Abstract
Introduction Acute gastroenteritis (AGE) is one of the most important causes of morbidity and
mortality in childhood. Among all the causative agents of AGE, rotavirus (RV) is the
most common pathogen. The aim of this study is to estimate the incidence by age group
of rotavirus gastroenteritis (RVGE) in children <5 years of age seen at primary care
level. This estimation relies on a specifically developed statistical model applied
on AGE data reported in the Pedianet database.
Materials and Methods This was an observational, retrospective, cohort study using the Pedianet database that included all children aged ˂12 years with a diagnosis of AGE or acute
diarrhea, and registered on the network during the period from January 2002 to December
2008. Since development of the model was specifically based on data collected during
the Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for
Losses in Public Health and Society Study (REVEAL study), RVGE estimation was restricted
to children aged <60 months who experienced an AGE.
Results A total of 128,154 children <12 years of age were registered on the Pedianet database during the study period by 83 family pediatricians (FPs). Information on
36,679 episodes of AGE between 2002 and 2008 was collected. Of overall 36,679 AGE
cases, 24,275 (66.2%) occurred in children <5 years of age. For children <5 years
of age, more than half the episodes of AGE occurred in children between 12 and 35
months. Number of RVGE predicted by the model ranged from 2,864 to 4,700 cases, allowing
for the estimated underreporting as calculated from the patients participating both
in the REVEAL study and included in Pedianet. As expected, the highest rate occurred from November to May, whereas a lower incidence
was reported during the summer season from June to September.
Conclusions The Pedianet database was found to be a useful instrument for collecting information about the
number and main features of AGE episodes at the primary care level in Italy. The statistical
model presented in this study has proved reliable to predict RV-positive cases. Epidemiological
results showed a consistent RVGE incidence from year to year in children less than
5 years old at the primary care level and underlined the persistent contribution of
RV infections to the winter workload of Italian FPs.
Keywords
rotavirus - gastroenteritis - primary care - Europe
