title: Societal Burden and Correlates of Acute Gastroenteritis in Families with Preschool Children.
abstract: Gastrointestinal infection morbidity remains high amongst preschool children in developed countries. We investigated the societal burden (incidence, healthcare utilization, and productivity loss) and correlates of acute gastroenteritis (AGE) in families with preschoolers. Monthly for 25 months, 2000 families reported AGE symptoms and related care, productivity loss, and risk exposures for one preschooler and one parent. Amongst 8768 child-parent pairs enrolled, 7.3% parents and 17.4% children experienced AGE (0.95 episodes/parent-year and 2.25 episodes/child-year). Healthcare utilization was 18.3% (children) and 8.6% (parents), with 1.6% children hospitalized. Work absenteeism was 55.6% (median 1.5 days) and day-care absenteeism was 26.2% (median 1 day). Besides chronic enteropathies, antacid use, non-breastfeeding, and toddling age, risk factors for childhood AGE were having developmental disabilities, parental occupation in healthcare, multiple siblings, single-parent families, and ≤ 12-month day-care attendance. Risk factors for parental AGE were female gender, having multiple or developmentally-disabled day-care-attending children, antimicrobial use, and poor food-handling practices. Parents of AGE-affected children had a concurrent 4-fold increased AGE risk. We concluded that AGE-causing agents spread widely in families with preschool children, causing high healthcare-seeking behaviours and productivity losses. Modifiable risk factors provide targets for AGE-reducing initiatives. Children may acquire some immunity to AGE after one year of day-care attendance.
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.|Utrecht University, Department of Infectious Diseases and Immunology, Yalelaan 1, De Uithof, 3584 CL Utrecht, the Netherlands.
authors.forename: Lapo
authors.initials: L
authors.lastname: Mughini-Gras
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Roan
authors.initials: R
authors.lastname: Pijnacker
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.|VU University Medical Center, Department of Medical Microbiology and Infection Control, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
authors.forename: Moniek
authors.initials: M
authors.lastname: Heusinkveld
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Remko
authors.initials: R
authors.lastname: Enserink
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Rody
authors.initials: R
authors.lastname: Zuidema
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: Duizer
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Titia
authors.initials: T
authors.lastname: Kortbeek
authors.affiliation: National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), PO Box 1, 3720 BA Bilthoven, the Netherlands.
authors.forename: Wilfrid
authors.initials: W
authors.lastname: van Pelt
mesh_terms: D000041:Absenteeism; D000863:Antacids / Q000627:therapeutic use; D002656:Child Day Care Centers / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000863:Antacids