Abstract
BackgroundInfectious intestinal disease (IID), usually presenting as diarrhoea and vomiting, is frequently preventable. Though often mild and self-limiting, its commonness makes IID an important public health problem. In the mid 1990s around 1 in 5 people in England suffered from IID a year, costing around £0.75 billion. No routine information source describes the UK's current community burden of IID. We present here the methods for a study to determine rates and aetiology of IID in the community, presenting to primary care and recorded in national surveillance statistics. We will also outline methods to determine whether or not incidence has declined since the mid-1990s.Methods/designThe Second Study of Infectious Intestinal Disease in the Community (IID2 Study) comprises several separate but related studies. We use two methods to describe IID burden in the community - a retrospective telephone survey of self-reported illness and a prospective, all-age, population-based cohort study with weekly follow-up over a calendar year. Results from the two methods will be compared. To determine IID burden presenting to primary care we perform a prospective study of people presenting to their General Practitioner with symptoms of IID, in which we intervene in clinical and laboratory practice, and an audit of routine clinical and laboratory practice in primary care. We determine aetiology of IID using molecular methods for a wide range of gastrointestinal pathogens, in addition to conventional diagnostic microbiological techniques, and characterise isolates further through reference typing. Finally, we combine all our results to calibrate national surveillance data.DiscussionResearchers disagree about the best method(s) to ascertain disease burden. Our study will allow an evaluation of methods to determine the community burden of IID by comparing the different approaches to estimate IID incidence in its linked components.
Highlights
Infectious intestinal disease (IID), usually presenting as diarrhoea and vomiting, is frequently preventable
Researchers disagree about the best method(s) to ascertain disease burden
Our study will allow an evaluation of methods to determine the community burden of IID by comparing the different approaches to estimate IID incidence in its linked components
Summary
Infectious intestinal disease (IID), usually presenting as diarrhoea and vomiting, is frequently preventable. A major advantage of population-based, prospective cohort studies is the ability to request stool specimens from people who report illness so that the range of gastrointestinal pathogens causing symptoms can be determined. Pre-defined set of diagnostic codes (Read codes [20]) the research nurse searches the practice database for every patient that presents with IID during the study period They cross-reference this list with the cases recruited to the GP Presentation Study to determine the proportion of eligible participants that are not recruited. The practice research nurse identifies from the practice database all patients who present with a new episode of IID during the study period They record the case's age, sex, postcode, and information about the place of consultation, admission to hospital and whether or not a faecal specimen has been requested.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have