Quantifying the incidence and cost of acute gastrointestinal illness in Sweden, 2013–2014

Abstract

In Sweden, acute gastrointestinal illness (AGI) incidence, severity, impact on productivity, related healthcare usage and associated costs are not ascertained. We measured these in 2013-2014 using a population-based cohort reporting weekly. We defined AGI as ⩾3 episodes of loose stools or vomiting/24 h; or loose stools or vomiting with ⩾2 other gastrointestinal symptoms. After each AGI episode, we collected information about perceived severity, healthcare use and absenteeism. We calculated incidence rates, AGI absenteeism and costs comprising direct healthcare costs and productivity loss due to work/school absenteeism. A total of 3241 participants reported 1696 AGI episodes [incidence 360/1000 person-years, 95% confidence interval (CI) 326-395; highest in the <5 years age group]. In the <5 years age group, 31% of episodes were perceived as mild, 61% as moderate and 8% as severe; 9·4% led to primary-care consultations, and 1·4% to hospital admissions. In the ⩾5 years age group, 18% of episodes were perceived as mild, 64% as moderate and 18% as severe; 6·4% led to primary-care consultations, and 1·9% to hospital admissions. AGI caused 8 891 000 days of absenteeism (95% CI 6 009 000-12 780 000). AGI cost €1 005 885 000 (95% CI 754 309 000-1 257 195 000) nationally for the year. In Sweden, a minority of cases perceive AGI as a mild illness. AGI is a burden on the healthcare system and causes productivity loss, with high costs. Countries may consider these estimates when prioritizing health interventions.

High added value of a population-based participatory surveillance system for community acute gastrointestinal, respiratory and influenza-like illnesses in Sweden, 2013–2014 using the web

“…Age-specific incidence for AGI has been reported previously [8]. We directly standardized the incidence for the geographical location (North, Centre and South of Sweden) and for the age of the Swedish population, as it was reported on 31 December 2013 for the following age groups: <2, 2–4, 5–14, 15–39, 40–64, and ⩾65 years [9].…”

Determinants and risk factors of gastroenteritis in the general population, a web-based cohort between 2014 and 2017 in France

“…Depending on the de nition used and the season, between 6 and 14% of participants presented at least one AGE episode during winter. In Sweden, a study collecting health status data on a weekly basis estimated that 35% of the participants reported having at least one AGE episode in 2013 (13). The study however adopted a more inclusive AGE de nition than ours, it considered a population where young children were overrepresented, and it focused on a whole year, all factors that may explain the higher reported incidence.…”

“…Through the years, few studies have tried to assess AGE incidence and risk factors at a population level (4,10,(12)(13)(14)(15)(16). Most of them used a retrospective data collection by conducting a telephone survey of selfreported AGE in the month preceding the phone call (4,12,14,16).…”

Cost of Illness for Five Major Foodborne Illnesses and Sequelae in Sweden

“…The estimated total costs amount to over €142 million each year, with campylobacter representing almost 70% of the total costs. As a comparison, it has been estimated that the total cost of all gastrointestinal illnesses in Sweden amount to approximately €1 billion, based on a cohort study with 3241 participants [ 58 ]. Annual COI estimates have also been reported for other illnesses in Sweden, such as rheumatoid arthritis (€600 million) [ 59 ], breast cancer (€330 million) [ 60 ] and atrial fibrillation (€708 million) [ 61 ].…”