What is the qualitative evidence concerning the risks, diagnosis, management and consequences of gastrointestinal infections in the community in the United Kingdom? A systematic review and meta-ethnography


Autoři: Suzanne Rotheram aff001;  Jessie Cooper aff003;  Sara Ronzi aff002;  Benjamin Barr aff002;  Margaret Whitehead aff002
Působiště autorů: Health Protection Research Unit in Gastrointestinal Infection (NIHR), Farr Institute @ The Health eResearch Centre, University of Liverpool, Liverpool, United Kingdom aff001;  Department of Public Health & Policy, The University of Liverpool, Liverpool, United Kingdom aff002;  Division of Health Services Research and Management, School of Health Sciences, University of London, London, United Kingdom aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227630

Souhrn

Background

Gastrointestinal (GI) infections cause a significant public health burden worldwide and in the UK with evidence pointing to socio-economic inequalities, particularly among children. Qualitative studies can help us understand why inequalities occur and contribute to developing more effective interventions. This study had two aims: 1. Conduct a systematic review to determine the extent and nature of UK qualitative evidence on gastrointestinal infections; 2. Use meta-ethnography to examine the influences of the differing social contexts in which people live.

Methods

MEDLINE, Scopus, Web of science, CINAHL and JSTOR were searched for UK qualitative studies engaging with the risk, diagnosis, management or consequences of gastrointestinal infections from 1980 to July 2019. Five reviewers were involved in applying inclusion and exclusion criteria, extracting and synthesising data (PROSPERO CRD 42017055157).

Results

Searches identified 4080 studies, 18 met the inclusion criteria. The majority (n = 16) contained data relating to the risk of gastrointestinal infection and these made up the main synthesis. The tenets of meta-ethnography were used to glean new understandings of the role of social and environmental contexts in shaping the risk of gastrointestinal infection, specifically with respect to foodborne GI illness. Three main explanations concerning risk emerged from the data: explanations of risk in the community were underpinned by understandings of ‘bugs’, dirt and where food comes from; risks were negotiated in households alongside diverse processes of decision making around food; and resources available to households shaped food practices.

Conclusion

This systematic review highlights the scarcity of UK qualitative evidence examining gastrointestinal infections. Apart from risk, questions around diagnosis, management and consequences of illness were largely untouched. No studies investigated patterning by socio-economic status. Nevertheless, the meta-ethnography yielded wider contextual theories and explanations as to why people might not follow food hygiene guidance, giving pointers to the types of qualitative enquiry needed to develop more effective interventions.

Klíčová slova:

Food consumption – Gastrointestinal infections – Genitourinary infections – Hygiene – Milk – Public and occupational health – Qualitative studies – Systematic reviews


Zdroje

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