Etiology of diarrhea by multiplex polymerase chain reaction among young children in the United Arab Emirates: a case-control study

Abstract

Background Little is known about the etiology of childhood diarrhea in the United Arab Emirates (UAE) especially after the introduction of rotavirus vaccines. This study aimed to identify gastrointestinal pathogens in children with diarrhea (cases) and the carriage rate of these pathogens in asymptomatic children (controls). Methods Stool samples were collected from 203 cases and 73 controls who presented to two major hospitals in Al Ain city, UAE. Samples were analyzed with Allplex™ Gastrointestinal Full Panel Assay for common entero-pathogens. The association between diarrhea and the isolated pathogens was calculated in a multivariate logistic regression model. The adjusted attributable fractions (aAFs) were calculated for all pathogens significantly associated with cases. Results At least one pathogen was identified in 87 samples (42.8%) from cases and 17 (23.3%) from controls (P < 0.001). Rotavirus, norovirus GII and adenovirus were significantly more prevalent in cases. Their aAFs with 95% ci are 0.95 (0.64, 1.00) for rotavirus, 0.86 (0.38, 0.97) for norovirus GII and 0.84 (0.29, 0.96) for adenovirus. None of the 13 bacteria tested for were more commonly found in the cases than in controls. Cryptosporidium spp. were more significantly detected in cases than in controls. Co-infections occurred in 27.9% of the children. Viruses and parasites were significantly more likely to occur together only in the cases. Conclusions Multiplex PCR revealed high positivity rates in both cases and controls which demand a cautious interpretation. Rotavirus remains the main childhood diarrhea pathogen in UAE. Effective strategies are needed to better control rotavirus and other causative pathogens.

Human Mastadenovirus Infections in Children: A Review of the Current Status in the Arab World in the Middle East and North Africa

“…We could not find relevant studies published in the following five countries: the Comoros Islands, Djibouti, Mauritania, Somalia, and Syria. Eleven studies were conducted in Middle East countries, namely: Iraq ( n = 2) [ 35 , 36 ], Jordan ( n = 2) [ 37 , 38 ], Kuwait ( n = 2) [ 39 , 40 ], Yemen ( n = 2) [ 41 , 42 ], Bahrain ( n = 1) [ 43 ], Lebanon ( n = 1) [ 44 ], and the United Arab Emirates ( n = 1) [ 45 ]. Whereas 10 studies were from North African countries, namely: Egypt ( n = 3) [ 46 , 47 , 48 ], Morocco ( n = 2) [ 49 , 50 ], Sudan ( n = 2) [ 51 , 52 ], Algeria ( n = 1) [ 53 ], Libya ( n = 1) [ 54 ], Tunisia ( n = 1) [ 55 ].…”

“…Additionally, in this review, a total of 14 studies were carried out among children less than five years of age. The prevalence of HAdV infections among children less than 5 years old was reported in the included studies as follows: Iraq, 14/320 (4.5%) [ 36 ]; Iraq, 3/100 (3%) [ 35 ]; Jordan, 54/350 (15.4%) [ 37 ]; Kuwait, 27/743 (3.6%) [ 40 ]; Yemen, 36/326 (11%) [ 41 ], United Arab Emirates, 35/203 (17.2%) [ 45 ], Egypt, 8/119 (6.7%) [ 48 ], Egypt, 20/100 (20%) [ 46 ], Egypt, 17/60 (28.3%) [ 47 ], Morocco, 119/700 (17%) [ 49 ], Sudan, 7/437 (1.6%) [ 52 ], Algeria, 9/117 (7.5%) [ 53 ], Libya, 17/239 (7.1%) [ 54 ], and Tunisia, 3/583 (19.6%) [ 55 ]. The remaining studies reported HAdV infections among older children.…”

Serological Humoral Immunity Following Natural Infection of Children with High Burden Gastrointestinal Viruses

“…The difference in virulence between recombinant viruses compared to non-recombinant viruses is under investigation but hampered by the lack of tools for evaluation [141,[145][146][147][148]. Co-infection with other AGE viruses, bacteria and parasites are also common and understudied [137,[149][150][151].…”

Acute Infectious Gastroenteritis: The Causative Agents, Omics-Based Detection of Antigens and Novel Biomarkers

“…HAstV infection mainly occurs during the dry season in the African continent; meanwhile, the highest occurrence reported in the tropical areas is often in the rainy season and winter season in temperate climate countries [ 47 , 49 ]. Patients usually manifested with diarrhoea, fever, vomiting, and abdominal pain [ 48 , 50 ].…”