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Các yếu tố môi trường ảnh hưởng đến nguy cơ nhiễm Campylobacter ở Philadelphia từ năm 1994 đến 2007
Tóm tắt
Nhiễm khuẩn Campylobacter là nguyên nhân phổ biến gây viêm dạ dày ruột cấp tính, và có thể ít gặp hơn nhưng cũng có thể dẫn đến các biến chứng liên quan đến thận, hệ thần kinh và khớp. Mặc dù đã quan sát thấy sự gia tăng nhiễm Campylobacter vào mùa hè, nhưng các cơ chế môi trường thúc đẩy tính mùa vụ của bệnh vẫn chưa được hiểu rõ. Chúng tôi đã tiến hành đánh giá mối quan hệ giữa các yếu tố môi trường và nguy cơ nhiễm Campylobacter ở một khu vực đô thị lớn tại Bắc Mỹ. Chúng tôi đã đánh giá 1532 trường hợp nhiễm Campylobacter được báo cáo tại Philadelphia giữa năm 1994 và 2007. Chúng tôi đã xây dựng các mô hình hồi quy Poisson với các bộ lọc dao động, và cũng sử dụng thiết kế trường hợp chéo, để đánh giá mối liên quan giữa các yếu tố môi trường và nguy cơ bệnh theo từng tuần và từng ngày. Cả hai phương pháp đều kiểm soát sự nhiễu loạn từ các yếu tố môi trường dao động theo mùa. Tỷ lệ nhiễm cao nhất vào tháng Sáu và tháng Bảy, với chu kỳ hàng năm. Tỷ lệ nhiễm theo tuần có liên quan đến độ ẩm tương đối tăng (tỷ lệ tỷ lệ nhiễm (IRR) mỗi % 1.017, khoảng tin cậy 95% 1.008–1.025), nhiệt độ (IRR mỗi °C 1.041, khoảng tin cậy 95% 1.011–1.072), và nhiệt độ sông Delaware giảm trong cùng tuần (IRR mỗi °C 0.922, khoảng tin cậy 95% 0.883–0.962), cũng như tại các độ trễ 4 tuần (IRR mỗi °C 0.953, khoảng tin cậy 95% 0.919–0.990). Không có mối liên quan cấp tính nào được xác định trong các phân tích trường hợp chéo. Các phát hiện của chúng tôi xác nhận tính mùa vụ vào mùa hè của nhiễm Campylobacter ở Philadelphia, và mối liên hệ giữa thời tiết ấm, ẩm ướt và nguy cơ bệnh. Tuy nhiên, mối liên hệ giữa nhiệt độ sông thấp và nguy cơ nhiễm Campylobacter ở người được mô tả ở đây là mới, phù hợp với các liên kết đã biết giữa nhiệt độ lưu vực và khả năng sống sót của Campylobacter, và chỉ ra rằng các lưu vực địa phương là các bể chứa quan trọng về dịch tễ học cho các tác nhân gây bệnh lây truyền qua thực phẩm.
Từ khóa
#Campylobacter #nhiễm khuẩn #yếu tố môi trường #bệnh viêm dạ dày ruột cấp tính #PhiladelphiaTài liệu tham khảo
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