title: The Risk of Reported Cryptosporidiosis in Children Aged <5 Years in Australia is Highest in Very Remote Regions.
abstract: The incidence of cryptosporidiosis is highest in children <5 years, yet little is known about disease patterns across urban and rural areas of Australia. In this study, we examine whether the risk of reported cryptosporidiosis in children <5 years varies across an urban-rural gradient, after controlling for season and gender. Using Australian data on reported cryptosporidiosis from 2001 to 2012, we spatially linked disease data to an index of geographic remoteness to examine the geographic variation in cryptosporidiosis risk using negative binomial regression. The Incidence Risk Ratio (IRR) of reported cryptosporidiosis was higher in inner regional (IRR 1.4 95% CI 1.2-1.7, p < 0.001), and outer regional areas (IRR 2.4 95% CI 2.2-2.9, p < 0.001), and in remote (IRR 5.2 95% CI 4.3-6.2, p < 0.001) and very remote (IRR 8.2 95% CI 6.9-9.8, p < 0.001) areas, compared to major cities. A linear test for trend showed a statistically significant trend with increasing remoteness. Remote communities need to be a priority for future targeted health promotion and disease prevention interventions to reduce cryptosporidiosis in children <5 years.
authors.affiliation: National Centre for Epidemiology and Population Health, Building 62, Australian National University, Acton, Canberra 2602, Australia. aparna.lal@anu.edu.au.
authors.forename: Aparna
authors.initials: A
authors.lastname: Lal
authors.affiliation: National Centre for Epidemiology and Population Health, Building 62, Australian National University, Acton, Canberra 2602, Australia. emily.fearnley@anu.edu.au.
authors.forename: Emily
authors.initials: E
authors.lastname: Fearnley
authors.affiliation: National Centre for Epidemiology and Population Health, Building 62, Australian National University, Acton, Canberra 2602, Australia. martyn.kirk@anu.edu.au.
authors.forename: Martyn
authors.initials: M
authors.lastname: Kirk
mesh_terms: D001315:Australia / Q000453:epidemiology; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D018570:Risk Assessment; D012424:Rural Population / Q000706:statistics & numerical data*
keywords: children; cryptosporidiosis; geographic; remote