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Under-reporting of infectious gastrointestinal illness in British Columbia, Canada: who is counted in provincial communicable disease statistics?

  • L. MacDOUGALL (a1), S. MAJOWICZ (a2) (a3), K. DORÉ (a2) (a3), J. FLINT (a2), K. THOMAS (a2), S. KOVACS (a2) and P. SOCKETT (a2)...

Summary

Under-reporting of infectious gastrointestinal illness (IGI) in British Columbia, Canada was calculated using simulation modelling, accounting for the uncertainty and variability of input parameters. Factors affecting under-reporting were assessed during a cross-sectional randomized telephone survey. For every case of IGI reported to the province, a mean of 347 community cases occurred (5th and 95th percentile estimates ranged from 181 to 611 community cases, respectively). Vomiting [odds ratio (OR) 2·15, 95% confidence interval (CI) 1·03–4·49] and antibiotic use in the previous 28 days (OR 3·59, 95% CI 1·17–10·97) significantly predicted health-care visits in a logistic regression model. In bivariate analyses, physicians were significantly less likely to request stool samples from patients with vomiting (RR 0·09, 95% CI 0·01–0·65) and patients of North American as opposed to non-North American cultural groups (RR 0·38, 95% CI 0·15–0·96). Physicians were more likely to request stool samples from older patients (P=0·003), patients with fewer household members (P=0·002) and those who reported anti-diarrhoeal use following illness (RR 3·33, 95% CI 1·32–8·45). People with symptoms of vomiting were under-represented in provincial communicable disease statistics. Differential degrees of under-reporting must be understood before biased surveillance data can be adjusted.

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Corresponding author

*Author for correspondence: Ms. L. MacDougall, Surveillance Epidemiologist, British Columbia Centre for Disease Control, 655 W12th Avenue, Vancouver, BC, V5Z 4R4, Canada. (Email: Laura.MacDougall@bccdc.ca)

References

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1. Palmer, S, et al. Problems in the diagnosis of foodborne infection in general practice. Epidemiology and Infection 1996; 117: 479484.
2. Wheeler, JG, et al. Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. British Medical Journal 1999; 318: 10461050.
3. de Wit, MA, et al. A comparison of gastroenteritis in a general practice-based study and a community-based study. Epidemiology and Infection 2001; 127: 389397.
4. Voetsch, AC, et al. (Emerging Infections Program FoodNet Working Group). FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States. Clinical Infectious Disease 2004; 38 (Suppl. 3), S127S134.
5. Hoque, ME, et al. Under-notification of giardiasis in Auckland, New Zealand: a capture-recapture estimation. Epidemiology and Infection 2005; 133: 7179.
6. Edge, V, et al. Physician diagnostic and reporting practices for gastrointestinal illnesses in three health regions of British Columbia. Canadian Journal of Public Health (in press).
7. Thomas, K, et al. Epidemiology of acute gastrointestinal illness in British Columbia: population incidence, distribution, and burden. BMC Public Health 2006; 6: 307.
8. Flint, JA, et al. From stool to statistics: reporting of acute gastrointestinal illnesses in Canada. Canadian Journal of Public Health 2004; 95: 309313.
9. Statistics Canada. Community Profiles, 2001 (http://www12.statcan.ca/english/profil01/PlaceSearchForm1.cfm). Accessed 26 October 2006.
10. Vose, D. Probability Distributions, 2nd edn. West Sussex, UK: John Wiley & Sons Ltd, 2000, pp. 99132.
11. Majowicz, S, et al. Estimating the under-reporting rate for infectious gastrointestinal illness in Ontario. Canadian Journal of Public Health 2005; 96: 178181.
12. de Wit, MA, et al. A comparison of gastroenteritis in a general practice-based study and a community-based study. Epidemiology and Infection 2001; 127: 389397.
13. Imhoff, B, et al. Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999. Clinical Infectious Diseases 2004; 28: S219S226.
14. Herikstad, H, et al. A population-based estimate of the burden of diarrhoeal illness in the United States: FoodNet, 1996–7. Epidemiology and Infection 2002; 129: 917.
15. Scallan, E, et al. Acute gastroenteritis in Northern Ireland and the Republic of Ireland: a telephone survey. Communicable Disease and Public Health 2004; 7: 6167.
16. Tam, CC, Rodrigues, LC, O'Brien, SJ. The study of infectious intestinal disease in England: what risk factors for presentation to general practice tell us about potential selection bias in case-control studies of reported cases of diarrhea. International Journal of Epidemiology 2003; 32: 99105.
17. Kuusi, M, et al. Incidence of gastroenteritis in Norway – a population-based survey. Epidemiology and Infection 2003; 131: 591597.
18. BC Health Services. Guidelines and Protocols: Investigation of Suspected Infectious Diarrhea, 2000 (http://www.health.gov.bc.ca/gpac/gastro_submenu.html). Accessed 26 October 2006.

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