JMIR Publications

ABSTRACT

Background:

Infectious intestinal disease (IID) is common and children are more likely than adults both to suffer from IID and to transmit infection onto others. Before the introduction of the vaccine, rotavirus was the leading cause of severe childhood diarrhoea, with norovirus and Campylobacter predominate pathogens. Public health surveillance of IID is primarily based on healthcare data and as such illness which is managed within the community will often go undetected. School attendance registers offer a novel dataset that has the potential to identify community cases and outbreaks of IID which would otherwise be missed by current health surveillance systems. Whilst studies have explored the role of school attendance registers in the monitoring of influenza amongst children, no studies have been identified which consider this approach in the surveillance of IID.

Objective:

The aim of this study is to explore the role and utility of school attendance registers in the detection and surveillance of IID in children. The secondary aims are to estimate the burden of IID on school absenteeism and to assess the impact of the rotavirus vaccine on illness absence amongst school-aged children.

Methods:

This study is a retrospective analysis of school attendance registers to investigate whether school absences due to illness can be used to capture seasonal trends and outbreaks of infectious intestinal disease amongst school-aged children. School absences in Merseyside, UK will be compared and combined with routine health surveillance data from primary care, laboratories and telehealth services. These data will be used to model spatial and temporal variations in the incidence of IID and to apportion likely cause to changes in school absenteeism trends. This will be used to assess the potential utility of school attendance data in the surveillance of IID and to estimate the burden of IID absenteeism in schools. It will also inform an analysis of the impact of the rotavirus vaccine on disease within this age-group.

Results:

This study has received ethical approval from the University of Liverpool Research Ethics Committee (Reference number 1819). Use of General Practice data has been approved for the evaluation of rotavirus vaccination in Merseyside by NHS Research Ethics Committee, South Central-Berkshire REC Reference: 14/SC/1140.

Conclusions:

This study is unique in considering whether school attendance registers could be used to enhance the surveillance of IID. Such data have multiple potential applications and could improve the identification of outbreaks within schools, allowing early intervention to reduce transmission both within and outside of school settings. These data have the potential to act as an early warning system, identifying infections circulating within the community before they enter healthcare settings. School attendance data could also inform the evaluation of vaccination programmes such as rotavirus and, in time, norovirus.