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Diarrhoea--defining the episode

S S Morris1, S N Cousens, C F Lanata

  • 1Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.

International Journal of Epidemiology
|June 1, 1994
PubMed
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Defining a diarrhea episode is crucial for accurate incidence rates. This study models illness patterns, suggesting chance plays a significant role in short intervals between diarrhea episodes, especially with high rates.

Area of Science:

  • Epidemiology
  • Infectious Disease Modeling

Background:

  • Lack of consensus on defining a diarrhea episode impacts incidence rate reporting.
  • Previous studies focused on observed illness patterns, not statistical deviations from chance.

Purpose of the Study:

  • To develop a theoretical model for diarrhea episode distribution.
  • To assess if observed illness patterns deviate from chance expectations.

Main Methods:

  • Developed a theoretical model based on 'trigger events'.
  • Incorporated symptom duration, incidence variation, and seasonality.
  • Utilized two empirical datasets for parameter derivation.

Main Results:

  • Short intervals between diarrhea episodes can occur by chance, particularly with high incidence and clustering.

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  • Symptom duration and seasonality have minimal impact on interval length.
  • Over 10% of events may be misclassified due to pre-existing illness.

    • Conclusions:

    • Supports previous findings that 2-3 symptom-free days often indicate a new diarrhea episode.
    • Modeling illness distribution can identify empirical data issues.