Retrospective Evaluation of the Incidence of Acute Gastroenteritis and Rotavirus Gastroenteritis in Italy

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.