J Pediatr Infect Dis 2015; 10(02): 047-052
DOI: 10.1055/s-0035-1566246
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Retrospective Evaluation of the Incidence of Acute Gastroenteritis and Rotavirus Gastroenteritis in Italy

Chiara Centenari
1   Pediatric Unit, Hospital of Trento, Trento, Italy
,
Daniele Donà
2   Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padova, Padova, Italy
,
Florie Fillol
3   Epidemiology Department, Sanofi Pasteur MSD, Lyon, France
,
Gino Picelli
4   International Pharmacoepidemiology and Pharmacoeconomics Research Center, Desio, Italy
,
Elena Mozzo
2   Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padova, Padova, Italy
,
Marco Villa
5   Epidemiology Service, Local Health Authority of Cremona, Cremona, Italy
,
Luigi Cantarutti
6   Family Pediatrician, Pedianet Project, Padova, Italy
,
Carlo Giaquinto
2   Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padova, Padova, Italy
,
on behalf of Pedianet › Author Affiliations
Further Information

Publication History

17 July 2015

09 September 2015

Publication Date:
23 November 2015 (online)

Abstract

Introduction Acute gastroenteritis (AGE) is one of the most important causes of morbidity and mortality in childhood. Among all the causative agents of AGE, rotavirus (RV) is the most common pathogen. The aim of this study is to estimate the incidence by age group of rotavirus gastroenteritis (RVGE) in children <5 years of age seen at primary care level. This estimation relies on a specifically developed statistical model applied on AGE data reported in the Pedianet database.

Materials and Methods This was an observational, retrospective, cohort study using the Pedianet database that included all children aged ˂12 years with a diagnosis of AGE or acute diarrhea, and registered on the network during the period from January 2002 to December 2008. Since development of the model was specifically based on data collected during the Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in Public Health and Society Study (REVEAL study), RVGE estimation was restricted to children aged <60 months who experienced an AGE.

Results A total of 128,154 children <12 years of age were registered on the Pedianet database during the study period by 83 family pediatricians (FPs). Information on 36,679 episodes of AGE between 2002 and 2008 was collected. Of overall 36,679 AGE cases, 24,275 (66.2%) occurred in children <5 years of age. For children <5 years of age, more than half the episodes of AGE occurred in children between 12 and 35 months. Number of RVGE predicted by the model ranged from 2,864 to 4,700 cases, allowing for the estimated underreporting as calculated from the patients participating both in the REVEAL study and included in Pedianet. As expected, the highest rate occurred from November to May, whereas a lower incidence was reported during the summer season from June to September.

Conclusions The Pedianet database was found to be a useful instrument for collecting information about the number and main features of AGE episodes at the primary care level in Italy. The statistical model presented in this study has proved reliable to predict RV-positive cases. Epidemiological results showed a consistent RVGE incidence from year to year in children less than 5 years old at the primary care level and underlined the persistent contribution of RV infections to the winter workload of Italian FPs.

