Enteric pathogen among children under five years old with diarrheal diseases in Indonesia

Abstract

Diarrheal diseases are the second cause of the high morbidity and mortality in children under five years old. According to the Basic Health Survey 2018 conducted by the Ministry of Health, the prevalence of diarrheal diseases among children under five years old that were diagnosed by healthcare workers was 11.0%. The aim of this study was to describe the enteric pathogen isolated from children with diarrhea. The study was conducted in five cities in Indonesia: Jakarta, Serang, Denpasar, Makassar, and Mataram. The Inclusion criteria were children aged one month to five years old, with diarrhea that was diagnosed by a healthcare worker. The rectal swabs were sent to the Centre for Research and Development for Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health in Jakarta. Virus and Enterotoxigenic Escherichia coli (ETEC) identification by using multiplex PCR from Seegene, meanwhile bacteria identified by conventional method. As many as 2626 children under five years old participated in this study. The highest viral pathogen that causes diarrhea is viral 1.807 (68,81%) and 486 (18,56%). The virus etiology was Rotavirus 982 (54,34%) cases, followed by Adenovirus 916 (50.69) cases, Norovirus II 444 (24,57%) cases, meanwhile the bacteria pathogen were Enterotoxigenic Escherichia coli detected in 262 (9,98%) followed by Campylobacter jejuni and Shigella spp. This study described Rotavirus is the prevalence etiology of diarrhea among children under five years old followed by Adenovirus and Norovirus, some other cases reported the cause of diarrhea were bacteria ETEC E. coli followed Campylobacter jejuni, Shigella spp, etc.

A pilot study using hospital surveillance and a birth cohort to investigate enteric pathogens and malnutrition in children, Dili, Timor-Leste

“…Within Timor-Leste and neighbouring Southeast Asian countries, there is limited evidence of the prevalence of enteric pathogens both in clinical and environmental settings. A multisite study of children aged under five years conducted in Indonesia between 2009 and 2012 detected a high prevalence of rotavirus (37.4%), adenovirus (34.9%) and ETEC (10.0%) [ 55 ]. Another Indonesian case-control study of diarrhoeal disease conducted between 1997 and 1999 detected very low levels of enteric pathogens in paediatric patients using culture-based methods (i.e., less than 8.0% prevalence for total pathogens) [ 56 ], however, it is worth noting that culture-based methods can be lower in sensitivity than PCR-based methods.…”

A pilot investigation of enteric pathogens and stunting and malnutrition using a combination of hospital surveillance and a birth cohort of children in Dili, Timor-Leste

“…Within Timor-Leste and neighbouring Southeast Asian countries, there is limited evidence on the prevalence of enteric pathogens both in clinical and environmental settings. A multisite study of children aged under five years conducted in Indonesia between 2009 and 2012 detected a high prevalence of rotavirus (37.4%), adenovirus (34.9%) and ETEC (10.0%) (45). Another Indonesian case-control study of diarrhoeal disease conducted between 1997 and 1999 detected very low levels of enteric pathogens in paediatric patients using culture-based methods (i.e., less than 8.0% prevalence for total pathogens)(46), however, it is worth noting that culture-based methods can be lower in sensitivity than PCR-based methods.…”

Prevalence, Risk Factors and Patterns of Different Underlying Enteropathogens in Pediatric Patients

“…Our findings were also in agreement with the study found that diarrheal ailments were the second leading cause of high morbidity and mortality among children under five and 11.0% of children under the age of five were diagnosed with diarrhea in Indonesia. Among the bacterial causes, Enterotoxigenic E. coli was identified as the most prevalent bacteria (9.98%), followed by Campylobacter jejuni and Shigella 13 .…”