High cost of Stomach Flu in Belize

By Benjamin Flowers
Staff Reporter

The economic burden caused by Acute Gastroenteritis (AGI), also known as stomach flu, is estimated at over $18 million, according to data released by the Ministry of Health.

The ministry released some of the findings from the Burden of Illness (BOI) research study on AGI and causes of food borne illness in Belize last week. The study was done in collaboration with Pan American Health Organization (PAHO), and the Caribbean Public Health Agency (CARPHA).

The impact on the public health system alone is estimated at $6.2 million annually, when considering basic medical services, supplies, hospitalization, and the need for care-giver services.

Loss of income due to unproductive days is estimated at $10.9 million, and patients are estimated to lose some $4 million annually due to being out of work.
Englebert Emmanuel, Burden of Illness coordinator and director of license accreditation for the MOH, explained that during the study the coordinators analyzed data over a five-year span to identify the patterns and determine the high and low seasons for AGI.

Emmanuel emphasized that the data suggests that lifestyle practices are responsible for the prevalence of AGI.

“A single food or group of food items cannot be isolated to determine the high and low AGI seasons because parasites and viruses were determined as the leading agents,” Emmanuel said.

“As you know viruses relate more to hygiene practices and parasites tend to lean more towards interaction with the environment. Therefore indications are that lifestyle practices need to change.”
The study was launched in September 2012, with the aim of estimating the proportion of the population suffering from AGI.

It was also geared towards investigating the common biological agents transmitted through food and water which cause foodborne illnesses in Belize.

Random sample questionaries were distributed to households throughout the six districts. A total of 2,901 questionnaires were completed from the 3,110 households sampled, with a response rate of 93.6 percent
Eighty-nine percent of the respondents were from low to low-middle monthly income groups ($0-$2,500), 10 percent from the medium-high income group, ($2,501-$6,000), and 1 percent from the high-medium to high income group (over $6,000).

Prevalence of AGI was equal among males and females.
The highest monthly prevalence was in the 5-14 age groups.

The results showed that April – May is the AGI high season while the low season occurs from September – October, which had a prevalence rate of 7.1 percent.
Parasites were found to be the predominant biological agent responsible for AGI; however, rotavirus infections were found to cause a greater burden on the health of patients and the health system.

The highest monthly prevalence of cases of AGI came from the Cayo District followed by the Belize District.
The results of this the survey led the ministry to believe that as much as 76.2 percent of AGI cases are not reported.

The ministry further estimates that the actual number of cases during the study period is 48,447 as opposed to the reported 11,535.Recommendations included targeted food safety and hygiene training and education, as well as improving/enforcing routine collection of stool samples from patients with diarrhea/AGI.

The coordinator underscored that the data will be used for targeted interventions in food safety and improvements in underreporting at the laboratory level.

Foodborne infections are linked to a significant number of illnesses and deaths worldwide. Studies have shown that 70% of diarrheal diseases are foodborne. Research also shows that cases are not reported to the health system.

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