title: Distribution, burden, and impact of acute gastroenteritis in Dominica, 2009-2010.
abstract: Acute gastroenteritis (AGE) is an important public-health issue in Dominica. To determine the burden of AGE in Dominica, a retrospective, cross-sectional population survey was conducted in March-April 2009 and October 2010 (low- and-high-AGE seasons) and a laboratory survey from April 2009 to March 2010. The overall monthly prevalence of self-reported AGE was 8.6 % (95% CI 7.0-10.6); the incidence rate was 1.1 episodes/person-year and 79,157.1 episodes of AGE for the total population/year. Monthly prevalence of AGE was the highest in the 1-4 year(s) age-group (25.0%), higher in females (10.8%) and also varied by health district, with the highest monthly prevalence of AGE being reported in the Portsmouth district (13.1%). This difference in gender and across the health region was statistically significant. The estimated underreporting of syndromic AGE to the Ministry of Health was 83.3%. Furthermore, for every reported laboratory-confirmed case of AGE and foodbome disease (FBD), there was an estimated underreporting factor of 280. Overall, 47% of AGE specimens tested were positive for FBD pathogens. The predominant pathogens isolated were norovirus, followed by Giardia, Salmonella, and Shigella. The total annual estimated cost of AGE was US$ 1,371,852.92, and the total cost per capita due to AGE was US$ 19.06, indicating an economic burden of AGE-related illness on a small island of Dominica.
authors.forename: Shalauddin
authors.initials: S
authors.lastname: Ahmed
authors.forename: Paul
authors.initials: P
authors.lastname: Ricketts
authors.forename: Marc
authors.initials: M
authors.lastname: Bergeron
authors.forename: Walter
authors.initials: W
authors.lastname: Jones
authors.forename: Lisa
authors.initials: L
authors.lastname: Indar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D019424:Dominica / Q000453:epidemiology; D005260:Female; D005517:Foodborne Diseases / Q000191:economics / Q000453:epidemiology; D005759:Gastroenteritis / Q000191:economics* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D055815:Young Adult