Majowicz S E, Hall G, Scallan E, Adak G K, Gauci C, Jones T F, O'Brien S, Henao O, Sockett P N
Foodborne, Waterborne, and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa, ON, Canada.
Epidemiol Infect. 2008 Jul;136(7):886-94. doi: 10.1017/S0950268807009375. Epub 2007 Aug 9.
National studies determining the burden of gastroenteritis have defined gastroenteritis by its clinical picture, using symptoms to classify cases and non-cases. The use of different case definitions has complicated inter-country comparisons. We selected four case definitions from the literature, applied these to population data from Australia, Canada, Ireland, Malta and the United States, and evaluated how the epidemiology of illness varied. Based on the results, we developed a standard case definition. The choice of case definition impacted on the observed incidence of gastroenteritis, with a 1.5-2.1 times difference between definitions in a given country. The proportion of cases with bloody diarrhoea, fever, and the proportion who sought medical care and submitted a stool sample also varied. The mean age of cases varied by <5 years under the four definitions. To ensure comparability of results between studies, we recommend a standard symptom-based case definition, and minimum set of results to be reported.
确定肠胃炎负担的全国性研究通过临床表现来定义肠胃炎，利用症状对病例和非病例进行分类。不同病例定义的使用使国家间的比较变得复杂。我们从文献中选取了四种病例定义，将其应用于澳大利亚、加拿大、爱尔兰、马耳他和美国的人口数据，并评估疾病的流行病学是如何变化的。基于这些结果，我们制定了一个标准病例定义。病例定义的选择影响了所观察到的肠胃炎发病率，在一个特定国家中，不同定义之间的差异为1.5至2.1倍。出现血性腹泻、发烧的病例比例，以及寻求医疗护理并提交粪便样本的比例也有所不同。在这四种定义下，病例的平均年龄差异不到5岁。为确保研究结果之间具有可比性，我们建议采用基于症状的标准病例定义，以及一套最低限度的报告结果。
