Browsing by Author "Fravalo, Philippe"
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- Risk factors for sporadic campylobacteriosis: a systematic review and meta-analysisPublication . Fravalo, Philippe; Kooh, Pauline; Mughini-Gras, Lapo; David, Julie; Thébault, Anne; Cadavez, Vasco; Gonzales-Barron, UrsulaCampylobacter spp. is an important causative agent of diarrheal illness worldwide. The disease is frequently associated with foodborne transmission, but other routes of exposure are increasingly recognized. A systematic review and meta-analysis of case-control studies were performed to determine the main risk factors associated with sporadic campylobacteriosis. Suitable scientific articles published up to March 2017 were identified through a systematic literature search and subject to methodological quality assessment. From each study, odds ratios (OR) as measures of association were extracted or calculated, as well as study characteristics such as study population, design, type of model used and risk factor categorization. Mixed-effects meta-analytical models were adjusted by population type to appropriate data partitions. From 4453 identified references, the quality assessment stage was passed by 71 case-control studies focusing on sporadic campylobacteriosis. The eligible studies were conducted between 1981 and 2012 and provided 1336 ORs for meta-analysis. The meta-analysis identified international travel (pooled OR=4.626), recent use of gastric antacids (pooled OR=2.911), occupational exposure to animals/carcasses (pooled OR=3.022), and food consumption (in particular raw or undercooked eggs, poultry, beef, and dairy) as the main risks factors for sporadic campylobacteriosis in the mixed population. In the child population, the main risk factors concerned environmental/animal transmission routes (e.g. drinking untreated water (pooled OR=3.261), exposure to recreational water (pooled OR=3.156), exposure to farm/rural environment (pooled OR=3.128), contact with farm animals (pooled OR=2.747), person-to-person transmission (pooled OR=2.736) and consumption of raw milk (pooled OR =2.603). The results of this meta-analysis highlight the importance of overlooked routes and vehicles of transmission (environment, animal contact, and other food vehicles) of Campylobacter that should be explored in dedicated studies.
- Risk factors for sporadic salmonellosis: a systematic review and meta-analysisPublication . Guillier, Laurent; Thébault, Anne; Fravalo, Philippe; Mughini-Gras, Lapo; Jourdan-da Silva, Nathalie; David, Julie; Kooh, Pauline; Cadavez, Vasco; Gonzales-Barron, UrsulaNon-typhoidal Salmonella is an important causative agent of diarrheal illness worldwide. A systematic review and meta-analysis of case-control studies were performed to determine the main risk factors associated with sporadic salmonellosis. Suitable scientific articles published up to 2017 were identified through a systematic literature search and subject to methodological quality assessment. From each study, odds ratios (OR) were extracted or calculated, as well as study characteristics such as population type, design, type of model used and risk factor categorization. Mixed-effects meta-analytical models were adjusted by population type to appropriate data partitions. From 3858 identified references, the quality assessment stage was passed by 62 case-control studies focusing on sporadic salmonellosis which provided 1154 ORs for meta-analysis. The meta-analysis identified host-specifics factors, travel, environmental, animal and food exposures as significant risk factors of salmonellosis in the mixed population. For the mixed population, foods significantly associated with salmonellosis were eggs and egg products, composite foods, and meat (pork, red meats other than beef and poultry meats). In the child population, the main risk factors were found for person-to-person transmission, recent use of gastric anti-acids or antibiotics, contact with pets and farm animals, environmental, and food vehicles. Breastfeeding was found to be a protective factor for children. The food vehicles identified in children comprised dairy (milk formula), produce, meat and eggs products. Untreated drinking water was a risk factor for the children and mixed population. The result of the meta-analysis conducted at the international level is very important in the context of increasing international trade in foodstuffs and changes in food consumption patterns.
- Risk factors for sporadic Yersinia enterocolitica infections: a systematic review and meta-analysisPublication . Guillier, Laurent; Fravalo, Philippe; Leclercq, Alexandre; Thébault, Anne; Kooh, Pauline; Cadavez, Vasco; Gonzales-Barron, UrsulaYersinia enterocolotica is an important causative agent of diarrheal illness. A systematic review and meta-analysis of case-control studies were performed to determine the main risk factors associated with sporadic Y. enterocolitica infections. Suitable scientific articles published between 1987 and 2017 were identified through a systematic literature search and subject to methodological quality assessment. From each study, odds ratios (OR) were extracted or calculated, as well as study characteristics such as population type, design, type of model used and risk factor categorization. Mixed-effects meta-analytical models were adjusted by population type to appropriate data partitions. From 807 identified references, the quality assessment stage was passed by 14 case-control studies focusing on sporadic Y. enterocolitica infections which provided 165 ORs for meta-analysis. All studies considered Y. enterocolitica as the cause of sporadic infections and are mainly located in Europe. The meta-analysis identified host-specifics factors, animal and food exposures as significant risk factors. The meta-analysis confirms the predominant role of the pig reservoir. The occupational contact with pigs and the consumption of pork meat are significantly associated with sporadic Y. enterocolitica infections occurrence. The consumption of raw or undercooked pork meat is also a very important risk factor. Untreated drinking water was also identified as risk factor. Further studies with other enteropathogenic Yersinia species, especially Y. pseudotuberculosis, and/or from other continents would help to refine conclusions of the meta-analysis of the risk factors of yersiniosis.