Academic journal article Canadian Journal of Public Health

A Descriptive Analysis of Hospitalization Due to Acute Gastrointestinal Illness in Canada, 1995-2004

Academic journal article Canadian Journal of Public Health

A Descriptive Analysis of Hospitalization Due to Acute Gastrointestinal Illness in Canada, 1995-2004

Article excerpt

ABSTRACT

Background: Gastrointestinal illness (GI) remains a leading cause of morbidity and mortality worldwide. In Canada, research has already demonstrated a rate in excess of one episode per person-year. National passive surveillance programs may be enhanced by information from hospitalizations for acute gastrointestinal disease. The objective of this report is to explore the incidence of acute GI in hospital administrative data collected by the Canadian Institute for Health Information (CIHI) - specifically the hospital morbidity database (HMDB).

Methods: Data from acute care facilities and select chronic care and rehabilitation facilities across Canada were analyzed using standardized rates, and age- and sex-adjusted rates for the years 1995-2004.

Results: The results indicate that GI causes at least 92,765 hospital admissions per year in Canada. In the majority (78.3%) of gastrointestinal hospitalizations, no specific etiology was recorded. Of the remaining diagnoses, 11.6% were due to viruses, 9.7% to bacteria and 0.3% to parasites. Age-standardized rates of hospitalizations for acute GI appear to have declined over the 10-year period.

Conclusion: Gastrointestinal illness is still present in the Canadian population and presents a significant burden to the health care system. Whereas the HMDB likely underestimates the true rate of GI, it does capture cases that are serious enough to require hospitalization. This is a unique source of data and highlights other pathogen-specific disease data not currently collected through national surveillance tools (e.g., viruses).

Key words: Gastrointestinal illness; diarrhea; hospitalization; Canada

Mots clés : maladies gastrointestinales; diarrhée; hospitalisation; Canada

The World Health Organization (WHO) estimated that in 2005 approximately 2 million deaths worldwide were due to gastrointestinal illness (GI) acquired specifically from food and water. GI can also be transmitted through person-to-person contact, recreational water and food contaminated with water. Globally GI remains one of the leading causes of morbidity and mortality, particularly in children, despite ongoing progress in our basic understanding of its epidemiology, pathogenesis, and treatment. 1 In industrialized countries such as the United States, 30% of the population still suffers from foodborne diseases, with approximately 76 million illnesses, 325,000 hospitalizations and 5,000 deaths reported annually.2,3

In Canada, there are an estimated 1.3 episodes per person-year of enteric disease.4 The incidence of specific GI infections is calculated from data reported to the National Notifiable Disease Reporting Systems (NDRS) database at the Public Health Agency of Canada. Data in the NDRS database include those collected on a mandatory basis by the local public health units/authorities. Data are submitted in case-level or aggregate form and include "confirmed" (laboratory identification of pathogen) and "closed" (investigation completed) reports. In addition, laboratory surveillance data are collected on a weekly basis from 11 provincial laboratories representing all provinces and territories through the National Enteric Surveillance Program (NESP). The NESP receives weekly aggregate totals of new identifications based on a group of selected enteric organisms provided by the Public Health Laboratories. For each of these national surveillance systems, reports are prepared and disseminated regularly. To date, there have been no estimates of hospitalizations due to GI for the general population in Canada. In previously published reports, investigations of hospitalizations for GI have generally focused on specific risk groups such as children, adults, or the elderly.5-7

The objective of this report is to explore the incidence of acute GI in hospital administrative data collected by the Canadian Institute for Health Information (CIHI) - specifically the hospital morbidity database (HMDB) - and how the data can enhance the passive surveillance program in Canada. …

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