Household presentation of acute gastroenteritis in a primary care sentinel network: retrospective database studies

Abstract

Background: Acute gastroenteritis (AGE) is a highly transmissible condition spreading rapidly between individuals and within households. Rotavirus vaccination was introduced in the UK in 2013. The study objectives were to investigate how acute gastroenteritis incidence changed over 25 years and household incidence of AGE since 2013. Methods: Repeated cross-sectional study of Royal College of General Practitioners Research and Surveillance Centre network. We used a negative binomial model to report incidence rate ratio (IRR) using the last 5 years data. We also conducted a retrospective cohort analysis, using a shared gamma frailty model (2013-2017). We explored the impact of child under 5-years, household size, socioeconomic status quintile, and rurality. Results: In the cross-sectional analysis, the IRR of AGE in households with a child of under 5 years was 12.20 (95%CI 11.08-13.45-, p < 0.001) compared with households without; the IRR fell across IMD quintiles, for example there is a 37% decrease in incidence comparing IMD quintile 1 to quintile 5 (95%CI-0.52-0.76, p < 0.001), The cohort study revealed that the presence of an under 5 in the household was associated with a higher risk of household presentation (HR = 6.29, 95% CI 5.61-7.06, p < 0.001). In addition, we observe a reduction in risk of presentation from the most to the least deprived socioeconomic quintile (second quintile: HR = 0.74 (95%CI 0.59-0.92), to least deprived quintile, HR = 0.55 (95%CI 0.41-0.74). We saw a lower association with male gender, white ethnicity and living outside London, but an increased association with increasing household size. Conclusions: The incidence of AGE has changed over time: preschool children, larger households, and living in London were associated with higher rates, and male gender and higher economic status associated with lower rates.

Global molecular prevalence and genotype distribution of Sapovirus in children with gastrointestinal complications: A systematic review and meta‐analysis

“…Studies have shown male gender is a risk factor for contracting AGE 201,202 . This is in line with our results, which reports a higher prevalence of SaV in boys (10.1%) than girls (8.6%).…”

Excess mortality in the first COVID pandemic peak: cross-sectional analyses of the impact of age, sex, ethnicity, household size, and long-term conditions in people of known SARS-CoV-2 status in England

“…Other variables included: age; sex; socioeconomic status using the index of multiple deprivation (IMD), based on lower super output area (LSOA) — a geographical subunit with a minimum population of 1000 — divided into quintiles; 13 ethnicity divided into white, Asian, black, mixed, and others; 14 and household size; determined using a pseudonymised household key based on identical address, this has been used in other studies. 10 , 15 , 16 smoking status (comparing current, ex- and non-smokers); obesity (using the World Health Organization categorisation of overweight [body mass index {BMI} = 25–29 kg/m 2 ]; obese [BMI = 30–34 kg/m 2 ]; and severely obese [BMI≥35 kg/m 2 ]; and population density (based on ONS locality data). 17 The highest population density was in ‘conurbations’, medium levels in ‘city and town’, and lowest density in ‘rural areas’.…”

“…household size; determined using a pseudonymised household key based on identical address, this has been used in other studies. 10 , 15 , 16 …”

Disparities in the excess risk of mortality in the first wave of COVID-19: Cross sectional study of the English sentinel network

“…Demographic and personal characteristics included gender, age, and ethnicity divided into white, Asian, Black, mixed and other, using an established ontology, 20 household size (1, 2–4,5–8 and 9 + ), 15 , 21 , 22 and socioeconomic status as determined by the Index of Multiple Deprivation (IMD). 23 We used the following body mass index (BMI) categories: (1) under weight and normal weight were grouped into “normal” (BMI<25 kg/m 2 ); (2) overweight or pre-obese (BMI 25–29 kg/m 2 ); (3) obese class I (BMI 30–34 kg/m 2 ); and (4) obese class II and III (BMI ≥35 kg/m 2 ).…”