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Dates: 2014-2019
Funding: NIHR
Collaborators: Sarah O’Brien, Margaret Whitehead, Miren Iturriza-Gómara - University of Liverpool Noel McCarthy, Martin Maiden – Department of Zoology, University of Oxford Paul Hunter, Arjan Narbad – University of East Anglia / Institute for Food Research Jeremy Hawker, Bob Adak, Kathie Grant, David Brown, Roberto Vivancos, Jim McLauchlin – Public Health England
Information: Mara Violato, Alastair Gray

Diarrhoeal diseases disrupt lives. Up to 17 million people are affected annually in the UK leading to at least 11 million working days lost to the economy and 8 million absences from school. Diarrhoeal diseases are also very common causes of outbreaks: for example, norovirus outbreaks repeatedly close hospital wards, especially during the winter months when pressures on the NHS are at their height. Death or life-long disability can result from infection with Escherichia coli O157, the main impact being felt by children and the elderly.

Researchers from the Universities of Liverpool, Oxford, and East Anglia, and the Institute for Food Research in partnership with Public Health England (PHE) have proposed a novel research programme for the NIHR-funded Health Protection Research Unit in Gastrointestinal Infections. The programme spans the translational spectrum from basic biology to applied public health research and, in the first phase of funding, will concentrate on the following six interrelated research themes:

1. People: exploring socio-economic and behavioural factors in gastrointestinal infections
2. Tracking disease in the population: developing novel methods for disease surveillance and outbreak investigation
3. Pathogens: exploiting recent advances in genomics
4. Places: elucidating the role of environment in gastrointestinal disease outbreaks
5. Pathways: understanding transmission of gastrointestinal infection to and between people
6. The microbiome: the role of microbial communities in gastrointestinal infections.

The aim is to develop new means of understanding and investigating diarrhoeal diseases in the context of people’s lives, and to reduce the overall disease burden and the associated inequalities.

HERC researchers will lead the health economics component of the research programme and will co-supervise DPhil students. Differences in the clinical, health care utilisation and cost consequences of gastrointestinal infections will be analysed across different socioeconomic and demographic groups within the UK population. A model will also be developed to test the economic consequences of a number of intervention scenarios. All of this will be achieved using a variety of data sources (including routine laboratory data, disease notification, survey data, and administrative healthcare utilisation records) and economic and statistical methods (including cross-sectional and pseudo-panel methods, costing methods, record linkage, and economic modelling approaches).

It is expected that this integrated, inter-disciplinary research programme will generate new strategies for control, meeting PHE’s main objectives of addressing inequalities, protecting the country from infectious diseases, and being an evidence-led organisation that provides answers to public health problems.


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Socioeconomic status and infectious intestinal disease in the community: a longitudinal study (IID2 Study)

Violato M., (2017), European Journal of Public Health

Socioeconomic status is associated with symptom severity and sickness absence in people with infectious intestinal disease in the UK

Rose TC. et al, (2017), BMC Infectious Diseases

Factors Associated with Sequelae of Campylobacter and Non-typhoidal Salmonella Infections: A Systematic Review

Esan O. et al, (2016), EBioMedicine

Relationship between socioeconomic status and measures of infectious intestinal disease severity

Rose T. et al, (2016), European Journal of Public Health, 26