跨不同社会人口群体的英格兰COVID-19测试和报告行为:基于人口的研究,使用测试数据和来自社区流行监测调查的数据
Sumali Bajaj1, Siyu Chen2, Richard Creswell3
1Department of Biology, University of Oxford, Oxford, UK.
The Lancet. Digital health
|October 25, 2024
概括
社会人口学因素影响了英格兰的COVID-19测试行为. 贫困地区的侧向流量测试使用率较低,而少数民族和老年人使用PCR测试的可能性较低.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 了解传染病检测行为的异质性对于保护弱势群体至关重要.
- 社会人口统计学差异可能影响了COVID-19测试在流行病期间的访问和利用.
- 确保公平获得COVID-19测试是英格兰测试战略的关键组成部分.
研究的目的:
- 调查社会人口因素与英格兰COVID-19测试行为之间的关系.
- 识别不同人口群体在测试寻求和报告方面的差异.
- 为未来公共卫生紧急情况提供公平干预的信息.
主要方法:
- 从2020年10月到2022年3月,使用大规模COVID-19测试数据 (LFD和PCR) 和社区流行调查 (REACT-1,ONS-CIS) 的基于人口的研究.
- 机械因果建模以调整PCR测试数据并根据种族和年龄估计SARS-CoV-2的患病率.
- 分析测试偏差,错误阳性率,敏感性,特异性和病例检测分数,按社会人口统计组进行分析.
主要成果:
- 从2021年3月起,最贫困地区的个人报告人均侧流装置 (LFD) 测试数量与最贫困地区相比减少了一半.
- 在2020年10月至2021年6月期间,最贫困地区的人均PCR测试数量几乎是最贫困地区的人均PCR测试数量的两倍.
- 在阿尔法和奥米克朗BA.1波中,亚洲人感染率更高;整体病例检测率为26-40%,没有因贫困或种族而存在一致的差异.
- 少数民族和老年人使用确认性PCR测试的可能性较低;黑人/非洲/加勒比人群中报告阳性LFD的延迟时间较长.
结论:
- 测试行为中的差异反映了自我隔离,可访问性,数字素养和测试实用性的感知成本的变化.
- 大规模测试数据与监测调查相结合,可以确定社会人口统计学群体之间的公共卫生干预差距.
- 调查结果为监测当地干预提供了一个框架,并确保在未来的流行病中提供公平的反应.
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