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

Area of Science:

• Epidemiology
• Infectious Diseases
• General Practice

Background:

• Gastroenteritis is a common illness with varying consultation patterns.
• Understanding factors influencing general practitioner (GP) consultation is crucial for accurate disease surveillance.
• GP-based studies may not fully represent the community burden of gastroenteritis.

Purpose of the Study:

• To compare community gastroenteritis cases that consulted a general practitioner (GP) versus those who did not.
• To identify factors associated with GP consultation and case inclusion by GPs.
• To assess the impact of consultation on pathogen detection and estimate under-ascertainment by GPs.

Main Methods:

• Community-based and GP-based studies conducted in The Netherlands.
• Comparison of consulting and non-consulting gastroenteritis cases.
• Analysis of factors influencing consultation and pathogen detection frequency.

Main Results:

• Only 5% of community gastroenteritis cases consulted a GP.
• Consulting cases experienced more severe episodes than non-consulting cases.
• GP inclusion selected more severe cases with chronic symptoms, affecting pathogen detection proportions (higher for bacteria/Giardia, lower for viruses).

Conclusions:

• GP-based studies may overestimate the proportion of bacterial and Giardia gastroenteritis and underestimate viral gastroenteritis.
• Under-ascertainment by GPs is significant, necessitating careful extrapolation of findings.
• Estimated gastroenteritis incidence in general practices ranged from 14 to 35 per 1000 person-years.