Abstract
BackgroundThe association between low socioeconomic status (SES) and poor health is well documented in the existing literature. Nonetheless, evidence on the relationship between SES and gastrointestinal (GI) infections is limited, and the mechanisms underlying this relationship are not well understood with published studies pointing to conflicting results. This review aims to identify studies that investigate the relationship between SES and GI infections in developed countries, in order to assess the direction of the association and explore possible explanations for any differences in the risk, incidence or prevalence of GI infections across socioeconomic groups.MethodsThree systematic methods will be used to identify relevant literature: electronic database, reference list and grey literature searching. The databases MEDLINE, Scopus and Web of Science Core Collection will be searched using a broad range of search terms. Screening of the results will be performed by two reviewers using pre-defined inclusion and exclusion criteria. The reference lists of included studies will be searched, and Google will be used to identify grey literature. Observational studies reporting quantitative results on the prevalence or incidence of any symptomatic GI infections by SES, in a representative population sample from a member country of the Organisation for Economic Co-operation and Development (OECD), will be included. Data will be extracted using a standardised form. Study quality will be assessed using the Liverpool University Quality Assessment Tools (LQAT). A narrative synthesis will be performed including tabulation of studies for comparison.DiscussionThis systematic review will consolidate the existing knowledge on the relationship between SES and GI infections. The results will help to identify gaps in the literature and will therefore provide an evidence base for future empirical studies to deepen the understanding of the relationship, including effective study design and appropriate data analysis methods. Ultimately, gaining insight into this relationship will help to inform policies to reduce any health inequalities identified.Systematic review registrationPROSPERO CRD42015027231Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0187-7) contains supplementary material, which is available to authorized users.
Highlights
The association between low socioeconomic status (SES) and poor health is well documented in the existing literature
Previous studies have estimated that around 25 % of people in the UK will suffer an episode of infectious intestinal disease (IID) per year and that foodborne illness in England and Wales costs around £1.5 billion per annum [7, 8]
We aim to explore the current knowledge of the relationship in developed countries; assess the magnitude, statistical significance and direction of the association; and shed light into possible explanations for any observed differences in the risk, incidence or prevalence of GI infections across socioeconomic groups
Summary
The association between low socioeconomic status (SES) and poor health is well documented in the existing literature. Evidence on the relationship between SES and gastrointestinal (GI) infections is limited, and the mechanisms underlying this relationship are not well understood with published studies pointing to conflicting results. Whilst there is evidence that the incidence of many infectious diseases, such as tuberculosis and human immunodeficiency virus [4,5,6], varies by social group, the association between socioeconomic status (SES) and gastrointestinal (GI) infections in particular is not well understood. Previous studies have estimated that around 25 % of people in the UK will suffer an episode of infectious intestinal disease (IID) per year and that foodborne illness (a proportion of IID) in England and Wales costs around £1.5 billion per annum [7, 8]. There are eight million absences from school and at least 11 million working days lost to the economy each year due to GI infections [7]
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