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Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results.

ABSTRACT: OBJECTIVES:To estimate the incidence of gastroenteritis in individuals in care homes. DESIGN:Prospective cohort study. SETTING:Five participating care homes in North West England, UK. PARTICIPANTS:Residents and staff present at the five study care homes between 15 August 2017 and 30 May 2019 (n=268). OUTCOME MEASURES:We calculated incidence rates for all gastroenteritis cases per 1000 person-years at risk and per 1000 bed-days at risk. We also calculated the incidence rate of gastroenteritis outbreaks per 100 care homes per year. RESULTS:In total 45 cases were reported during the surveillance period, equating to 133.7 cases per 1000 person-years at risk. In residents the incidence rate was 0.62 cases per 1000 bed-days. We observed seven outbreaks in all care homes included in surveillance, a rate of 76.4 outbreaks per 100 care homes per year. 15 stool samples were tested; three were positive for norovirus, no other pathogens were detected. CONCLUSIONS:We found that surveillance of infectious gastroenteritis disease in care homes based on outbreaks, the current general approach, detected a majority of cases of gastroenteritis. However, if policymakers are to estimate the burden of infectious gastroenteritis in this setting using only routine outbreak surveillance data and not accounting for non-outbreak cases, this study implies that the total burden will be underestimated.

SUBMITTER: Inns T

PROVIDER: S-EPMC6924874 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results.

Inns Thomas T Pulawska-Czub Anna A Harris John P JP Vivancos Roberto R Beeching Nicholas J NJ Iturriza-Gomara Miren M O'Brien Sarah J SJ

BMJ open 20191208 12

<h4>Objectives</h4>To estimate the incidence of gastroenteritis in individuals in care homes.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Five participating care homes in North West England, UK.<h4>Participants</h4>Residents and staff present at the five study care homes between 15 August 2017 and 30 May 2019 (n=268).<h4>Outcome measures</h4>We calculated incidence rates for all gastroenteritis cases per 1000 person-years at risk and per 1000 bed-days at risk. We also calculated the i ...[more]

PMID: 31818842

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Project description:BACKGROUND:Rotavirus is a leading worldwide cause of acute gastroenteritis in young children. This retrospective hospital-based study assessed the burden of rotavirus gastroenteritis in children younger than 6 years in Japan. METHODS:Children admitted to eight hospitals for acute gastroenteritis between 2008 and 2009 were identified from hospital admission databases. Diagnosis of acute gastroenteritis/rotavirus gastroenteritis and hospital-acquired rotavirus gastroenteritis was confirmed based on either the International Classification of Diseases and Related Health Problems 10th revision (ICD10) codes (intestinal infectious diseases [AA00-AA09] and rotavirus gastroenteritis [A08.0]) or from rapid rotavirus diagnostic test results. RESULTS:Of 13,767 hospitalized children, 11.9% (1,644), 4.8% (665) and 0.6% (81) were diagnosed with acute gastroenteritis, rotavirus gastroenteritis and hospital-acquired rotavirus gastroenteritis, respectively. Among acute gastroenteritis hospitalizations, 40.5% (665/1,644; ICD10 and rapid test) and 57.7% (645/1,118; rapid test only) were confirmed as rotavirus positive. Of 1,563 children with community-acquired acute gastroenteritis, 584 (37.4%) cases were confirmed as rotavirus positive. The median durations of hospitalization for all and community-acquired rotavirus gastroenteritis were 5.0 days (range: 2.0-133.0 days) and 5.0 days (range: 2.0-34.0 days), respectively. Among rotavirus gastroenteritis hospitalizations, 12.2% (81/665) of cases were hospital-acquired and the median duration of hospitalization was 10.0 days (range: 2.0-133.0 days). The median duration of additional hospitalization due to hospital-acquired rotavirus gastroenteritis was 3.0 days (range: 0-14 days). The overall incidence rate of hospital-acquired rotavirus gastroenteritis was 1.0 per 1,000 children hospital-days. The number of rotavirus gastroenteritis cases peaked between February and May in both 2008 and 2009, and the highest number of cases was reported in March 2008 (21.8%; 145/665). The highest number of rotavirus gastroenteritis hospitalizations (24.1%; 160/665) was observed in children aged 12-18 months. The proportion of hospital-acquired rotavirus gastroenteritis was higher in children aged below 18 months as compared to children at least 18 months of age (0.94 [95% CI: 0.71-1.21] vs. 0.39 [95% CI: 0.25-0.58]) and for children hospitalized for at least 5 days compared to those hospitalized for less than 5 days (0.91 [95% CI: 0.72-1.14] vs. 0.15 [95% CI: 0.05-0.32]). CONCLUSIONS:Both community- and hospital-acquired rotavirus gastroenteritis are significant public health problems in Japan. Data from this study justify the need for the introduction and implementation of rotavirus vaccination in the Japanese national immunization program. TRIAL REGISTRATION:ClinicalTrials.gov, NCT01202201.

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Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results.

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Prospective cohort study to investigate the burden and transmission of acute gastroenteritis in care homes: epidemiological results.

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