Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

Piers Mook; D. Gardiner; S. Kanagarajah; M. Kerac; Gwenda Hughes; Nigel Field; Noel McCarthy; C. Rawlings; Ian Simms; C. Lane; Paul Crook

doi:10.1017/S0950268818001681

Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

Piers Mook, D. Gardiner, S. Kanagarajah, M. Kerac, Gwenda Hughes, Nigel Field, Noel McCarthy, C. Rawlings, Ian Simms, C. Lane, Paul Crook^*

^*Corresponding author for this work

Blood Safety, Hep, STI and HIV Divisional Office

Research output: Contribution to journal › Article › peer-review

20 Citations (Scopus)

Abstract

Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25-49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8-76.1% male), Giardia (53.1-57.6%) and Campylobacter (52.1-53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.

Original language	English
Pages (from-to)	1468-1477
Number of pages	10
Journal	Epidemiology and Infection
Volume	146
Issue number	11
DOIs	https://doi.org/10.1017/S0950268818001681
Publication status	Published - 1 Aug 2018

Bibliographical note

Funding Information:
et al . Epidemiology & Infection Mook P. 1 2 Gardiner D. 1 * Kanagarajah S. 1 * Kerac M. 1 3 4 Hughes G. 5 Field N. 5 6 McCarthy N. 1 2 7 Rawlings C. 1 Simms I. 5 Lane C. 8 http://orcid.org/0000-0003-4965-2619 Crook P. D. 1 1 Field Epidemiology Service , Public Health England , London , UK 2 Division of Health Sciences , Warwick Medical School, University of Warwick , Coventry , UK 3 Department of Population Health , London School of Hygiene and Tropical Medicine , London , UK 4 Department of Epidemiology & Public Health , Leonard Cheshire Disability & Inclusive Development Centre , University College London , London , UK 5 HIV and STI Department, National Infection Service , Public Health England , London , UK 6 Centre for Molecular Epidemiology and Translational Research , Institute for Global Health , University College London , London , UK 7 National Institute Health Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections , London , UK 8 Gastrointestinal , Emerging and Zoonotic Infections Department , Public Health England , London , UK Author for correspondence: P. D. Crook, E-mail: [email protected] * These authors contributed equally to this work. 08 2018 20 06 2018 146 11 1468 1477 28 02 2018 20 04 2018 23 05 2018 Copyright © Cambridge University Press 2018 2018 Cambridge University Press

Publisher Copyright:
© 2018 Cambridge University Press.

Keywords

Gastrointestinal infections
gender ratio
men who have sex with men
outbreaks
sexually transmitted infections (STIs)
surveillance

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Mook, P., Gardiner, D., Kanagarajah, S., Kerac, M., Hughes, G., Field, N., McCarthy, N., Rawlings, C., Simms, I., Lane, C., & Crook, P. (2018). Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England. Epidemiology and Infection, 146(11), 1468-1477. https://doi.org/10.1017/S0950268818001681

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title = "Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England",

abstract = "Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25-49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8-76.1% male), Giardia (53.1-57.6%) and Campylobacter (52.1-53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.",

keywords = "Gastrointestinal infections, gender ratio, men who have sex with men, outbreaks, sexually transmitted infections (STIs), surveillance",

author = "Piers Mook and D. Gardiner and S. Kanagarajah and M. Kerac and Gwenda Hughes and Nigel Field and Noel McCarthy and C. Rawlings and Ian Simms and C. Lane and Paul Crook",

