Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.
University of Basel, Petersplatz 1, 4001, Basel, Switzerland.
Infection. 2017 Dec;45(6):811-824. doi: 10.1007/s15010-017-1049-5. Epub 2017 Aug 4.
Acute gastroenteritis (AG) leads to considerable burden of disease, health care costs and socio-economic impact worldwide. We assessed the frequency of medical consultations and work absenteeism due to AG at primary care level, and physicians' case management using the Swiss Sentinel Surveillance Network "Sentinella".
During the 1-year, longitudinal study in 2014, 172 physicians participating in "Sentinella" reported consultations due to AG including information on clinical presentation, stool diagnostics, treatment, and work absenteeism.
An incidence of 2146 first consultations due to AG at primary care level per 100,000 inhabitants in Switzerland was calculated for 2014 based on reported 3.9 thousand cases. Physicians classified patients' general condition at first consultation with a median score of 7 (1 = poor, 10 = good). The majority (92%) of patients received dietary recommendations and/or medical prescriptions; antibiotics were prescribed in 8.5%. Stool testing was initiated in 12.3% of cases; more frequently in patients reporting recent travel. Among employees (15-64 years), 86.3% were on sick leave. Median duration of sick leave was 4 days.
The burden of AG in primary care is high and comparable with that of influenza-like illness (ILI) in Switzerland. Work absenteeism is substantial, leading to considerable socio-economic impact. Mandatory infectious disease surveillance underestimates the burden of AG considering that stool testing is not conducted routinely. While a national strategy to reduce the burden of ILI exists, similar comprehensive prevention efforts should be considered for AG.
急性肠胃炎（AG）在全球范围内导致了相当大的疾病负担、医疗保健费用和社会经济影响。我们评估了初级保健水平上因 AG 导致的医疗咨询和工作缺勤的频率，以及使用瑞士监测网络“Sentinella”的医生的病例管理情况。
在 2014 年为期 1 年的纵向研究中，172 名参与“Sentinella”的医生报告了因 AG 导致的咨询情况，包括临床症状、粪便诊断、治疗和工作缺勤情况。
根据报告的 3900 例病例，2014 年瑞士每 10 万居民中有 2146 例首次因 AG 到初级保健机构就诊，发病率为 2146 例。医生在首次就诊时对患者的一般情况进行分类，中位数评分为 7 分（1 分为差，10 分为好）。大多数（92%）患者接受了饮食建议和/或医疗处方；抗生素的处方率为 8.5%。粪便检测在 12.3%的病例中启动；在近期有旅行史的患者中更常见。在员工（15-64 岁）中，86.3%请病假。病假的平均持续时间为 4 天。
初级保健中 AG 的负担很高，与瑞士的流感样疾病（ILI）相当。工作缺勤情况严重，造成了相当大的社会经济影响。强制性传染病监测低估了 AG 的负担，因为没有常规进行粪便检测。虽然存在减轻 ILI 负担的国家战略，但应考虑针对 AG 采取类似的综合预防措施。
