Household socioeconomic position and infectious disease risk in rural Kenya

de Glanville, William WA, Thomas, Lian, Cook, EAJ, Bronsvoort, BM, Wamae, NC, Kariuki, S and Fevre, Eric (2018) Household socioeconomic position and infectious disease risk in rural Kenya. [Data Collection]

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Household socioeconomic position and infectious disease risk in rural Kenya de Glanville W.A. PhD1,2,#, Thomas L.F. PhD 1,2, Cook E.A.J. PhD 1,2, Bronsvoort B.M. PhD 3,4, Wamae N.C. PhD 6, Kariuki S. PhD 7, Fèvre E.M. PhD 2,8* 1Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, West Mains Road, Edinburgh, EH9 3JT, UK 2 International Livestock Research Institute, Old Naivasha Road, PO BOX 30709, 00100-Nairobi, Kenya 3 The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, EH25 9RG, UK 4 Roslin Institute, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, EH25 9RG, UK 6 School of Pharmacy and Health Sciences, United States International Research University, PO Box 14634-00800, Nairobi, Kenya 7 Centre for Microbiology Research, Kenya Medical Research Institute, PO Box 19464-00200, Nairobi, Kenya 8 Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK *Corresponding author # Current address: Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom, G12 8QQ. Background Household socioeconomic position (SEP) has been repeatedly shown to predict individual infectious disease risk, yet few studies have quantified this association for the full range of pathogens that are typically endemic in low income settings. This cross-sectional study assesses the impact of SEP on a range of infectious agents with diverse transmission routes within a single community in western Kenya. Methods Information on productive and material household assets, household resources, and access to services was collected and combined to derive a single index of SEP. The relationship between household SEP and individual infection with Plasmodium falciparum, hookworm (Ancylostoma duodenale and/or Necator americanus), Entamoeba histolytica/dispar, Mycobacterium tuberculosis, and HIV was assessed using multivariable logistic regression. The relationship between co-infections with hookworm, P. falciparum and E. histolytica/dispar and SEP was assessed using multinomial logistic regression. Findings Individuals in households with the lowest SEP were at greatest risk of infection with P. falciparum, hookworm and E. histolytica/dispar, as well as co-infection with each pathogen. Infection with M. tuberculosis, by contrast, was most likely in individuals living in households with the highest SEP. There was no evidence of a relationship between individual HIV infection and household SEP. Interpretation A household socioeconomic gradient exists in this predominantly poor, rural farming community. This gradient significantly impacts upon individual infectious disease risk, but the relationship between household SEP and infection is not consistent for all pathogens. Funding Wellcome Trust, BBSRC, MRC and CGIAR Research Program on Agriculture for Nutrition and Health

Keywords: multilevel models; social determinants of health; infectious disease
Divisions: Faculty of Health and Life Sciences
Depositing User: Eric Fevre
Date Deposited: 14 Feb 2018 14:30
Last Modified: 14 Feb 2018 14:30
DOI: 10.17638/datacat.liverpool.ac.uk/447
URI: https://datacat.liverpool.ac.uk/id/eprint/447

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