Diarrhea in Children under 5 Years of Age from Ifakara, Tanzania: a Case-Control Study

Gascón, Joaquím; Vargas, Martha; Schellenberg, David; Urassa, Honorathy; Casals, Climent; Kahigwa, Elizeus; Aponte, John J.; Mshinda, Hassan; Vilà, Jordi

doi:10.1128/jcm.38.12.4459-4462.2000

Cited by 107 publications

(58 citation statements)

References 17 publications

(17 reference statements)

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“…This emphasizes the need for an integrated approach to the management of anaemia, particularly in ensuring that children who receive blood transfusions also receive antimalarials and ferrous sulphate treatment. In our setting, however, routine use of antihelminthics is probably not appropriate as a very low proportion of the young children with anaemia were found to harbour helminths, in keeping with earlier work from this area (Gascon et al 2000).…”

Section: Discussionsupporting

confidence: 74%

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study

Kahigwa

Schellenberg

Sanz

et al. 2002

Tropical Med Int Health

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SummaryIn malaria endemic areas anaemia is a usually silent condition that nevertheless places a considerable burden on health services. Cases of severe anaemia often require hospitalization and blood transfusions. The objective of this study was to assess risk factors for admission with anaemia to facilitate the design of anaemia control programmes. We conducted a prospective case-control study of children aged 2-59 months admitted to a district hospital in southern Tanzania. There were 216 cases of severe anaemia [packed cell volume (PCV) < 25%] and 234 age-matched controls (PCV ‡ 25%). Most cases [55.6% (n ¼ 120)] were < 1 year of age. Anaemia was significantly associated with the educational level of parents, type of accommodation, health-seeking behaviour, the child's nutritional status and recent and current medical history. Of these, the single most important factor was Plasmodium falciparum parasitaemia [OR 4.3, 95% confidence interval (CI) 2.9-6.5, P < 0.001]. Multivariate analysis showed that increased recent health expenditure [OR 2.2 (95% CI 1.3-3.9), P ¼ 0.005], malnutrition [OR 2.4 (95%CI 1.3-4.3), P < 0.001], living > 10 km from the hospital [OR 3.0 (95% CI 1.9-4.9), P < 0.001], a history of previous blood transfusion [OR 3.8 (95% CI 1.7-9.1), P < 0.001] and P. falciparum parasitaemia 3), P < 0.001] were independently related to risk of being admitted with anaemia. These findings are considered in terms of the pathophysiological pathway leading to anaemia. The concentration of anaemia in infants and problems of access to health services and adequate case management underline the need for targeted preventive strategies for anaemia control.

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Section: Discussionsupporting

confidence: 74%

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study

Kahigwa

Schellenberg

Sanz

et al. 2002

Tropical Med Int Health

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“…These two pathologies, which decrease the immunological resistance, are closely related and contribute significantly to infant mortality [10]. These factors combine to facilitate the spread of enteropathogens and epidemics are common in such environment [11].…”

Section: Discussionmentioning

confidence: 99%

Polymicrobial infections in children with diarrhoea in a rural area of Jordan

Nimri

Elnasser

Batchoun

2004

FEMS Immunology &Amp; Medical Microbiology

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Polymicrobial infections associated with diarrhoea are common in developing countries. Stool specimens were collected from 220 patient children and 100 controls. Potential pathogenic agents isolated from 143 (65%) children were identified by molecular and standard microbiological methods. Co-infections with two or more agents were detected in 50 (35%) cases. Escherichia coli, Shigella dysenteriae, Giardia and Entamoeba histolytica were found to be predominant. The etiologic agents could not be determined in 77 (35%) cases. The most significant risk factors were the age, the education level of the mother and the use of non-chlorinated water. The high infection rate of diarrhoeal diseases is a strong indication that these pathogens circulate easily through the population.

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“…There are few studies of EAEC prevalence in children with acute diarrhea illness from Africa and less-developed European countries. From Africa, there are reports from Ghana (Opintan et al, 2010a), Mozambique (Rappelli et al, 2005), Nigeria (Ogunsanya et al, 1994;Okeke et al, 2000Okeke et al, , 2011, and Tanzania (Gascon et al, 2000;Moyo et al, 2007Moyo et al, , 2011. In relation with less-developed European countries, although one of the first-documented EAEC outbreaks (because of a unique EAEC strain) occurred in a neonatal nursery Serbian ward (Cobeljic et al, 1996), there are only two other studies of EAEC association with diarrhea illness in young children from this region (Sobieszczanska & Osek, 2003;Usein et al, 2009).…”

Section: Acute Diarrhea In Infants and Young Childrenmentioning

confidence: 99%

EnteroaggregativeEscherichia colipathotype: a genetically heterogeneous emerging foodborne enteropathogen

Estrada-García

Navarro-Garcı́a

2012

FEMS Immunol Med Microbiol

114

132

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Until now, a common feature that defines the enteroaggregative Escherichia coli (EAEC) strains is the ability to produce a ‘stacked‐brick’ appearance on epithelial cells, but it does not distinguish between pathogenic and nonpathogenic strains. Numerous adhesins, toxins, and proteins associated with virulence have been described, as well as multiple factors contributing to EAEC‐induced inflammation. None of these factors are found in all EAEC isolates, and no single factor has ever been implicated in EAEC virulence. The European outbreak of Shiga‐toxin‐producing EAEC raises its pathogenic potential and interest on finding the true pathogenic factors that may define this pathotype. EAEC were first associated with persistent diarrhea in infants from developing countries, since then they have increasingly been linked as a cause of acute and persistent diarrhea in young infants and children in developing and industrialized countries, individuals infected with human immunodeficiency virus, as a cause of acute diarrhea in travelers from industrialized regions, and with foodborne outbreaks. A major effect of EAEC infection is on the malnourished children in developing countries. Here, we will discuss the EAEC public health relevance and their complexity because of the strain heterogeneity regarding their pathogenesis, identification, diagnosis, lineage, epidemiology, and clinical manifestations.

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Diarrhea in Children under 5 Years of Age from Ifakara, Tanzania: a Case-Control Study

Cited by 107 publications

References 17 publications

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study

Risk factors for presentation to hospital with severe anaemia in Tanzanian children: a case–control study

Polymicrobial infections in children with diarrhoea in a rural area of Jordan

EnteroaggregativeEscherichia colipathotype: a genetically heterogeneous emerging foodborne enteropathogen

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