Epidemiology and Infection



A comparison of gastroenteritis in a general practice-based study and a community-based study


M. A. S.  DE WIT  a1 c1, L. M.  KORTBEEK  a2, M. P. G.  KOOPMANS  a3, C. J.   DE JAGER  a1, W. J. B.  WANNET  a2, A. I. M.  BARTELDS  a4 and Y. T. H. P.  VAN DUYNHOVEN  a1
a1 Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, PO Box 1, 37208A Bilthoven, The Netherlands
a2 Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, PO Box 1, 37208A Bilthoven, The Netherlands
a3 Research Laboratory for Infectious Diseases, National Institute of Public Health and the Environment, PO Box 1, 37208A Bilthoven, The Netherlands
a4 Netherlands Institute of Primary Health Care, Utrecht, The Netherlands

Abstract

We compared gastroenteritis cases that consulted a general practitioner (GP) with those who did not in a community-based study and also with those in a GP-based study. We aimed to identify factors associated with consultation, and with inclusion of cases by GPs, and secondly to study the effects on the frequency of detection of pathogens. Furthermore, we estimated the under-ascertainment by GPs. Both studies were performed in The Netherlands in the same population in an overlapping time-period. Overall, 5% of community cases consulted a GP. Cases who consulted suffered from more severe episodes than non-consulting cases. Inclusion of cases by GPs, instead of a study team, caused a selection of more severe cases with more chronic symptoms. When extrapolating data from GP-based studies, it should be taken into account that, in general practice, gastroenteritis due to bacteria and Giardia lamblia is a relatively large proportion of that in the community and gastroenteritis due to Norwalk-like viruses is a relatively small proportion. The incidence of gastroenteritis in general practices was estimated between 14 and 35 per 1000 person years.

(Accepted August 5 2001)


Correspondence:
c1 Author for correspondence.


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