Estimating the Incidence of Acute Infectious Intestinal Disease in the Community in the UK: A Retrospective Telephone Survey

Abstract

ObjectivesTo estimate the burden of intestinal infectious disease (IID) in the UK and determine whether disease burden estimations using a retrospective study design differ from those using a prospective study design.Design/SettingA retrospective telephone survey undertaken in each of the four countries comprising the United Kingdom. Participants were randomly asked about illness either in the past 7 or 28 days.Participants14,813 individuals for all of whom we had a legible recording of their agreement to participateOutcomesSelf-reported IID, defined as loose stools or clinically significant vomiting lasting less than two weeks, in the absence of a known non-infectious cause.ResultsThe rate of self-reported IID varied substantially depending on whether asked for illness in the previous 7 or 28 days. After standardising for age and sex, and adjusting for the number of interviews completed each month and the relative size of each UK country, the estimated rate of IID in the 7-day recall group was 1,530 cases per 1,000 person-years (95% CI: 1135–2113), while in the 28-day recall group it was 533 cases per 1,000 person-years (95% CI: 377–778). There was no significant variation in rates between the four countries. Rates in this study were also higher than in a related prospective study undertaken at the same time.ConclusionsThe estimated burden of disease from IID varied dramatically depending on study design. Retrospective studies of IID give higher estimates of disease burden than prospective studies. Of retrospective studies longer recall periods give lower estimated rates than studies with short recall periods. Caution needs to be exercised when comparing studies of self-reported IID as small changes in study design or case definition can markedly affect estimated rates.

Burden of gastrointestinal illness in Sweden-SMS as a tool for collecting self-reported gastrointestinal illness

“…As reported in previous studies [12,14], the GII incidence in the present study was affected by recall time. This may be linked to a recall bias commonly known as telescoping, where participants remember disease episodes as occurring more recently than they actually were.…”

“…European studies have reported incidence ranging from 0.27 to 1.4 AGI episodes per person-year [10][11][12][13][14][15][16][17][18]. Most of the previous estimates are for the total population, including children, thus partly explaining the low AGI reported in our study.…”

The Incidence of Acute Gastrointestinal Illness in Canada, Foodbook Survey 2014-2015

“…Retrospective studies in the UK (IID2) gave higher estimates of disease burden than prospective studies [ 19 ]. However, retrospective studies with longer recall periods gave lower estimated rates than studies with shorter recall periods [ 44 ]. Extrapolation from a reported seven-day prevalence was almost twice the rate of illness estimated when extrapolating from the month recall period [ 6 , 35 , 45 ].…”

Incidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households

“…Besides, loss to follow up is a further disadvantage of prospective studies, which may occur already at 1 month of follow up [9]. Recently, Viviani et al [10] compared the incidence estimates of AGI in their retrospective telephone survey with another study with prospective data collection during the same time period [11], and found higher incidence estimates in the retrospective data collection for the general population. But publications explicitly comparing prospective and retrospective data collection for AGI in the households with children attending day care are scarce.…”