title: Community based study to compare the incidence and health services utilization pyramid for gastrointestinal, respiratory and dermal symptoms.
abstract: BACKGROUND
  Gastrointestinal (GI), respiratory and dermal symptoms are common and cause substantial morbidity, although the information on their exact incidence and comparative burden is limited. The aim of this study was to describe the epidemiology and rate these three major symptom complexes in order to improve our understanding of the health burden imposed by these symptoms.
  
  
  METHODS
  We used data from a community based randomised control trial conducted from June 2007 to August 2008 among 277 South Australian families consuming rainwater. Using weekly health diaries, we prospectively collected information on GI (diarrhoea or vomiting), respiratory (sore throat, runny nose or cough) and dermal (rash, generalised itch or dermal infection) symptoms, as well as on relevant GP visits, time off work and/or hospitalisation due to these symptoms. Data were analysed using generalized estimating equations approach taking into account the variable number of weeks of follow-up of each individual and within-family clustering of responses.
  
  
  RESULTS
  Over one year, at least one episode of GI symptoms was reported by 54% of participants (95% CI 50%-58%), at least one respiratory episode by 91% (95% CI 88%-93%) and at least one episode of dermal symptoms by 27% (95% CI 24%-30%). The average number of weeks per year during which respiratory symptoms occurred was four times greater than for GI or dermal symptoms (4.9, 1.2 and 1.2 weeks, respectively, p<0.001), with an average number of GP visits per person per year being twice as frequent (0.48, 0.26, 0.19 respectively, p<0.001). However, on a per episode basis, a higher proportion of people saw a GP or were hospitalised for GI symptoms.
  
  
  CONCLUSIONS
  This first comparative study of three different symptom complexes showed that although respiratory symptoms are most common, GI symptoms cause a greater per episode burden on healthcare resources. Measuring and comparing the community based burden of these symptom complexes will assist evidence-based allocation of resources.
authors: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors: Nusrat
authors: N
authors: Najnin
authors: Martha
authors: M
authors: Sinclair
authors: Andrew
authors: A
authors: Forbes
authors: Karin
authors: K
authors: Leder
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D055812:Community-Based Participatory Research; D017281:Cost of Illness; D004311:Double-Blind Method; D005191:Family Characteristics; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000628:therapy; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011891:Rain; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000628:therapy; D012871:Skin Diseases / Q000453:epidemiology* / Q000628:therapy; D012923:Social Class; D013021:South Australia / Q000453:epidemiology; D018508:Water Purification / Q000379:methods; D014881:Water Supply / Q000592:standards