note = "Funding Information: et al . Epidemiology & Infection Mook P. 1 2 Gardiner D. 1 * Kanagarajah S. 1 * Kerac M. 1 3 4 Hughes G. 5 Field N. 5 6 McCarthy N. 1 2 7 Rawlings C. 1 Simms I. 5 Lane C. 8 http://orcid.org/0000-0003-4965-2619 Crook P. D. 1 1 Field Epidemiology Service , Public Health England , London , UK 2 Division of Health Sciences , Warwick Medical School, University of Warwick , Coventry , UK 3 Department of Population Health , London School of Hygiene and Tropical Medicine , London , UK 4 Department of Epidemiology & Public Health , Leonard Cheshire Disability & Inclusive Development Centre , University College London , London , UK 5 HIV and STI Department, National Infection Service , Public Health England , London , UK 6 Centre for Molecular Epidemiology and Translational Research , Institute for Global Health , University College London , London , UK 7 National Institute Health Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections , London , UK 8 Gastrointestinal , Emerging and Zoonotic Infections Department , Public Health England , London , UK Author for correspondence: P. D. Crook, E-mail: [email protected] * These authors contributed equally to this work. 08 2018 20 06 2018 146 11 1468 1477 28 02 2018 20 04 2018 23 05 2018 Copyright {\textcopyright} Cambridge University Press 2018 2018 Cambridge University Press Publisher Copyright: {\textcopyright} 2018 Cambridge University Press.",

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Mook, P, Gardiner, D, Kanagarajah, S, Kerac, M, Hughes, G, Field, N, McCarthy, N, Rawlings, C, Simms, I, Lane, C & Crook, P 2018, 'Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England', Epidemiology and Infection, vol. 146, no. 11, pp. 1468-1477. https://doi.org/10.1017/S0950268818001681

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T1 - Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

AU - Mook, Piers

AU - Gardiner, D.

AU - Kanagarajah, S.

AU - Kerac, M.

AU - Hughes, Gwenda

AU - Field, Nigel

AU - McCarthy, Noel

AU - Rawlings, C.

AU - Simms, Ian

AU - Lane, C.

AU - Crook, Paul

N1 - Funding Information: et al . Epidemiology & Infection Mook P. 1 2 Gardiner D. 1 * Kanagarajah S. 1 * Kerac M. 1 3 4 Hughes G. 5 Field N. 5 6 McCarthy N. 1 2 7 Rawlings C. 1 Simms I. 5 Lane C. 8 http://orcid.org/0000-0003-4965-2619 Crook P. D. 1 1 Field Epidemiology Service , Public Health England , London , UK 2 Division of Health Sciences , Warwick Medical School, University of Warwick , Coventry , UK 3 Department of Population Health , London School of Hygiene and Tropical Medicine , London , UK 4 Department of Epidemiology & Public Health , Leonard Cheshire Disability & Inclusive Development Centre , University College London , London , UK 5 HIV and STI Department, National Infection Service , Public Health England , London , UK 6 Centre for Molecular Epidemiology and Translational Research , Institute for Global Health , University College London , London , UK 7 National Institute Health Research (NIHR) Health Protection Research Unit in Gastrointestinal Infections , London , UK 8 Gastrointestinal , Emerging and Zoonotic Infections Department , Public Health England , London , UK Author for correspondence: P. D. Crook, E-mail: [email protected] * These authors contributed equally to this work. 08 2018 20 06 2018 146 11 1468 1477 28 02 2018 20 04 2018 23 05 2018 Copyright © Cambridge University Press 2018 2018 Cambridge University Press Publisher Copyright: © 2018 Cambridge University Press.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25-49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8-76.1% male), Giardia (53.1-57.6%) and Campylobacter (52.1-53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.

AB - Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25-49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8-76.1% male), Giardia (53.1-57.6%) and Campylobacter (52.1-53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.

KW - Gastrointestinal infections

KW - gender ratio

KW - men who have sex with men

KW - outbreaks

KW - sexually transmitted infections (STIs)

KW - surveillance

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SN - 0950-2688

VL - 146

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EP - 1477

JO - Epidemiology and Infection

JF - Epidemiology and Infection

IS - 11

ER -

Use of gender distribution in routine surveillance data to detect potential transmission of gastrointestinal infections among men who have sex with men in England

Abstract

Bibliographical note

Keywords

UN SDGs

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