Paediatric hospital admissions for rotavirus gastroenteritis and infectious gastroenteritis of all causes in England: an analysis of correlation with deprivation

Abstract

Objectives:

Infectious intestinal diseases cause substantial morbidity and economic loss in the UK. Rotavirus gastroenteritis (RVGE), a form of gastroenteritis, is the primary cause of severe diarrhoea in children. The primary objective of this study was to examine whether hospitalisation for gastroenteritis, and particularly RVGE, is linked to social deprivation.

Methods:

A retrospective study relating to hospital admissions in England with rotavirus, gastroenteritis, or type 1 diabetes mellitus (T1DM) was conducted in children aged under 5 years between 1st April 2009 and 31st March 2010 using the CHKS database. Admissions with selected diagnoses were extracted based on ICD-10 coding. Deprivation data were obtained from the Index of Multiple Deprivation (IMD) 2007 for England.

Results:

A total of 20,571 unique hospital admissions were made by children, in England, with RVGE (n = 1334; 6.5%) together with a diagnosis of infectious gastroenteritis of all causes (n = 19,237; 93.5%), giving an overall hospital admission rate, for those aged under 5 years, of 65.7 per 10,000 population. With ‘rank of average score’ and the ‘rank of average rank’ as measures of deprivation, the rate of hospital admissions with gastroenteritis of all causes decreased by 0.346 and 0.287 per 10,000 (p < 0.001) respectively for every unit increase in deprivation rank (decreasing deprivation), though this trend was not observed in patients admitted with RVGE specifically.

Conclusions:

Hospital admissions with gastroenteritis of all causes increased as deprivation increased. The implementation of a rotavirus vaccination programme would help to reduce the burden of RVGE and gastroenteritis of all causes, and in the context of gastroenteritis, some elements of health and social inequality may be vaccine preventable.

Limitations:

It is possible that the study is limited by the accuracy and completeness of deprivation indices, and coding within CHKS; the existence of the ‘ecological fallacy’ must also be considered.

Key words::

• Correlation
• Infectious gastroenteritis
• Paediatric admissions
• Rotavirus

Transparency

Declaration of funding

This study was funded by, and the writing of this manuscript was supported by, an unrestricted grant from Sanofi-Pasteur MSD.

Declaration of financial/other relationships

N.A., S.C. and F.R. are full-time employees of Sanofi-Pasteur MSD. R.D.P. is a full-time employee of Cardiff Research Consortium and acted as a consultant to Sanofi-Pasteur MSD.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

The authors would like to acknowledge the help, in the preparation and submission of this manuscript, given by Sunita Nair and Mahendra Rai.