Individual Predisposition, Household Clustering and Risk Factors for Human Infection with Ascaris lumbricoides: New Epidemiological Insights
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{"title"=>"Individual predisposition, household clustering and risk factors for human infection with Ascaris lumbricoides: New epidemiological insights", "type"=>"journal", "authors"=>[{"first_name"=>"Martin", "last_name"=>"Walker", "scopus_author_id"=>"55461484300"}, {"first_name"=>"Andrew", "last_name"=>"Hall", "scopus_author_id"=>"55196059600"}, {"first_name"=>"María Gloria", "last_name"=>"Basáñez", "scopus_author_id"=>"6701712698"}], "year"=>2011, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"pmid"=>"21541362", "doi"=>"10.1371/journal.pntd.0001047", "sgr"=>"79955809124", "isbn"=>"1935-2727", "scopus"=>"2-s2.0-79955809124", "issn"=>"19352727", "pui"=>"361746058"}, "id"=>"53f2f50c-952c-3ce5-b65d-413ac43d1ae7", "abstract"=>"BACKGROUND: Much of our current understanding of the epidemiology of Ascaris lumbricoides infections in humans has been acquired by analyzing worm count data. These data are collected by treating infected individuals with anthelmintics so that worms are expelled intact from the gastrointestinal tract. Analysis of such data established that individuals are predisposed to infection with few or many worms and members of the same household tend to harbor similar numbers of worms. These effects, known respectively as individual predisposition and household clustering, are considered characteristic of the epidemiology of ascariasis. The mechanisms behind these phenomena, however, remain unclear. In particular, the impact of heterogeneous individual exposures to infectious stages has not been thoroughly explored.\\n\\nMETHODOLOGY/PRINCIPAL FINDINGS: Bayesian methods were used to fit a three-level hierarchical statistical model to A. lumbricoides worm counts derived from a three-round chemo-expulsion study carried out in Dhaka, Bangladesh. The effects of individual predisposition, household clustering and household covariates of the numbers of worms per host (worm burden) were considered simultaneously. Individual predisposition was found to be of limited epidemiological significance once household clustering had been accounted for. The degree of intra-household variability among worm burdens was found to be reduced by approximately 58% when household covariates were included in the model. Covariates relating to decreased affluence and quality of housing construction were associated with a statistically significant increase in worm burden.\\n\\nCONCLUSIONS/SIGNIFICANCE: Heterogeneities in the exposure of individuals to infectious eggs have an important role in the epidemiology of A. lumbricoides infection. The household covariates identified as being associated with worm burden provide valuable insights into the source of these heterogeneities although above all emphasize and reiterate that infection with A. lumbricoides is inextricably associated with acute poverty.", "link"=>"http://www.mendeley.com/research/individual-predisposition-household-clustering-risk-factors-human-infection-ascaris-lumbricoides-new", "reader_count"=>49, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Researcher"=>12, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>7, "Student > Master"=>9, "Other"=>1, "Student > Bachelor"=>4, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Researcher"=>12, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>7, "Student > Master"=>9, "Other"=>1, "Student > Bachelor"=>4, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Agricultural and Biological Sciences"=>15, "Business, Management and Accounting"=>1, "Veterinary Science and Veterinary Medicine"=>1, "Earth and Planetary Sciences"=>1, "Engineering"=>1, "Environmental Science"=>2, "Nursing and Health Professions"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>11, "Psychology"=>1, "Social Sciences"=>4, "Immunology and Microbiology"=>5}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>11}, "Social Sciences"=>{"Social Sciences"=>4}, "Psychology"=>{"Psychology"=>1}, "Unspecified"=>{"Unspecified"=>4}, "Environmental Science"=>{"Environmental Science"=>2}, "Engineering"=>{"Engineering"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>5}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Venezuela"=>1, "United States"=>1, "Brazil"=>1, "United Kingdom"=>1, "Bulgaria"=>1, "Spain"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/780278"], "description"=>"<p> Fitted points are posterior means calculated across all households from the “full” model (Model 1, see <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001047#pntd-0001047-t003\" target=\"_blank\">Table 3</a>). Squares and solid lines denote males, circles and dashed lines females. Household risk factors are adjusted to their null levels, i.e. a Bangladeshi family of 2–4 sleeping members with no children, paying no rent, living in a house with a single room, an earth floor and private well and latrine facilities (see <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001047#pntd-0001047-t004\" target=\"_blank\">Table 4</a>). Error bars represent 95% Bayesian credible intervals.