 
  • References

  • 1 Parashar UD, Alexander JP, Glass RI ; Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC). Prevention of rotavirus gastroenteritis among infants and children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006; 55 (RR-12): 1-13
  • 2 Soriano-Gabarró M, Mrukowicz J, Vesikari T, Verstraeten T. Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 2006; 25 (1, Suppl): S7-S11
  • 3 Saia M, Giliberti A, Callegaro G , et al. Hospitalisation for rotavirus gastroenteritis in the paediatric population in the Veneto Region, Italy. BMC Public Health 2010; 10: 636
  • 4 Gabutti G, Marsella M, Lazzara C, Fiumana E, Cavallaro A, Borgna-Pignatti C. Epidemiology and burden of rotavirus-associated hospitalizations in Ferrara, Italy. J Prev Med Hyg 2007; 48 (1) 5-9
  • 5 Zuccotti G, Meneghin F, Dilillo D , et al. Epidemiological and clinical features of rotavirus among children younger than 5 years of age hospitalized with acute gastroenteritis in Northern Italy. BMC Infect Dis 2010; 10: 218
  • 6 Van Damme P, Giaquinto C, Huet F, Gothefors L, Maxwell M, Van der Wielen M ; REVEAL Study Group. Multicenter prospective study of the burden of rotavirus acute gastroenteritis in Europe, 2004-2005: the REVEAL study. J Infect Dis 2007; 195 (Suppl. 01) S4-S16
  • 7 Tam CC, Rodrigues LC, Viviani L , et al; IID2 Study Executive Committee. Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice. Gut 2012; 61 (1) 69-77
  • 8 Diez-Domingo J, Baldo JM, Patrzalek M , et al; SPRIK Rotavirus Study Group. Primary care-based surveillance to estimate the burden of rotavirus gastroenteritis among children aged less than 5 years in six European countries. Eur J Pediatr 2011; 170 (2) 213-222
  • 9 Szlagatys-Sidorkiewicz A, Kurlenda J, Liberek A , et al. Etiology of community-acquired acute diarrhea in children [in Polish]. Med Wieku Rozwoj 2006; 10 (2) 519-527
  • 10 Ehlken B, Laubereau B, Karmaus W, Petersen G, Rohwedder A, Forster J ; RoMoD Study Group. Prospective population-based study on rotavirus disease in Germany. Acta Paediatr 2002; 91 (7) 769-775
  • 11 Italian Society of Paediatrics. Recommendations for infant immunization against rotavirus. Available at: http://www.fimppalermo.org/portale/index.php?ind=news&op=news_show_single&ide=133 . Accessed March 24, 2014
  • 12 Menniti-Ippolito G, Raschetti R, Da Cas R, Giaquinto C, Cantarutti L ; Italian Paediatric Pharmacosurveillance Multicenter Group. Active monitoring of adverse drug reactions in children. Lancet 2000; 355 (9215) 1613-1614
  • 13 Giaquinto C, Sturkenboom M, Mannino S, Arpinelli F, Nicolosi A, Cantarutti L ; Gruppo di studio sulla varicella in età pediatrica (Pedianet Varicella Study Group). Epidemiology and outcomes of varicella in Italy: results of a prospective study of children (0-14 years old) followed up by pediatricians (Pedianet study) [in Italian]. Ann Ig 2002; 14 (4) (Suppl. 06) 21-27
  • 14 Barbato A, Panizzolo C, Biserna L , et al; Pedianet Family Pediatricians Asthma Study Group (F-PASG). Asthma prevalence and drug prescription in asthmatic children. Eur Ann Allerg Clin Immunol 2003; 35 (2) 47-51
  • 15 Sturkenboom M, Nicolosi A, Cantarutti L , et al; NSAIDs Paediatric Research Group. Incidence of mucocutaneous reactions in children treated with niflumic acid, other nonsteroidal antiinflammatory drugs, or nonopioid analgesics. Pediatrics 2005; 116 (1) e26-e33
  • 16 Sturkenboom MC, Verhamme KM, Nicolosi A , et al; TEDDY European Network of Excellence. Drug use in children: cohort study in three European countries. BMJ 2008; 337: a2245
  • 17 Neubert A, Verhamme K, Murray ML , et al; TEDDY Network of Excellence. The prescribing of analgesics and non-steroidal anti-inflammatory drugs in paediatric primary care in the UK, Italy and the Netherlands. Pharmacol Res 2010; 62 (3) 243-248
