AbstractsBiology & Animal Science

Characterization and prediction of multiple episodes of different reportable diseases in Montreal residents, 1990-2012

by Melissa Caron




Institution: McGill University
Department: Department of Epidemiology and Biostatistics
Degree: MS
Year: 2015
Keywords: Health Sciences - Epidemiology
Record ID: 2059713
Full text PDF: http://digitool.library.mcgill.ca/thesisfile130464.pdf


Abstract

Studies of public health reporting have examined multiple episodes of the same communicable disease within an individual, but have not described multiple episodes of different reportable diseases within individuals. Such an analysis could identify ways in which to prevent consecutive reportable disease episodes and could guide future revisions to public health intervention strategies. Using passive surveillance data, an exploratory analysis of Montreal residents with multiple reportable disease episodes from 1990 to 2012 was conducted. During this time, there were 157,839 individuals with at least one disease report and a total of 179,455 reportable disease episodes. Individuals with more than one communicable disease episode accounted for one of every five communicable disease reports, were more likely to have sexually transmitted infections (STIs) and were more likely to reside in the neighbourhood encompassing Montreal's gay village. Enteric diseases, as a group, were reported at lower rates in persons with multiple episodes. However, amoebiasis, giardiasis and shigellosis were reported more commonly in men with multiple episodes than in men with only one episode. This finding supports the mounting evidence that enteric diseases may be sexually transmitted, especially among men who have sex with men. Consequently, to aid public health authorities in identifying probable cases of sexually acquired enteric diseases, we developed a logistic regression model to predict the probability of acquiring a future STI in individuals with an enteric disease report. Our final prediction model accounted for the age, sex, residential location, history of STI episodes and type of enteric disease acquired. This model had an area under the receiver operating characteristic curve of 0.77 and had acceptable calibration. It follows that this prediction model can be used to guide efforts to investigate and control reported cases of enteric diseases by public health officials. Les études épidémiologiques portant sur la signalisation des maladies à déclaration obligatoire (MADO) sont réalisées en tenant compte que d'une MADO à la fois et n'ont jamais décrites de multiples épisodes de différentes MADO chez un même individu. Une analyse qui tiendrait compte de toutes les MADO pourrait identifier des stratégies servant à empêcher des MADO à répétition et pourrait guider de futurs changements apportés aux interventions de santé publique. Nous avons utilisé des données de surveillance pour réaliser une analyse exploratoire ayant pour but de décrire la situation épidémiologique chez les Montréalais faisant des MADO à répétition. Entre 1990 et 2012, 179,455 cas de MADO vécus par 157,839 individus ont été déclarés à la direction de santé publique de Montréal. Une MADO sur cinq ont été signalée chez les personnes ayant eu plus d'un épisode. Ces personnes étaient plus susceptibles d'avoir des infections transmissibles sexuellement et par le sang (ITSS) et d'habiter dans le quartier comprenant le village gai de Montréal. Les maladies entériques,…