在向文化独立的诊断测试过渡期间,建模反事实发生率
Jessica M Healy1, Logan Ray1, Danielle M Tack1
1Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
International journal of epidemiology
|October 11, 2023
概括
文化独立诊断测试 (CIDT) 增加了报告的食物传播疾病病例. 分析严重的结果,如住院治疗,可以揭示真正的感染趋势,不受测试变化的影响.
科学领域:
- 传染病流行病学 传染病流行病学
- 公共卫生监督是对公共卫生的监督.
- 微生物学诊断 诊断 微生物学诊断
背景情况:
- 文化独立诊断测试 (CIDT) 正在迅速取代检测肠道病原体的传统方法.
- 增加敏感性和CIDT的使用可能会增加病例检测率,掩盖真正的感染趋势.
- 严重疾病的结果 (住院治疗,死亡) 受检测方法转变的影响较小,可以作为可靠的趋势指标.
研究的目的:
- 评估CIDT采用对9种肠道病原体报告发病率的影响.
- 通过调整CIDT效应来建模真实发病率趋势.
- 评估严重结果作为监测指标的有用性.
主要方法:
- 利用了1996-2019年美国食品传播疾病积极监测网络 (FoodNet) 的数据.
- 采用混合效应准松回归来估计每年的病原体发病率.
- 通过计算CIDT使用,面板测试和培养确认来建模发病率.
主要成果:
- 对大多数病原体的模拟发病率低于调整CIDT后观察到的.
- 观察到的坎皮洛巴克特的上升趋势在模型中逆转为下降 (每年2.8%).
- 对于沙门氏菌,氏菌和STEC O157的发生率,与观察到的发生率相比,在模拟发病率中发现了显著的减少.
结论:
- 严重的结果可以作为评估公共卫生监测系统趋势的有价值指标,这些系统在诊断方法中经历了重大变化.
- 根据CIDT的影响进行调整对于准确解释食物传播疾病趋势至关重要.
- 采用CIDT可能导致过高估计了某些食源性病原体的发生率.
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