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Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020

As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario’s laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric...

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Autores principales: Harish, Vinyas, Buajitti, Emmalin, Burrows, Holly, Posen, Joshua, Bogoch, Isaac I., Corbeil, Antoine, Gubbay, Jonathan B., Rosella, Laura C., Morris, Shaun K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022755/
https://www.ncbi.nlm.nih.gov/pubmed/36963058
http://dx.doi.org/10.1371/journal.pgph.0001608
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author Harish, Vinyas
Buajitti, Emmalin
Burrows, Holly
Posen, Joshua
Bogoch, Isaac I.
Corbeil, Antoine
Gubbay, Jonathan B.
Rosella, Laura C.
Morris, Shaun K.
author_facet Harish, Vinyas
Buajitti, Emmalin
Burrows, Holly
Posen, Joshua
Bogoch, Isaac I.
Corbeil, Antoine
Gubbay, Jonathan B.
Rosella, Laura C.
Morris, Shaun K.
author_sort Harish, Vinyas
collection PubMed
description As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario’s laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008–2020 to identify high-resolution geographical clusters for potential targeted pre-travel prevention. Smoothed standardized incidence ratios (SIRs) and 95% posterior credible intervals (CIs) were estimated using a spatial Bayesian hierarchical model. High- and low-incidence areas were described using data from the 2016 Census based on the home forward sortation area of patients testing positive. A second model was used to estimate the association between drivetime to the nearest travel clinic and incidence of TAI within high-incidence areas. There were 6,114 microbiologically confirmed TAIs across Ontario over the study period. There was spatial clustering of TAIs (Moran’s I = 0.59, p<0.0001). Compared to low-incidence areas, high-incidence areas had higher proportions of immigrants (p<0.0001), were lower income (p = 0.0027), had higher levels of university education (p<0.0001), and less knowledge of English/French languages (p<0.0001). In the high-incidence Greater Toronto Area (GTA), each minute increase in drive time to the closest travel clinic was associated with a 3% reduction in TAI incidence (95% CI 1–6%). While urban neighbourhoods in the GTA had the highest burden of TAIs, geographic proximity to a travel clinic in the GTA was not associated with an area-level incidence reduction in TAI. This suggests other barriers to seeking and adhering to pre-travel advice.
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spelling pubmed-100227552023-03-18 Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020 Harish, Vinyas Buajitti, Emmalin Burrows, Holly Posen, Joshua Bogoch, Isaac I. Corbeil, Antoine Gubbay, Jonathan B. Rosella, Laura C. Morris, Shaun K. PLOS Glob Public Health Research Article As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario’s laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008–2020 to identify high-resolution geographical clusters for potential targeted pre-travel prevention. Smoothed standardized incidence ratios (SIRs) and 95% posterior credible intervals (CIs) were estimated using a spatial Bayesian hierarchical model. High- and low-incidence areas were described using data from the 2016 Census based on the home forward sortation area of patients testing positive. A second model was used to estimate the association between drivetime to the nearest travel clinic and incidence of TAI within high-incidence areas. There were 6,114 microbiologically confirmed TAIs across Ontario over the study period. There was spatial clustering of TAIs (Moran’s I = 0.59, p<0.0001). Compared to low-incidence areas, high-incidence areas had higher proportions of immigrants (p<0.0001), were lower income (p = 0.0027), had higher levels of university education (p<0.0001), and less knowledge of English/French languages (p<0.0001). In the high-incidence Greater Toronto Area (GTA), each minute increase in drive time to the closest travel clinic was associated with a 3% reduction in TAI incidence (95% CI 1–6%). While urban neighbourhoods in the GTA had the highest burden of TAIs, geographic proximity to a travel clinic in the GTA was not associated with an area-level incidence reduction in TAI. This suggests other barriers to seeking and adhering to pre-travel advice. Public Library of Science 2023-03-17 /pmc/articles/PMC10022755/ /pubmed/36963058 http://dx.doi.org/10.1371/journal.pgph.0001608 Text en © 2023 Harish et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Harish, Vinyas
Buajitti, Emmalin
Burrows, Holly
Posen, Joshua
Bogoch, Isaac I.
Corbeil, Antoine
Gubbay, Jonathan B.
Rosella, Laura C.
Morris, Shaun K.
Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title_full Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title_fullStr Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title_full_unstemmed Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title_short Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
title_sort geographic clustering of travel-acquired infections in ontario, canada, 2008–2020
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022755/
https://www.ncbi.nlm.nih.gov/pubmed/36963058
http://dx.doi.org/10.1371/journal.pgph.0001608
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