title: A comparison of gastroenteritis in a general practice-based study and a community-based study.
abstract: 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.
authors.affiliation: Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: de Wit
authors.forename: L M
authors.initials: LM
authors.lastname: Kortbeek
authors.forename: M P
authors.initials: MP
authors.lastname: Koopmans
authors.forename: C J
authors.initials: CJ
authors.lastname: de Jager
authors.forename: W J
authors.initials: WJ
authors.lastname: Wannet
authors.forename: A I
authors.initials: AI
authors.lastname: Bartelds
authors.forename: Y T
authors.initials: YT
authors.lastname: van Duynhoven
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data*; D004522:Educational Status; D005194:Family Practice / Q000706:statistics & numerical data*; D005759:Gastroenteritis / Q000145:classification / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012720:Severity of Illness Index