SARS-CoV-2 infections in migrants and the role of household overcrowding : a causal mediation analysis of Virus Watch data
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ..
BACKGROUND: Migrants are over-represented in SARS-CoV-2 infections globally; however, evidence is limited for migrants in England and Wales. Household overcrowding is a risk factor for SARS-CoV-2 infection, with migrants more likely to live in overcrowded households than UK-born individuals. We aimed to estimate the total effect of migration status on SARS-CoV-2 infection and to what extent household overcrowding mediated this effect.
METHODS: We included a subcohort of individuals from the Virus Watch prospective cohort study during the second SARS-CoV-2 wave (1 September 2020-30 April 2021) who were aged ≥18 years, self-reported the number of rooms in their household and had no evidence of SARS-CoV-2 infection pre-September 2020. We estimated total, indirect and direct effects using Buis' logistic decomposition regression controlling for age, sex, ethnicity, clinical vulnerability, occupation, income and whether they lived with children.
RESULTS: In total, 23 478 individuals were included. 9.07% (187/2062) of migrants had evidence of infection during the study period vs 6.27% (1342/21 416) of UK-born individuals. Migrants had 22% higher odds of infection during the second wave (total effect; OR 1.22, 95% CI 1.01 to 1.47). Household overcrowding accounted for approximately 36% (95% CI -4% to 77%) of these increased odds (indirect effect, OR 1.07, 95% CI 1.03 to 1.12; proportion accounted for: indirect effect on log odds scale/total effect on log odds scale=0.36).
CONCLUSION: Migrants had higher odds of SARS-CoV-2 infection during the second wave compared with UK-born individuals and household overcrowding explained 36% of these increased odds. Policy interventions to reduce household overcrowding for migrants are needed as part of efforts to tackle health inequalities during the pandemic and beyond.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Journal of epidemiology and community health - 77(2023), 10 vom: 12. Okt., Seite 649-655 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Boukari, Yamina [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 11.09.2023 Date Revised 14.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/jech-2022-220251 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359642438 |
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| 100 | 1 | |a Boukari, Yamina |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a SARS-CoV-2 infections in migrants and the role of household overcrowding |b a causal mediation analysis of Virus Watch data |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 11.09.2023 | ||
| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. | ||
| 520 | |a BACKGROUND: Migrants are over-represented in SARS-CoV-2 infections globally; however, evidence is limited for migrants in England and Wales. Household overcrowding is a risk factor for SARS-CoV-2 infection, with migrants more likely to live in overcrowded households than UK-born individuals. We aimed to estimate the total effect of migration status on SARS-CoV-2 infection and to what extent household overcrowding mediated this effect | ||
| 520 | |a METHODS: We included a subcohort of individuals from the Virus Watch prospective cohort study during the second SARS-CoV-2 wave (1 September 2020-30 April 2021) who were aged ≥18 years, self-reported the number of rooms in their household and had no evidence of SARS-CoV-2 infection pre-September 2020. We estimated total, indirect and direct effects using Buis' logistic decomposition regression controlling for age, sex, ethnicity, clinical vulnerability, occupation, income and whether they lived with children | ||
| 520 | |a RESULTS: In total, 23 478 individuals were included. 9.07% (187/2062) of migrants had evidence of infection during the study period vs 6.27% (1342/21 416) of UK-born individuals. Migrants had 22% higher odds of infection during the second wave (total effect; OR 1.22, 95% CI 1.01 to 1.47). Household overcrowding accounted for approximately 36% (95% CI -4% to 77%) of these increased odds (indirect effect, OR 1.07, 95% CI 1.03 to 1.12; proportion accounted for: indirect effect on log odds scale/total effect on log odds scale=0.36) | ||
| 520 | |a CONCLUSION: Migrants had higher odds of SARS-CoV-2 infection during the second wave compared with UK-born individuals and household overcrowding explained 36% of these increased odds. Policy interventions to reduce household overcrowding for migrants are needed as part of efforts to tackle health inequalities during the pandemic and beyond | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a EPIDEMIOLOGY | |
| 650 | 4 | |a HOUSING | |
| 650 | 4 | |a HUMAN MIGRATION | |
| 650 | 4 | |a INFECTIONS | |
| 700 | 1 | |a Beale, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Fong, Wing Lam Erica |e verfasserin |4 aut | |
| 700 | 1 | |a Burns, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Yavlinsky, Alexei |e verfasserin |4 aut | |
| 700 | 1 | |a Hoskins, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Lewis, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Geismar, Cyril |e verfasserin |4 aut | |
| 700 | 1 | |a Navaratnam, Annalan Md |e verfasserin |4 aut | |
| 700 | 1 | |a Braithwaite, Isobel |e verfasserin |4 aut | |
| 700 | 1 | |a Byrne, Thomas E |e verfasserin |4 aut | |
| 700 | 1 | |a Oskrochi, Youssof |e verfasserin |4 aut | |
| 700 | 1 | |a Tweed, Sam |e verfasserin |4 aut | |
| 700 | 1 | |a Kovar, Jana |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Parth |e verfasserin |4 aut | |
| 700 | 1 | |a Hayward, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Aldridge, Robert |e verfasserin |4 aut | |
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