RESUMEN
OBJECTIVES: To determine the incidence of acute gastroenteritis in pilgrims on St. James' Way, as well as associated risk factors and microbiological characteristics. METHODS: Two studies were designed simultaneously: a cross-sectional study through self-completed questionnaires among pilgrims reaching Santiago, and a case-control study of pilgrims traveling along the Way. Multivariate analysis was performed using logistic regression. RESULTS: In the cross-sectional study, the incidence rate was 23.5 episodes of acute gastroenteritis/10³ pilgrims-day (95% CI: 18.9-2.4/10³. In the case-control study, the major risk factors were age <20 years (OR=4.72; 95% CI: 2.16-10.28), traveling in groups (three or more) (OR=1.49; 95% CI: 0.98-2.28), and drinking unbottled water (OR=2.09; 95% CI: 0.91-4.82). The most frequent etiologic agent was norovirus (56%). CONCLUSIONS: Age less than 20 years, traveling in groups and drinking unbottled water were important risk factors for acute gastroenteritis.
Asunto(s)
Gastroenteritis/epidemiología , Enfermedad Aguda , Adulto , Estudios de Casos y Controles , Catolicismo , Estudios Transversales , Femenino , Francia , Gastroenteritis/microbiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estaciones del Año , España , Adulto JovenRESUMEN
In this study, we aimed to describe the evolution of three cholera epidemics that occurred in Lusaka, Zambia, between 2003 and 2006 and to analyse the association between the increase in number of cases and climatic factors. A Poisson autoregressive model controlling for seasonality and trend was built to estimate the association between the increase in the weekly number of cases and weekly means of daily maximum temperature and rainfall. All epidemics showed a seasonal trend coinciding with the rainy season (November to March). A 1 degrees C rise in temperature 6 weeks before the onset of the outbreak explained 5.2% [relative risk (RR) 1.05, 95% CI 1.04-1.06] of the increase in the number of cholera cases (2003-2006). In addition, a 50 mm increase in rainfall 3 weeks before explained an increase of 2.5% (RR 1.02, 95% CI 1.01-1.04). The attributable risks were 4.9% for temperature and 2.4% for rainfall. If 6 weeks prior to the beginning of the rainy season an increase in temperature is observed followed by an increase in rainfall 3 weeks later, both exceeding expected levels, an increase in the number of cases of cholera within the following 3 weeks could be expected. Our explicative model could contribute to developing a warning signal to reduce the impact of a presumed cholera epidemic.
Asunto(s)
Cólera/epidemiología , Clima , Brotes de Enfermedades/estadística & datos numéricos , Humanos , Modelos Estadísticos , Vigilancia de la Población , Lluvia , Factores de Riesgo , Estaciones del Año , Zambia/epidemiologíaRESUMEN
BACKGROUND: Non-lineal temperature-mortality relationship varies depending on the characteristics of the designated study geographic zone. In given places, a growing level of economic development has led to lesser influence of environmental variables on mortality. This paper analyzes trends in the association between maximum temperatures and organic-cause mortality from 1975 to 2003 in Castile-La Mancha (Spain). METHODS: Daily maximum temperatures and organic-cause mortality data were divided into 3 time period: 1975-1984, 1985-1994 and 1995-2003. After data pre-whitening by applying ARIMA model estimated for the daily maximum temperature series, we calculate cross-correlation functions between residuals of temperature and mortality, 7 days lagged for summer, 15 for cold months, and comparing its correlation coefficients. RESULTS: We observe an increasing number of significant lags during the warm season (p < 0.05) between first and second decades studied in regional overall but with some provincial differences. In the third study period the number of significant lags varies slightly, although cross correlation coefficients were significantly upward (p < 0.05) at lag 3 in the entire region and Toledo in particular. CONCLUSIONS: Maximum temperature and mortality by organic cause association became more extensive and intense since 1975-1984 decade in Castile-La Mancha. The aging of regional population could offset the probable beneficial effect of economic growth on this relationship. No appreciable time trends are found in cold months.