Academic literature on the topic 'Gastroenteritis Australia'

The aim of this study was to determine the prevalence of gastroenteritis among children aged 4 years in South Australia. A cross-sectional survey of 9543 South Australian children aged 4 years was undertaken. Parents completed a questionnaire on behalf of their child who had attended a pre-school health check in 1998. The questionnaire covered gastrointestinal and respiratory symptoms experienced by the child in the previous 2 weeks and other risk factors for gastroenteritis. The 2-week prevalence of gastroenteritis among 4-year-old children was 14·2%. The major risk factors for gastroenteritis were presence of persons who had gastroenteritis inside the home, contact with persons who had gastroenteritis outside the home, antibiotic use and sore throat. Medical attention was sought for 20% of children who had gastroenteritis. Gastroenteritis is a significant cause of morbidity among young children and presents a considerable burden on the community. A substantial proportion of these occurrences of highly credible gastrointestinal symptoms may be manifestations of respiratory infections.

SUMMARYInfectious gastroenteritis is a common illness in Australia as elsewhere. Data from a year-long national gastroenteritis survey in 2001–2002 showed that gastroenteritis was more common in the northern and hotter part of Australia. These data were used to quantify associations between local weather variables and gastroenteritis in people aged >5 years while controlling for socioeconomic status. A distributed lag model was used to examine the influence of weather over a period of days prior to an event and the maximal effect was found at a lag of 2–5 days. The total effect over the preceding week indicated a relative increase from baseline in the probability of gastroenteritis of 2·48% (95% CI 1·01–3·97) for each degree rise (°C) over that period. Given the very high burden of gastroenteritis, this represents a substantial effect at the population level and has relevance for health predictions due to climate change.

SUMMARYThe aim of this study was to estimate the healthcare usage and loss of productivity due to gastroenteritis in Australia using the National Gastroenteritis Survey II. In 2008–2009, 7578 participants across Australia were surveyed about infectious gastroenteritis by telephone interview. A gastroenteritis case was defined as a person experiencing ⩾3 loose stools and/or ⩾2 vomits in a 24-h period, excluding cases with a non-infectious cause for their symptoms, such as pregnancy or consumption of alcohol. Lost productivity was considered any lost time from full- or part-time paid work due to having gastroenteritis or caring for someone with the illness. Interference with other daily activities was also examined along with predictors of healthcare-seeking practices using multivariable regression. Results were weighted to obtain nationally representative estimates using Stata v. 13·1. Of the 341 cases, 52 visited a doctor due to gastroenteritis, 126 reported taking at least one medication for their symptoms and 79 cases reported missing ⩾1 days’ paid work due to gastroenteritis. Gastroenteritis results in a total of 13·1 million (95% confidence interval 6·7–19·5) days of missed paid work each year in Australia. The indirect costs of gastroenteritis are significant, particularly from lost productivity.

SUMMARYTo estimate the frequency of infectious gastroenteritis across Australia, and to identify risk factors, we conducted a national telephone survey of 6087 randomly selected respondents in 2001–2002. The case definition was three or more loose stools and/or two or more vomits in a 24-hour period in the last 4 weeks, with adjustment to exclude non-infectious causes and symptoms secondary to a respiratory infection. Frequency data were weighted to the Australian population. Multivariate logistic regression was used to assess potential risk factors including season, region, demographic and socioeconomic status. Among contacted individuals, 67% responded. The case definition applied to 7% of respondents (450/6087) which extrapolates to 17·2 million (95% CI 14·5–19·9 million) cases of gastroenteritis in Australia in one year, or 0·92 (95% CI 0·77–1·06) cases/person per year. In the multivariate model, the odds of having gastroenteritis were increased in summer and in the warmest state, in young children, females, those with higher socioeconomic status and those without health insurance.

Summary Objective: To determine factors affecting length of hospitalisation of infants for recurrent gastroenteritis using linked data records from the Western Australia heath information system. Methods: A seven-year retrospective cohort study was undertaken on all infants born in Western Australia in 1995 who were admitted for gastroenteritis during their first year of life (n = 519). Linked hospitalisation records were retrieved to derive the outcome measure and other demographic variables for the cohort. Unlike previous studies that focused mainly on a single episode of gastroenteritis, the durations of successive hospitalisations were analysed using a proportional hazards model with correlated frailty to determine the prognostic factors influencing recurrent gastroenteritis. Results: Older children experienced a shorter stay with an increased discharge rate of 1.9% for each month increase in admission age. An additional comorbidity recorded in the hospital discharge summary slowed the adjusted discharge rate by 46.5%. Aboriginal infants were readmitted to hospital more frequently, and had an adjusted hazard ratio of 0.253, implying a much higher risk of prolonged hospitalisation compared to non-Aborigines. Conclusions: The use of linked hospitalisation records has the advantage of providing access to hospital-based population information in the context of medical informatics. The analysis of linked data has enabled the assessment of prognostic factors influencing length of hospitalisations for recurrent gastroenteritis with high statistical power.

