Incidence and Outcomes of Acute Gastroenteritis in Italian Children

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Background and Aims:Little is known about the epidemiology of acute gastroenteritis (AGE) and intussusception (IS) or gastrointestinal obstruction (GO) in Italy. We conducted a retrospective study to assess AGE incidence and symptoms, 1-month hospitalization risk, and IS incidence among Italian children.Methods:A dynamic cohort study was conducted using the PEDIANET general practice research database. The study population comprised 79,949 children aged <10 years, from September 2001 to September 2004. AGE, GO, and IS cases were identified from diagnoses, hospitalizations, and free-text searches in patient diaries, and were individually validated. AGE outcomes were assessed. Episodes with ascertained rotavirus (RV) infection and incidence rates with 95% confidence intervals (CIs) were calculated.Results:Overall, 13,978 AGE episodes were identified, and 20 cases of GO including 9 IS cases. The overall AGE incidence rate was 76.1 (74.8–77.4) per 1000 person-years (PY), dropping with age from 124/1000 PY among 0–12 months old to 97/1000 PY among 13–48 months old, and 45/1000 PY among 5–10 years old. Male/female AGE rates were similar. The overall rate of GO including IS was 11.2 per 100,000 PY (95% CI: 7.1–16.9). The overall rate of IS alone was 5.0 per 100,000 PY (95% CI: 2.5–9.2). The rate of GO decreased substantially with increasing age from 32 per 100,000 PY (95% CI 17–56) among children 0–12 months of age to 5.5 per 100,000 PY (95% CI 2.1–12.1) among children 5–10 years of age. Most children with AGE presented with diarrhea (91%), about 30% had vomiting, and 29% had fever. The hospitalization risk for children with AGE was 3.0% (95% CI: 2.70–3.27) within 30 days after start of AGE.Conclusions:AGE is a substantial disease burden in primary care, especially among children aged <5 years. AGE etiology is rarely identified. Most of the cases occurred during the winter period and in children of 6–24 months of age, suggesting that rotavirus could be frequently involved. IS constitutes a rare event in this population, although underreporting might have occurred.

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