title: Influence of material deprivation on hospital admissions for gynaecologic infections.
abstract: This study was conducted to examine the relationship between age, material deprivation, and hospital admissions for selected gynaecologic infections in an English health region. Data from hospital episode statistics relating to hospital admissions for pelvic inflammatory disease (PID), infections of the uterus, and infections of the cervix, vagina, and vulva were obtained. Townsend deprivation scores (based on 1991 census data) were allocated by linking postcodes of cases to enumeration districts (EDs) and then assigning the EDs to appropriate quintiles of material deprivation. Both single variable and multivariable (Poisson regression) analyses were performed. For women with PID, the risk of hospitalisation increased with increasing deprivation (P<0.0001), and women in the most deprived quintile were at increased risk (relative risk [RR] 1.31; 95% confidence interval [95%CI] 1.24-1.39) for hospitalisation. Multivariable analysis identified an elevated risk of hospital admission in women aged 25-44 years for PID (RR 2.03; 95%CI 0.84-4.87) and infections of the cervix, vagina, and vulva (RR 1.47; 95%CI 1.16-1.87), and the incidence of both conditions increased significantly with age. In summary, the results obtained suggest that women from the most deprived areas are at greatest risk of hospitalisation for gynaecologic infections, particularly PID. Preventive measures together with earlier diagnostic, treatment, and referral procedures are required to reduce morbidity.
authors.affiliation: Health Protection Agency (West Midlands) Regional Epidemiology Unit, Heartlands Hospital, 2nd Floor Lincoln House, Birmingham, B9 5SS, UK. babatunde.olowokure@hpa.org.uk
authors.forename: B
authors.initials: B
authors.lastname: Olowokure
authors.forename: J I
authors.initials: JI
authors.lastname: Hawker
authors.forename: S
authors.initials: S
authors.lastname: Harcourt
authors.forename: F
authors.initials: F
authors.lastname: Warburton
authors.forename: J
authors.initials: J
authors.lastname: Weinberg
authors.forename: R C
authors.initials: RC
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000453:epidemiology*; D011203:Poverty; D012189:Retrospective Studies; D018570:Risk Assessment; D006113:United Kingdom / Q000453:epidemiology