Thesis (PhD) - Faculty of Life and Social Sciences, Swinburne University of Technology, 2007.
Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Life and Social Sciences, Swinburne University of Technology - 2007. Typescript. "September 2007". Includes bibliographical references (p. 173-204).

[Truncated abstract] Gastroenteritis is frequently associated with a food or water borne source and the investigation of such cases is undertaken to identify potential sources of infection. Where contaminated food or water are identified as the source of infection/intoxication, action may be taken to limit or prevent further people being affected, and in so doing limit costs to the health care system. This study was undertaken to determine if there is a more effective and efficient way to collect information from patients with certain enteric illnesses. This was based on a trial process of posting self-administered questionnaires with a reply-paid return envelope to the patient and compared with the existing process where local government Environmental Health Officers interview the patient and provide a report to the Department of Health. A limiting factor in the existing process is the time lapse between the onset of illness and follow-up by Environmental Health Officers (EHOs), which results in difficulties in contacting the patient and obtaining a dietary history. Furthermore, the existing system is resource intense, requiring officers to individually interview patients either in person or by telephone. The study was of those patients living in the Perth metropolitan area whose doctor notified the Department of Health that the patient had contracted any of three notifiable enteric illnesses (campylobacterosis, giardiasis or salmonellosis), and the patient was not part of a known outbreak and was assessed as not requiring urgent follow-up. The trial process was used for patients living in five local government areas and the return rate, timeliness of return and completeness of questionnaires in the trial process was compared with the reports returned under the existing process of investigation and reporting by EHOs from 24 metropolitan local government areas that were not part of the trial process. An estimate of the potential costs to local government and the Department of Health was undertaken for both the existing and trial processes of collecting information from patients. A survey of local government EHOs in the metropolitan area was also undertaken to assess the perception of EHOs about roles and responsibilities in the follow-up investigation, the use of the Enteric Disease Investigation Report (EDIR) and the limitations that they identified in the current investigation process.

My placement for the Master of Philosophy in Applied Epidemiology (MAE) degree was with the Zoonoses, Foodborne and Emerging Infectious Diseases section (ZoFE), within the Office of Health Protection, Australian Government Department of Health. This placement has allowed me to apply the skills and knowledge of the epidemiology of infectious diseases acquired throughout my degree. I focused on the following four core projects. My review of the National Enhanced Listeriosis Surveillance System (NELSS) found that it had been invaluable in listeriosis surveillance in Australia since 2010. It has been used not only to detect clusters and outbreaks but has also assisted in the identification and investigation of possible sources of these outbreaks. NELSS is viewed as valuable with a high level of acceptability by the users of the system, despite limitations including a lack of understanding of system capabilities, duplication of data entry and the system not storing all available data. This review highlights the effectiveness of enhanced surveillance for a foodborne disease, though improvements are needed. In 2013 I was part of a team that investigated an outbreak of foodborne gastroenteritis linked to a buffet meal served at a Canberra restaurant. The cohort study and environmental and laboratory investigations suggested that a breakdown in cleanliness, temperature control and food handling practices resulted in contamination of the buffet food. Our investigation resulted in public health actions, such as repairs to the kitchen of the implicated restaurant, staff training and the development of food business management plans, to limit the potential for such an outbreak to occur in the future. As there is no reliable treatment for Australian Bat lyssavirus (ABLV) or rabies virus infection upon the onset of symptoms, treatment must occur as either pre or post-exposure prophylaxis. The National Human Rabies Immunoglobulin Database records information of people who have received Human Rabies Immunoglobulin (HRIg) in Australia as part of post-exposure prophylaxis treatment. Between 1 January 2010 and 31 December 2013, 3,003 individuals received HRIg for potential exposures to ABLV or rabies virus. A third received HRIg due to potential exposures to ABLV occurring in Australia. The current messaging for the risks of ABLV infection from bats in Australia should be reviewed and revised to ensure that it is appropriately targeted and effective. Two thirds of people received HRIg for potential exposures to the rabies virus overseas. Most occurred in Indonesia and most due to exposure to monkeys. We need to continue to warn of the risk of potential exposure to rabies virus when travelling overseas, particularly to Indonesia. Q fever is a zoonosis that has a wide range of reservoirs in Australia. In humans the disease can manifest as either acute febrile illness or chronic illness that may affect the heart or liver. The Australian Government funded the National Q fever Management Program (NQFMP) from 2000 to 2006, which provided screening and vaccination for target high risk groups. We found notified Q fever cases were predominately male, aged 40 to 59 years, who resided in Queensland or New South Wales. Interestingly the age of notified Q fever cases and the proportion of cases that were female both increased over time. It may be time to re-evaluate the at-risk groups recommended for Q fever vaccination as per the Australian Immunisation Handbook. Additionally, there may be a place for an agreed and consistent enhanced dataset for collection at the jurisdictional level or at the national level to better understand the epidemiology of Q fever in Australia.

