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  • Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992–2017): cross-sectional and retrospective cohort study protocol

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Gastroenterology and hepatology
Protocol
Incidence of household transmission of acute gastroenteritis (AGE) in a primary care sentinel network (1992–2017): cross-sectional and retrospective cohort study protocol
  1. Simon de Lusignan1,2,
  2. Emmanouela Konstantara1,
  3. Mark Joy1,
  4. Julian Sherlock1,
  5. Uy Hoang1,
  6. Rachel Coyle1,
  7. Filipa Ferreira1,
  8. Simon Jones1,3,
  9. Sarah J O’Brien4
  1. 1 Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
  2. 2 Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), London, UK
  3. 3 Center for Healthcare Innovation and Delivery Science, Department of Population Health, NYU School of Medicine, New York City, New York, USA
  4. 4 NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK
  1. Correspondence to Professor Simon de Lusignan; s.lusignan{at}surrey.ac.uk

Abstract

Introduction Acute gastroenteritis (AGE) is a highly transmissible condition. Determining characteristics of household transmission will facilitate development of prevention strategies and reduce the burden of this disease.

We are carrying out this study to describe household transmission of medically attended AGE, and explore whether there is an increased incidence in households with young children.

Methods and analysis This study used the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, comprising data from 1 750 167 registered patients (August 2017 database). We conducted a novel analysis using a ’household key', to identify patients within the same household (n=811 027, mean 2.16 people). A 25-year repeated cross-sectional study will explore the incidence of medically attended AGE overall and then a 5-year retrospective cohort study will describe household transmission of AGE. The cross-sectional study will include clinical data for a 25-year period—1 January 1992 until the 31 December 2017. We will describe the incidence of AGE by age-band and gender, and trends in incidence. The 5-year study will use Poisson and quasi-Poisson regression to identify characteristics of individuals and households to predict medically attended AGE transmitted in the household. This will include whether the household contained a child under 5 years and the age category of the first index case (whether adult or child under 5 years). If there is overdispersion and zero-inflation we will compare results with negative binomial to handle these issues.

Ethics and dissemination All RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. The protocol follows STrengthening the Reporting of OBservational studies in Epidemiology guidelines (STROBE). The study results will be published in a peer-review journal, the dataset will be available to other researchers.

  • disease transmission, infectious
  • medical records systems, computerized
  • general practice
  • infectious disease transmission, vertical
  • gastroenteritis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022524

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    Footnotes

    • Contributors SdeL conceived and designed the creation of a household key, the study, and led the writing of the manuscript. EK contributed to the manuscript. MJ contributed to the paper, and was lead medical statistician, including methodological and sample size advice. JS identified and processed all the baseline data and contributed to the manuscript. UH advised on study design and reviewed the manuscript. RC contributed to and reviewed the manuscript. FF contributed and reviewed the manuscript. SJ reviewed the statistical analysis design and the manuscript. SJOB reviewed the manuscript and study design and contributed to the final manuscript draft.

    • Funding This research is funded by Takeda Pharmaceuticals.

    • Disclaimer The funders are updated periodically with the research; the funders have not had a role in the development of this protocol, and no access to the study dataset.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Approval for this work has been granted by the RCGP RSC study approval committee. Although in accordance with their policy for studies that were not a result of competitive peer-reviewed award, they require an open access peer-review protocol to be published.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement RCGP RSC data are available to analyse. Application form online at www.rcgp.org.uk/rsc. The authors will share their R scripts and the code lists used for this analysis.