</p>", "links"=>[], "tags"=>["worm", "baseline"], "article_id"=>450650, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.g002", "stats"=>{"downloads"=>1, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mean_worm_burden_at_baseline_vs_host_age_and_sex_/450650", "title"=>"Mean worm burden at baseline vs. host age and sex.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-04-26 00:10:50"}
  • {"files"=>["https://ndownloader.figshare.com/files/780461"], "description"=>"†<p>Degrees of freedom.</p>‡<p>Deviance is the difference between a fitted model's log-likelihood and the maximum achievable log-likelihood.</p>", "links"=>[], "tags"=>["parsimonious", "worm", "ignoring"], "article_id"=>450831, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.t002", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_most_parsimonious_model_of_the_worm_burden_of_Ascaris_lumbricoides_ignoring_random_effects_/450831", "title"=>"The most parsimonious model of the worm burden of <i>Ascaris lumbricoides</i> ignoring random effects.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-26 00:13:51"}
  • {"files"=>["https://ndownloader.figshare.com/files/780493"], "description"=>"<p>*Deviance information criterion. A lower DIC indicates a more parsimonious fit.</p>†<p>Bayesian credible interval.</p>‡<p>Not defined.</p>", "links"=>[], "tags"=>["models", "fitted", "worm"], "article_id"=>450864, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.t003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_the_8_models_fitted_to_data_on_Ascaris_lumbricoides_worm_counts_/450864", "title"=>"Summary of the 8 models fitted to data on <i>Ascaris lumbricoides</i> worm counts.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-26 00:14:24"}
  • {"files"=>["https://ndownloader.figshare.com/files/780429"], "description"=>"<p>*Estimates were derived from the fit of the “full” model (Model 1, see <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001047#pntd-0001047-t003\" target=\"_blank\">Table 3</a>).</p>†<p>Bayesian credible interval.</p>‡<p>Baseline relative risk is by definition equal to 1.</p>", "links"=>[], "tags"=>["risks", "worm"], "article_id"=>450798, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.t004", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_estimated_relative_risks_of_the_worm_burden_of_Ascaris_lumbricoides_for_household_variables_/450798", "title"=>"The estimated relative risks of the worm burden of <i>Ascaris lumbricoides</i> for household variables.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-26 00:13:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/391212", "https://ndownloader.figshare.com/files/391302", "https://ndownloader.figshare.com/files/391363", "https://ndownloader.figshare.com/files/391425"], "description"=>"<div><h3>Background</h3><p>Much of our current understanding of the epidemiology of <em>Ascaris lumbricoides</em> infections in humans has been acquired by analyzing worm count data. These data are collected by treating infected individuals with anthelmintics so that worms are expelled intact from the gastrointestinal tract. Analysis of such data established that individuals are predisposed to infection with few or many worms and members of the same household tend to harbor similar numbers of worms. These effects, known respectively as individual predisposition and household clustering, are considered characteristic of the epidemiology of ascariasis. The mechanisms behind these phenomena, however, remain unclear. In particular, the impact of heterogeneous individual exposures to infectious stages has not been thoroughly explored.</p><h3>Methodology/Principal Findings</h3><p>Bayesian methods were used to fit a three-level hierarchical statistical model to <em>A. lumbricoides</em> worm counts derived from a three-round chemo-expulsion study carried out in Dhaka, Bangladesh. The effects of individual predisposition, household clustering and household covariates of the numbers of worms per host (worm burden) were considered simultaneously. Individual predisposition was found to be of limited epidemiological significance once household clustering had been accounted for. The degree of intra-household variability among worm burdens was found to be reduced by approximately 58% when household covariates were included in the model. Covariates relating to decreased affluence and quality of housing construction were associated with a statistically significant increase in worm burden.