Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2023 Oct 31;18(10):e0293739. doi: 10.1371/journal.pone.0293739. eCollection 2023.
In the United States, public health surveillance systems often underestimate the burden of acute gastroenteritis (AGE) because they only identify disease among those who interact with the healthcare system.
To identify factors associated with healthcare-seeking behavior among individuals experiencing community-acquired AGE.
From October 2016 -September 2017, we conducted a weekly, age-stratified, random sample of Kaiser Permanente Northwest members located in northwest Oregon and southwest Washington, United States. Individuals who completed the online survey and experienced AGE were included in the analysis. Univariate and multivariable logistic regressions were performed to identify predictors of healthcare-seeking behavior.
Of the 3,894 survey respondents, 395 experienced an AGE episode and were eligible for analysis, of whom, 82 (21%) sought care for their AGE episode. In the final multivariable model, individuals with a concurrent fever (odds ratio [OR]: 4.76, 95% confidence interval [95% CI]: 2.48-9.13), increased diarrhea duration (≥6 days vs 1-4 days, OR: 4.22, 95% CI: 1.78-10.03), or increased vomiting duration (≥3 days vs 1 days, OR: 2.97, 95% CI: 1.22-7.26), were significantly more likely to seek healthcare. In the adjusted model, no sociodemographic or chronic disease variables were associated with healthcare-seeking behavior.
These findings suggest that individuals with a short duration of AGE and those without concurrent fever are underrepresented in healthcare facility-based surveillance systems.
在美国，公共卫生监测系统往往低估了急性胃肠炎（AGE）的负担，因为它们只识别与医疗保健系统互动的人群中的疾病。
确定与社区获得性 AGE 患者寻求医疗保健行为相关的因素。
从 2016 年 10 月至 2017 年 9 月，我们对美国俄勒冈州西北部和华盛顿州西南部的 Kaiser Permanente Northwest 会员进行了每周一次、按年龄分层的随机抽样。完成在线调查并经历 AGE 的个人被纳入分析。进行单变量和多变量逻辑回归以确定寻求医疗保健行为的预测因素。
在 3894 名调查受访者中，有 395 名经历了 AGE 发作，符合分析条件，其中 82 名（21%）因 AGE 发作寻求医疗。在最终的多变量模型中，同时有发热的个体（优势比 [OR]：4.76，95%置信区间 [95%CI]：2.48-9.13）、腹泻持续时间延长（≥6 天与 1-4 天，OR：4.22，95% CI：1.78-10.03）或呕吐持续时间延长（≥3 天与 1 天，OR：2.97，95% CI：1.22-7.26），更有可能寻求医疗保健。在调整后的模型中，没有社会人口统计学或慢性疾病变量与寻求医疗保健行为相关。
这些发现表明，在医疗设施为基础的监测系统中，AGE 持续时间较短且无同时发热的个体代表性不足。
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