Social factors related to the clinical severity of influenza cases in Spain during the A (H1N1) 2009 virus pandemic 英文参考文献.docVIP

Mayoraletal.BMCPublicHealth2013,13:118 /1471-2458/13/118 RESEARCH ARTICLE OpenAccess Socialfactorsrelatedtotheclinicalseverityof influenzacasesinSpainduringtheA(H1N1) 2009viruspandemic JoséMaríaMayoral1,17*,JordiAlonso2,3,OlatzGarín2,3,ZaidaHerrador4,JenaroAstray5,MaretvaBaricot3, JesúsCastilla3,6,RafaelCantón3,7,AdyCastro8,MiguelDelgado-Rodríguez3,9,AliciaFerri3,PereGodoy3,10, FernandoGónzález-Candelas3,11,VicenteMartín3,12,TomásPumarola13,JoséMaríaQuintana3,14,NúriaSoldevila3, SoniaTamames15,ángelaDomínguez3,16andtheCIBERESPCasesandControlsinPandemicInfluenzaWorking Group,Spain Abstract Background:Duringthe2009influenzapandemic,achangeinthetypeofpatientsmostoftenaffectedby influenzawasobserved.Theobjectiveofthisstudywastoassesstheroleofindividualandsocialdeterminantsin hospitalizationsduetoinfluenzaA(H1N1)2009infection. Methods:Westudiedhospitalizedpatients(cases)andoutpatients(controls)withconfirmedinfluenzaA(H1N1) 2009infection.Astandardizedquestionnairewasusedtocollectdata.Variablesthatmightberelatedtothe hospitalizationofinfluenzacaseswerecomparedbyestimationoftheoddsratio(OR)and95%confidenceintervals (CI)andthevariablesenteredintobinomiallogisticregressionmodels. Results:HospitalizationduetopandemicA(H1N1)2009influenzavirusinfectionswasassociatedwith non-Caucasianethnicity(OR:2.18,95%CI1.17?4.08),overcrowding(OR:2.84,95%CI1.20?6.72),comorbidityand thelackofpreviouspreventiveinformation(OR:2.69,95%CI:1.50?4.83).Secondaryorhighereducationwas associatedwithalowerriskofhospitalization(OR0.56,95%CI:0.36?0.87) Conclusions:Inadditiontoindividualfactorssuchascomorbidity,otherfactorssuchaseducationallevel,ethnicity orovercrowdingwereassociatedwithhospitalizationduetoA(H1N1)2009influenzavirusinfections. Keywords:InfluenzaA(H1N1)2009,Pandemic,Hospitalization,Socialfactors Background Objective material conditions and available individual The pathogenesis of infectious diseases is generally well andsocialresourcesinfluencethehealthstatus,regardless known. Biomedical a