Household Transmission of Helicobacter pylori: Application of Epidemic Chain Model to 2186 Subjects in Matsu
Date Issued
2004
Date
2004
Author(s)
Chou, Yu-Min
DOI
en-US
Abstract
Background
Helicobacter pylori (H. pylori) could transmit through multiple pathways, including food-borne, water-borne and person-to-person routes. The clusters of H. pylori infection in family are common. Spouse-to-spouse, parent-to-child and sibling-to-sibling transmissions were reported in previous studies. The aim of this study therefore applied both epidemiological design and epidemic chain binomial model to elucidate transmission dynamics of H. pylori using data from the area with a high prevalence rate of H. pylori infection and gastric cancer.
Methods
We exploited a total of 2186 subject who attended gastric cancer screening in Matsu to elucidate possible transmission modes of H. pylori within household. As the transmission of H. pylori may have multiple pathways we first applied epidemiological study design to explore person-to-person, waterborne, and foodborne transmissions. We then applied epidemic chain model to quantify the probability of transmission from generation to generation.
Results
For over-crowded situation, the odds ratios were 1.59 (95% CI: 1.07-2.38) for number in family 3-5 and 2.03 (95% CI: 1.28-3.26) for number in family larger than 5. Trend test for the association between number of persons and H. pylori infection was statistically significant (x2=8.25, P=0.004). For intrafamilial transmission, a significant association of H. pylori-seropositive between married couples was identified with the estimated odds ratio of 1.71 (95% CI: 1.08-2.70). Odds ratios were 1.81 (95% CI: 0.84-3.93) fro children whose mother who had H. pylori-seropositive compared with those whose mother who had H. pylori-seronegative. The corresponding figure for father-to-child was 2.48 (95% CI:0.70-8.74).
For common sources, only drinking well water was a significant risk factor for transmission. After controlling for age, gender, and crowded situation, the adjusted odds ratio was 2.61 (95% CI: 1.07-6.36).
Different epidemic chain models were also tried in this thesis. The escape of being infected ranged from 0.58-0.70. The most adequate model was epidemic chain model with parameters varying with generations. It was not dissimilar to general model assuming parameters that are constant across generation. However, both models behave better than both Greenwood and Reed-Frost models.
Conclusion
The findings from epidemic chain model together with the association between exposure to well water and H. pylori infection suggest that common exposure to well water may play an important role in overcrowded family but person-to-person transmission may still make significant contribution to less overcrowded family.
Subjects
傳染模式
流行感染世代鏈模式
幽門螺旋桿菌
Helicobacter pylori
transmission model
epidemic chain model
SDGs
Type
thesis
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