title: Geographical variations in Salmonella incidence in Israel 1997-2006: the effect of rural residency.
abstract: The overall incidence and serotype distribution of non-typhoid Salmonella (NTS) may vary between different geographical localities. To investigate possible regional differences and the effect of demographic factors, we studied 15 865 episodes of laboratory-confirmed NTS infection in Israel. Using Poisson models we found significant variation in the average annual incidence rate of NTS in 15 administrative sub-districts, which was inversely associated with the percent of rural residency (incidence rate ratio 0.75, 95% confidence interval 0.65–0.86, P<0.001). Variation was also found in the relative incidence of the most prominent serotypes (Enteritidis, Virchow, Typhimurium, Hadar, Infantis), which was affected by rural residency, the percent of non-Jewish population in the sub-district, and the percent of population aged o55 years in the sub-district.Rural residency had a major effect on the epidemiology of salmonellosis in Israel. Future research is required to understand whether decreased incidence in rural areas is an under-detection bias or reflects true differences in NTS illnesses.
authors.affiliation: Infectious Diseases Unit, Assaf Harofeh Medical Center, Zerifin, Israel. miriw@netvision.net.il
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
authors.forename: V
authors.initials: V
authors.lastname: Agmon
authors.forename: S
authors.initials: S
authors.lastname: Yaron
authors.forename: I
authors.initials: I
authors.lastname: Nissan
authors.forename: C
authors.initials: C
authors.lastname: Peretz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012424:Rural Population / Q000706:statistics & numerical data; D012480:Salmonella Infections / Q000453:epidemiology*