Acute gastro-enteritis in children in France: estimates of disease burden through national hospital discharge data

Despite available control and prevention measures, diarrhea remains a common cause of hospitalization among children, especially during the winter season. Objectives.-To estimate the burden of hospitalized infectious gastroenteritis of children younger than 5 years of age and associated costs. Methods.-We analyzed 1997 hospital discharges with a primary diagnosis of gastroenteritis or a secondary diagnosis of gastroenteritis with gastroenteritis symptoms or complications as primary diagnosis and compared the deaths with those of the national mortality data. Results.-Gastroenteritis was associated with 51125 hospitalizations which accounted for 11.4% of hospitalization discharges for this age group and an annual rate of 1385 per 100 000 children <5-year-old. Most gastroenteritis (56%) were registered as "probably infectious", 36% as "viral" (43% of which were coded "rotavirus") and 8% as "bacterial" (of which 60% were coded "Salmonella"). The seasonal peak was winter for rotaviral, viral and "probably infectious" gastroenteritis, summer for those related to salmonellosis. Incidence increased inversely with age: 3606/100000 infants <1-year-old, 257/100000 4-year-old children. Complications (especially dehydration) were observed in 21% of viral gastroenteritis and 17% of bacterial gastroenteritis. At least, 14 deaths were found in both hospital discharge and mortality data. The mean duration of stay (3.2 days) was significantly higher in infants <1-year-old, viral etiology, association with complications or bronchiolitis. The costs of hospitalization could be estimated to 62 million Euros. Discussion.-Our results are similar to those obtained in other developed countries. Despite variations in encoding the discharge reports, data has proven to be effective to describe national trends for this health event. Our study indicates that the public health burden and economic impact of prevention and control measures can be monitored through hospital discharge surveillance. (C) 2003 Editions scientifiques et medicales Elsevier SAS. All rights reserved.