</p><h3>Conclusions/Significance</h3><p>Heterogeneities in the exposure of individuals to infectious eggs have an important role in the epidemiology of <em>A. lumbricoides</em> infection. The household covariates identified as being associated with worm burden provide valuable insights into the source of these heterogeneities although above all emphasize and reiterate that infection with <em>A. lumbricoides</em> is inextricably associated with acute poverty.</p></div>", "links"=>[], "tags"=>["clustering", "factors", "epidemiological", "insights"], "article_id"=>137258, "categories"=>["Mathematics", "Medicine", "Biological Sciences"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>["https://dx.doi.org/10.1371/journal.pntd.0001047.s001", "https://dx.doi.org/10.1371/journal.pntd.0001047.s002", "https://dx.doi.org/10.1371/journal.pntd.0001047.s003", "https://dx.doi.org/10.1371/journal.pntd.0001047.s004"], "stats"=>{"downloads"=>23, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Individual_Predisposition_Household_Clustering_and_Risk_Factors_for_Human_Infection_with_Ascaris_lumbricoides_New_Epidemiological_Insights/137258", "title"=>"Individual Predisposition, Household Clustering and Risk Factors for Human Infection with <em>Ascaris lumbricoides</em>: New Epidemiological Insights", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-04-26 02:00:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/780530"], "description"=>"<p>*Baseline, first and second re-infection populations refer to the first, second and third treatments respectively.</p>", "links"=>[], "tags"=>["chemo-expulsive"], "article_id"=>450902, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.t001", "stats"=>{"downloads"=>1, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_number_of_participants_who_were_8220_satisfactorily_de_wormed_8221_after_each_round_of_chemo_expulsive_treatment_/450902", "title"=>"The number of participants who were “satisfactorily de-wormed” after each round of chemo-expulsive treatment.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-04-26 00:15:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/780356"], "description"=>"<p> Fitted points are posterior means estimated from the “full” model (Model 1, see <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001047#pntd-0001047-t003\" target=\"_blank\">Table 3</a>). Squares and solid lines denote the first re-infection population, circles and dashed lines the second re-infection population. Error bars represent 95% Bayesian credible intervals.</p>", "links"=>[], "tags"=>["baseline", "worm", "months", "re-infection"], "article_id"=>450724, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.g003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_proportion_of_the_baseline_mean_worm_burden_after_six_months_re_infection_vs_host_age_/450724", "title"=>"The proportion of the baseline mean worm burden after six months re-infection vs. host age.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-04-26 00:12:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/780192"], "description"=>"<p>Participants live in households such that <i>n<sub>k</sub></i> participants live in household <i>k</i> and there are <i>K</i> households all together (<i>K = </i>459, see main text “<i>Sample Size, Data Structure and Missing Values</i>”). The total number of participants is 1,795. Each participant contributes at most three measurements of worm burden, one after each round of chemo-expulsive treatment with pyrantel pamoate, and at least one measurement (after the first round of treatment). Participants who were not “satisfactorily de-wormed” (see main text “<i>Sample Size, Data Structure and Missing Values</i>”) at a given round of treatment were not subsequently followed up.</p>", "links"=>[], "tags"=>["hierarchical", "worm"], "article_id"=>450561, "categories"=>["Mathematics", "Medicine", "Computational Biology"], "users"=>["Martin Walker", "Andrew Hall", "María-Gloria Basáñez"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001047.g001", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_An_illustration_of_the_hierarchical_structure_of_the_data_on_Ascaris_lumbricoides_worm_counts_/450561", "title"=>"An illustration of the hierarchical structure of the data on <i>Ascaris lumbricoides</i> worm counts.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-04-26 00:09:21"}

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Relative Metric

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