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

Published online by Cambridge University Press:  05 February 2002

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

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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.

Type
Research Article
Copyright
2001 Cambridge University Press