  • 18 Baiardi P, Ceci A, Felisi M , et al. In-label and off-label use of respiratory drugs in the Italian paediatric population. Acta Paediatr 2010; 99 (4) 544-549
  • 19 Hsia Y, Neubert A, Sturkenboom MC , et al; TEDDY Network of Excellence. Comparison of antiepileptic drug prescribing in children in three European countries. Epilepsia 2010; 51 (5) 789-796
  • 20 World Health Organization Guideline for Estimating the Economical Burden of Diarrhoeal Disease with Focus on Assessing the Cost of Rotavirus Diarrhoea. Geneva: WHO; 2005. Available at: http://whqlibdoc.who.int/hq/2005/ WHO_ IVB_05.10.pdf
  • 21 Sturkenboom M, Soriano-Gabarró M, Picelli G , et al. Incidence and outcomes of acute gastroenteritis in Italian children. Pediatr Infect Dis J 2008; 27: S42-S47
  • 22 Hosmer D, Lemeshow S. Applied Logistic Regression. 2nd ed. New York: John Wiley & Sons Inc; 2000
  • 23 Karsten C, Baumgarte S, Friedrich AW , et al. Incidence and risk factors for community-acquired acute gastroenteritis in north-west Germany in 2004. Eur J Clin Microbiol Infect Dis 2009; 28 (8) 935-943
  • 24 Gauci C, Gilles H, O'brien S , et al. The magnitude and distribution of infectious intestinal disease in Malta: a population-based study. Epidemiol Infect 2007; 135 (8) 1282-1289
  • 25 Frühwirth M, Karmaus W, Moll-Schüler I, Brösl S, Mutz I. A prospective evaluation of community acquired gastroenteritis in paediatric practices: impact and disease burden of rotavirus infection. Arch Dis Child 2001; 84 (5) 393-397
  • 26 Newman RD, Grupp-Phelan J, Shay DK, Davis RL. Perinatal risk factors for infant hospitalization with viral gastroenteritis. Pediatrics 1999; 103 (1) E3
  • 27 Tinsa F, Brini I, Yahyaoui S , et al. Infectious diarrhoea in children under five years [in French]. Tunis Med 2009; 87 (9) 599-602
  • 28 Ozdemir S, Delialioğlu N, Emekdaş G. Investigation of rotavirus, adenovirus and astrovirus frequencies in children with acute gastroenteritis and evaluation of epidemiological features [in Turkish]. Mikrobiyol Bul 2010; 44 (4) 571-578
  • 29 de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Vinjé J, van Duynhoven YT. Etiology of gastroenteritis in sentinel general practices in the Netherlands. Clin Infect Dis 2001; 33 (3) 280-288
  • 30 Malek MA, Teleb N, Abu-Elyazeed R , et al. The epidemiology of rotavirus diarrhea in countries in the Eastern Mediterranean Region. J Infect Dis 2010; 202 (Suppl): S12-S22
  • 31 Terletskaia-Ladwig E, Eggers M, Enders M, Regnath T. Epidemiological aspects of gastrointestinal infections [in German]. Dtsch Med Wochenschr 2011; 136 (3) 69-75
  • 32 Giaquinto C, van Damme P ; REVEAL Study Group. Age distribution of paediatric rotavirus gastroenteritis cases in Europe: the REVEAL study. Scand J Infect Dis 2010; 42 (2) 142-147
  • 33 Payne DC, Staat MA, Edwards KM , et al. Active, population-based surveillance for severe rotavirus gastroenteritis in children in the United States. Pediatrics 2008; 122 (6) 1235-1243
  • 34 Greenberg HB, Estes MK. Rotaviruses: from pathogenesis to vaccination. Gastroenterology 2009; 136 (6) 1939-1951
  • 35 Velázquez FR, Matson DO, Calva JJ , et al. Rotavirus infections in infants as protection against subsequent infections. N Engl J Med 1996; 335 (14) 1022-1028
  • 36 Ray PG, Kelkar SD, Walimbe AM, Biniwale V, Mehendale S. Rotavirus immunoglobulin levels among Indian mothers of two socio-economic groups and occurrence of rotavirus infections among their infants up to six months. J Med Virol 2007; 79 (3) 341-349
  • 37 Cook SM, Glass RI, LeBaron CW, Ho MS. Global seasonality of rotavirus infections. Bull World Health Organ 1990; 68 (Suppl. 02) 171-177
  • 38 D'Souza RM, Hall G, Becker NG. Climatic factors associated with hospitalizations for rotavirus diarrhoea in children under 5 years of age. Epidemiol Infect 2008; 136 (1) 56-64