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Determinants of the geographical distribution of endemic giardiasis in Ontario, Canada: a spatial modelling approach

Published online by Cambridge University Press:  08 November 2004

A. ODOI ,
S. W. MARTIN ,
P. MICHEL ,
J. HOLT ,
D. MIDDLETON  and
J. WILSON
A. ODOI
Affiliation:
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada, N1G 2W1
S. W. MARTIN
Affiliation:
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada, N1G 2W1
P. MICHEL
Affiliation:
Université de Montreal, CP 5000, St-Hyacinthe, Québec, Canada
J. HOLT
Affiliation:
Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
D. MIDDLETON
Affiliation:
Ministry of Health and Long-Term Care, Ontario, Canada
J. WILSON
Affiliation:
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada, N1G 2W1 Division of Enteric, Foodborne and Waterborne Diseases, Population and Public Health Branch, Health Canada, Ontario, Canada
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Abstract

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Giardiasis surveillance data as well as drinking water, socioeconomic and land-use data were used in spatial regression models to investigate determinants of the geographic distribution of endemic giardiasis in southern Ontario. Higher giardiasis rates were observed in areas using surface water [rate ratio (RR) 2·36, 95% CI 1·38–4·05] and in rural areas (RR 1·79, 95% CI 1·32–2·37). Lower rates were observed in areas using filtered water (RR 0·55, 95% CI 0·42–0·94) and in those with high median income (RR 0·62, 95% CI 0·42–0·92). Chlorination of drinking water, cattle density and intensity of manure application on farmland were not significant determinants. The study shows that waterborne transmission plays an important role in giardiasis distribution in southern Ontario and that well-collected routine surveillance data could be useful for investigation of disease determinants and identification of high-risk communities. This information is useful in guiding decisions on control strategies.

Type
Research Article
Information
Epidemiology & Infection , Volume 132 , Issue 5 , October 2004 , pp. 967 - 976
Copyright
© 2004 Cambridge University Press