An Evaluation of Enteropathogen- Specific Disease Severity and Duration in Children with Acute Gastroenteritis
Abstract
Objectives Our primary objectives were to describe pathogen- specific symptom severity and duration in a prospective cohort study of children with acute gastroenteritis (AGE). Our secondary objective was to quantify health care resource utilization. Methods This secondary analysis of 2 trials included children 3-48 months with AGE. Children were eligible if they had ≥ 3 watery stools in the preceding 24 hours and were brought to the Emergency Department. Disease severity was quantified by frequency and duration of vomiting and diarrhea and the Modified Vesikari Scale score. We used descriptive statistics to summarize severity and regression models to identify associations between pathogen type and outcomes. Results 1565 trial participants had pathogen testing performed and completed follow-up. Viral pathogens were identified in 47.9% (749/1565) and bacterial in 5.9% (92/1565). Norovirus (322/1565; 20.6%) was the most frequently identified pathogen. Diarrhea duration was greatest (median 160 hours, IQR 98, 216) for children with Salmonella. Vomiting (aOR 11.02; 95% CI 7.47, 16.26) occurred more commonly in children with viruses compared to bacteria. The mean duration of diarrhea was shorter for viruses compared to bacteria (aIRR 0.81, 95% CI 0.68, 0.96). Mean MVS scores were higher in children with viruses compared to those with bacteria (coefficient 1.64, 95% CI 0.46, 2.82). Conclusions We describe the clinical course of viral and bacterial pathogens. Although statistically…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,565 participants or records.
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