Elderly people are potentially at higher risk of gastroenteritis and foodborne diseases due to declining immunity, co-morbid illnesses and poorer food handling. In particular, residents of Long-Term Care Facilities (LTCF) have been highlighted as an 'at-risk' group, as outbreaks often occur in these facilities. The objectives of my research were to estimate the incidence of gastroenteritis and foodborne diseases in elderly Australians compared with other age groups, and elderly Australians living in LTCFs compared to elderly people in the community. I also examined the occurrence of outbreaks and causes of foodborne diseases in elderly people. To achieve these objectives I analyzed five different datasets: (1) a systematic review of gastroenteritis in LTCF residents, (2) 12-months longitudinal surveillance for gastroenteritis in residents of 16 LTCF in New South Wales, (3) two national surveys of gastroenteritis in the Australian community, (4)food- and waterborne infections in elderly people from Victorian public health surveillance, and (5) national surveillance of outbreaks of gastroenteritis and foodborne disease in Australian LTCF. I defined elderly people as 65 years or older. I analyzed datasets using meta-analysis, and negative binomial and logistic regression, depending on the nature of the data. In a meta-analysis of 15 international studies included in the systematic review, I estimated LTCF residents experience 0.15 episodes of gastroenteritis per person per year. Incidence was higher for studies conducted outside the United States at 0.27 episodes per person per year, which was similar to my findings of 0.23 episodes of diarrhea per person per year from longitudinal surveillance of 16 Australian LTCF. I estimated from national surveys that elderly people living in the community experienced 0.15 episodes of diarrhea per year, which was lower than any other age group. From Victorian surveillance data, the rate of Campylobacter infection in LTCF residents was 37!% lower than in community residents, after adjusting for age, gender and reporting period. However, Victorian LTCF residents were at higher risk of Salmonella infections, particularly in association with outbreaks. From longitudinal surveillance, 96% (245/254) of gastroenteritis episodes in LTCF residents were outbreak-associated. Analysis of 3,257 outbreaks of gastroenteritis that occurred in Australian LTCF over six years identified that 84,769 people were affected and facilities could expect one outbreak every three years. Outbreaks were predominantly transmitted from one infected person to another, with norovirus causing 35% (1,136/3,257) of outbreaks. Foodborne outbreaks were extremely rare and a food-vehicle was only identified in 27% (14/52) of outbreaks, where the main causes were meals that were pureed or contained eggs. In outbreaks of foodborne salmonellosis, 6.1% (15/244) of affected LTCF residents died. It was surprising to find that elderly people do not experience more gastroenteritis than younger people. Elderly people living in LTCF had a lower incidence of many foodborne infections than those living in the community, with the exception of salmonellosis. Gastroenteritis in LTCF residents was often associated with outbreaks, which were mainly spread from person-to-person. From these studies, health agencies should focus on identifying interventions to contain outbreaks of viral gastroenteritis in LTCF.

Background: Gastroenteritis is an important cause of morbidity in older adults, resulting in a significant health burden globally. The aims of this thesis were to describe the epidemiology of gastroenteritis in older adults and to investigate factors associated with hospitalisation with all-cause and cause-specific gastroenteritis in a cohort of middle-aged and older Australians. Methods: I used design-based logistic regression and proportional hazards regression to analyse two datasets: (1) a national survey of gastroenteritis in the Australian community conducted in 2008–2009; and (2) a large-scale population-based cohort of middle-aged and older Australians with data linkage to hospitalisations, pharmaceuticals, notifiable diseases and deaths data. Additionally, I conducted a systematic review and meta-analysis of Clostridium difficile infection among people with inflammatory bowel disease. Results: I estimated that 78,356 people aged ≥65 years old visited a doctor due to gastroenteritis in Australia annually, with 157,317 million courses of medication usage in one year from 2008−2009. From population-based cohort data, I demonstrated that the incidence of hospitalisation with gastroenteritis increased with older age; from 2.4 per 1,000 person-years in adults aged 45-54 years old to 9.5 per 1,000 in those aged ≥65 years. Compared to adults aged 45-54 years old, older persons had a higher incidence of hospitalisation with Salmonella infection and C. difficile infection. After adjustment, the risk of hospitalisation with gastroenteritis differed depending on sex and region of residence. Poor self-rated health and use of proton pump inhibitors (PPI) were significantly associated with gastroenteritis hospitalisation. Hospitalisation with C. difficile infection was associated with longer hospital stays, greater in-hospital costs and higher in-hospital deaths compared to hospitalisation without C. difficile infection. In a meta-analysis of six international studies included in the systematic review, C. difficile infection was a significant risk factor for colectomy among patients with inflammatory bowel disease (Odds Ratio: 1.90; 95%CI 1.23-2.93). Conclusions: This thesis demonstrates a significant burden of gastroenteritis in older Australians. Incidence of hospitalisation with all-cause and cause-specific gastroenteritis increases significantly with age. Future efforts should focus on defining and improving preventive measures for gastroenteritis hospitalisation among the elderly. The risk of hospitalisation varies by sex and region of residence, which reflects differences in exposure. PPI use is significantly associated with gastroenteritis hospitalisation. Given the widespread of PPI use, particularly among older people, clinicians should be aware of this potential association when considering PPI therapy. In addition, early recognition and supportive treatment of diarrhoea in older patients with poor self-rated health may prevent subsequent hospitalisation and improve their health outcomes