Acute, infectious diarrhea among children in developing countries

Podewils, Laura Jean; Mintz, Eric D.; Nataro, James P.; Parashar, Umesh D.

doi:10.1053/j.spid.2004.05.008

Cited by 115 publications

(87 citation statements)

References 103 publications

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“…The majority of children treated were 2 years old or younger (214/366, 58.5 %), which is consistent with the age considered most susceptible to diarrhoeal diseases worldwide (Podewils et al, 2004;Vu Nguyen et al, 2006). The group treated were considered to be similar with respect to their age (P50.787, Student's t-test).…”

Section: Population Descriptionmentioning

confidence: 54%

Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil

Quetz

Lima

Havt

et al. 2012

Journal of Medical Microbiology

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Campylobacter is an important cause of foodborne gastroenteritis. We determined the occurrence of Campylobacter jejuni and Campylobacter coli, using culture-based methods and PCRs targeting virulence-associated genes (VAGs) among children aged ¡14 years who were treated for diarrhoea at emergency rooms in northeastern Brazil. Genomic DNA was extracted directly from stool samples collected from 366 children. A questionnaire was also applied to qualify the clinical conditions presented by each child at the time of admission. C. jejuni and C. coli were detected in 16.4 % (60/366) and 1.4 % (5/366) of the diarrhoeal samples, respectively, by PCR, a much higher proportion than that detected by conventional methods. C. jejuni VAGs were detected in the following proportions of hipO-positive samples: ciaB, 95 % (57/60); dnaJ, 86.7 % (52/60); racR, 98.3 % (59/60); flaA, 80 % (48/60); pldA, 45 % (27/60); cdtABC, 95 % (57/60); and pVir 0 % (0/ 60). Particular symptoms, such as blood in faeces, vomiting, fever, and/or abdominal pain, were not associated with detection of C. jejuni nor were they associated with any particular VAG or combination of VAGs (P.0.05). C. jejuni and its VAGs were detected in a substantial proportion of the children admitted. Further efforts shall be directed towards elucidating whether these genetic factors or their expressed proteins play a role in Campylobacter pathogenesis. INTRODUCTIONThe genus Campylobacter, a group of thermotolerant, microaerophilic, Gram-negative bacteria, includes a number of pathogens that primarily cause gastrointestinal disease in humans, particularly Campylobacter jejuni and Campylobacter coli. Campylobacter-associated gastroenteritis is thought to occur through zoonotic transmission, being acquired from exposure to tainted food and/or contaminated drinking water (Sherman et al., 2010). Campylobacter infection frequently presents as self-limiting acute enteritis with diarrhoea, malaise, fever and abdominal pain, sometimes with vomiting and the presence of blood in faeces (Allos, 2001); disruption of epithelial cells and inflammation of the intestinal mucosa are hallmark features of severe cases (Beltinger et al., 2008). C. jejuni and C. coli cause significant morbidity worldwide, especially in children (Amieva, 2005;Tam et al., 2003;Wang et al., 2008; Fernández et al., 2008).Adherence and colonization are crucial steps in the pathogenesis of C. jejuni. Flagella have a major role in invasion; markedly reduced internalization in vitro has been reported with flaA 2 C. jejuni mutants (Wassenaar, 1997). The genes racR and dnaJ are determinants for C. jejuni colonization and are presumably expressed in response to conditions encountered in the intestinal microenviroment, such as differences in temperature between environmental reservoirs and human intestines (Konkel et al., 1998; Brás et al., 1999 antigen B protein, which confers invasive properties, as shown by C. jejuni ciaB null mutants which display a significant reduction in internalization (Konkel et al., 1999). Also, ...

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Section: Population Descriptionmentioning

confidence: 54%

Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil

Quetz

Lima

Havt

et al. 2012

Journal of Medical Microbiology

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“…This contrasts with the positive associations found in studies of temperature as an annual average (Singh et al 2001), and of short-term (monthly or weekly) temperature variability (Checkley et al 2000, Lama et al 2004. Pathogens respond differently to temperature, with bacteria and protozoa thriving in warm conditions and viruses generally peaking in the cooler seasons (Podewils et al 2004). Our study considered all-cause diarrhoea in a broad range of sites, possibly having quite different pathogen profiles, and this may explain the lack of an association between diarrhoea and temperature.…”

Section: Variablementioning

confidence: 82%

Global diarrhoea morbidity, weather and climate

Lloyd¹,

Kovats²,

Armstrong³

2007

Clim. Res.

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Diarrhoea rates are influenced by weather and climate; transmission can be affected by temperature and rainfall extremes, although few studies have quantified this effect. We undertook a global cross-sectional study of diarrhoea incidence in children under 5, drawing on studies published in the last 50 yr, and assessed the association with climate variables. Log-linear regression was used to quantify any association, controlling for the effects of age, socio-economic conditions and access to improved water and sanitation. We found a negative association between rainfall and diarrhoea rates, with a 4% increase in diarrhoea incidence (95% confidence interval, CI: 1-7%, p = 0.02) for each 10 mm mo -1 decrease in rainfall. Little evidence for association with temperature or climate type was found. Our result for rainfall is consistent with a similar study covering a smaller geographic region. Though biases cannot be excluded, the most likely mechanism is that low rainfall leads to water scarcity, which in turn leads to the use of unprotected water sources and reduces hygiene practices. In the future, greater numbers are expected to experience water scarcity, which may lead to more diarrhoea cases in some locations. This study lends support to programmes for hygiene and water and sanitation coverage, as well as lending support to actions to adapt to and mitigate climate change.

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“…The bacterial pathogens associated with diarrhea include species of Shigella, Campylobacter, Salmonella, Escherichia coli and Yersinia enterocolitica. Escherichia coli is one of the leading causes of acute diarrhea in developing countries in children under 5 years old, with significant morbidity and mortality 6 .…”

Section: Introductionmentioning

confidence: 99%

Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town

et al. 2015

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Background: Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area. Objectives: To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age. Methods: A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures. Results: The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero-groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented. Conclusion: High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.

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Acute, infectious diarrhea among children in developing countries

Cited by 115 publications

References 103 publications

Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil

Campylobacter jejuni infection and virulence-associated genes in children with moderate to severe diarrhoea admitted to emergency rooms in northeastern Brazil

Global diarrhoea morbidity, weather and climate

Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town

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