification. In addition, studies in other parts of the United States are needed to corroborate this study’s findings.”
Disclosure: The researchers report no relevant disclosures.
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