Author:
Navaranjan Debeka,Rosella Laura C,Kwong Jeffrey C,Campitelli Michael,Crowcroft Natasha
Abstract
Abstract
Background
Novel risk factors were associated with the 2009 pandemic A/H1N1 virus (pH1N1). Ethnicity was among these risk factors. Ethnic disparities in hospitalization and death due to pH1N1 were noted. The purpose of this study is to determine whether there are ethnic disparities in acquiring the 2009 pandemic H1N1.
Methods
We conducted a test-negative case–control study of the risk of pH1N1 infection using data from Ontario, Canada. Cases were laboratory confirmed to have influenza using reverse-transcriptase polymerase chain reaction (RT-PCR), and controls were obtained from the same population and were RT-PCR negative. Multivariate logistic regression was used to determine the association between ethnicity and pH1N1 infection, while adjusting for demographic, clinical and ecological covariates.
Results
Adult cases were more likely than controls to be self-classified as East/Southeast Asian (OR = 2.59, 95% CI 1.02-6.57), South Asian (OR = 6.22, 95% CI 2.01-19.24) and Black (OR = 9.72, 95% CI 2.29-41.27). Pediatric cases were more likely to be self-identified as Black (OR = 6.43, 95% CI 1.83-22.59). However, pediatric cases without risk factors for severe influenza infection were more likely to be South Asian (OR 2.92, 95% CI 1.11-7.68), Black (OR 16.02, 95% CI 2.85-89.92), and West Asian/Arab, Latin American or Multi-racial groups (OR 3.09 95% CI 1.06-9.00).
Conclusions
pH1N1 cases were more likely to come from certain ethnic groups compared to test-negative controls. Insights into whether these disparities arise due to social or biological factors are needed in order to understand what approaches can be taken to reduce the burden of a future influenza pandemic.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference25 articles.
1. Statistics Canada: Canada’s Ethnocultural Mosaic, 2006 Census. http://www12.statcan.ca/census-recensement/2006/as-sa/97-562/pdf/97-562-XIE2006001.pdf,
2. Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA, Kelemen L, Yi C, Lonn E, Gerstein H, Hegele RA, McQueen M: Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000, 356 (9226): 279-284. 10.1016/S0140-6736(00)02502-2.
3. Manuel DG, Schultz SE: Diabetes Health Status and Risk Factors. Diabetes in Ontario: An ICES Practice Atlas. Edited by: Hux J, Booth G, Laupacis A. 2002, Toronto, Ontario: Institute for Clinical Evaluative Sciences, 4.77-4.93.
4. Tremblay MS, Pérez CS, Ardern CI, Bryan SN, Katzmarzyk PT: Obesity, overweight and ethnicity. Health Rep. 2005, 16 (4): 23-34.
5. Yousey-Hindes KM, Hadler JL: Neighborhood Socioeconomic Status and Influenza Hospitalizations Among Children: New Haven County, Connecticut, 2003–2010. Am J Public Health. 2011, 101 (9): 1785-1789. 10.2105/AJPH.2011.300224.
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