Increase in the detection rate of viral and parasitic enteric pathogens among Egyptian children with acute diarrhea

El-Mohammady, Hanan; Mansour, Adel; Shaheen, Hind I.; Henien, Nagwa H.; Motawea, Mohamed S.; Raafat, Ismail; Moustafa, Manal; Adib-Messih, Ibrahim A.; Sebeny, Peter J.; Young, Scott W.; Klena, John D.

doi:10.3855/jidc.2349

Cited by 25 publications

(12 citation statements)

References 28 publications

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“…Giardia lamblia , Entamoeba histolytica , and Cryptosporidium parvum are the major parasitic organisms causing childhood diarrhea in developing countries [28]. These have been estimated to be associated with 15–20 and 2–5% of diarrhea cases in developing and developed countries respectively [30].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana

et al. 2017

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BackgroundDiarrhea is an important cause of morbidity and mortality worldwide. In Africa and Ghana in particular, it is estimated to contribute directly to 19 and 25% of pediatric mortality among children under 5 years, respectively.MethodsSurveillance for hospitalized acute diarrheal illness was initiated in November 2010 through October 2012 in a referral hospital in southern Ghana, and a teaching hospital in northern Ghana. Consenting hospitalized patients who met a standardized case definition for acute diarrheal illness provided demographic and epidemiologic data. Stool samples were collected and tested by culture for bacteria and by enzyme immunoassays for a panel of viruses and parasites.ResultsA total of 429 patients were enrolled; 216 (50.3%) were under 5 years, and 221 (51.5%) were females. Stool samples were received from 153 patients. Culture isolates included Shigella sp., Salmonella spp., Plesiomonas sp. and Vibrio cholerae. Of 147 samples tested for viruses, 41 (27.9%) were positive for rotaviruses, 11 (7.5%) for astroviruses, 10 (6.8%) for noroviruses, and 8 (5.4%) for adenoviruses. Of 116 samples tested for parasitic infections; 4 (3.4%) were positive for Cryptosporidium sp. and 3 (2.6%) for Giardia lamblia. Of the enrolled patients, 78.8% had taken antibiotics prior to sample collection.ConclusionsDiarrheal pathogens were identified across all ages, however, predominantly (81%) in the children under 5 years of age. This study also detected high antibiotic use which has the potential of increasing antibiotic resistance. The most common enteric pathogen detected (49.4%) was rotavirus.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2621-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana

et al. 2017

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“…Regionally, in the Middle East and North Africa (MENA), several studies have recently assessed the prevalence of NoV among hospitalized children aged < 5 years (hospitalized due to signs of acute gastroenteritis). These studies were performed on a variable sample size in Egypt[30], Israel[31,32], Iran[33], Jordan[34], Kuwait[35], Libya[36,37], Morocco[38], Tunisia[39,40], Turkey[41-45] and Yemen[46]. NoV was detected in stool samples of 6%-30% of hospitalized children aged < 5 years, with GII.4 and GII.3 predominantly reported in these studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

Melhem

Zaraket

Kreidieh

et al. 2016

WJG

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AIMTo assess the burden of norovirus (NoV) and to determine the diversity of circulating strains among hospitalized children in Lebanon.METHODSStool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software.RESULTSOverall, 11.2% of stool samples collected from children aged < 5 years tested positive for NoV genogroups I (GI) and II (GII). GII accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GI (0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GI gastroenteritis cases were designated GI.3 and one case as GI.4. GII.4 was predominantly detected in stool of our study participants (68%). We report a JB-15/KOR/2008 GII.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GII.4 Sydney 2012 and Sydney 2012/FRA GII.4 strains. We also report the co-circulation of non-GII.4 genotypes among hospitalized children. Our data show that NoV gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months.CONCLUSIONThe majority of NoV-associated viral gastroenteritis cases among our participants are attributable to GII.4, which is compatible with results reported worldwide.

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“…Diarrheal diseases are among the leading infectious causes of morbidity and mortality in developing countries, especially in malnourished children, in patients with chronic diseases and in immunocompromized patients, e.g., suffering from HIV-infection or cancer (Abdel-Hafeez et al 2012;Antonios et al 2010;Baiomy et al 2010;Curtale et al 1998;El-Helaly et al 2012;El-Mohammady et al 2012;El-Naggar et al 2006;Hassanein et al 2012). Parasites must be distinguished as causative agents of diarrhea from viruses or bacteria because of possible chronic and extraintestinal manifestations in protozoal infections and different treatment requirements.…”

Section: Introductionmentioning

confidence: 98%

“…Both methods have been shown to be more sensitive than light microscopy for the detection of intestinal protozoa (den Hartoq et al 2013;Selim et al 2009;Stark et al 2010). An Egyptian study performed in Cairo and the Nile Delta between 2005 and 2007 applied ELISA technique for the detection of bacterial, viral and parasitic pathogens in 2112 diarrhoeic children below 5 years of age (El-Mohammady et al 2012). G. duodenalis and Cryptosporidium spp.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous detection of Entamoeba histolytica/dispar, Giardia duodenalis and cryptosporidia by immunochromatographic assay in stool samples from patients living in the Greater Cairo Region, Egypt

Banisch

El-Badry

Klinnert³

et al. 2015

World J Microbiol Biotechnol

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Gastrointestinal infection due to intestinal parasites is an enormous health problem in developing countries and its reliable diagnosis is demanding. Therefore, this study aimed at evaluating a commercially available immunochromatographic assay (ICA) for the detection of cryptosporidia, Giardia duodenalis, and Entamoeba histolytica/dispar for its usefulness in the Greater Cairo Region, Egypt. Stool samples of 104 patients who presented between October 2012 and March 2013 with gastrointestinal symptoms or for the exclusion of parasites at Kasr-Al-Ainy University Medical School were examined by light microscopy of wet mounts and the triple ICA. Microscopy revealed in 20% of the patients [95% confidence interval (CI), 13.5-29.0%] parasites with Hymenolepis nana, E. histolytica/dispar and Blastocystis hominis being the most frequent ones, but was not able to detect G. duodenalis and cryptosporidia, whereas ICA was positive in 21% (95% CI, 14.3-30.0%) and detected E. histolytica/dispar in 12.5% (95% CI, 7.3-20.4%), cryptosporidia in 6.7% (95% CI, 3.1-13.5%) and G. duodenalis in 15.4% (95% CI, 9.6-23.6%) of the patients. Detection of one or more pathogens was associated with access to water retrieved from a well or pump (p = 0.01). Patients between 20 and 29 years of age (p = 0.08) and patients with symptoms of 5 days or longer (p = 0.07) tended to have a higher risk to be infected than patients of other age groups or with shorter-lasting symptoms. In conclusion, the ICA was easy to perform and timesaving. Importantly, it enabled the detection of cryptosporidia, which cannot be found microscopically in unstained smears, demonstrated a higher sensitivity for the detection of G. duodenalis than microscopy, and was more specific for distinguishing E. histolytica/dispar from apathogenic amoeba.

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Increase in the detection rate of viral and parasitic enteric pathogens among Egyptian children with acute diarrhea

Cited by 25 publications

References 28 publications

Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana

Prevalence of enteric infections among hospitalized patients in two referral hospitals in Ghana

Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

Simultaneous detection of Entamoeba histolytica/dispar, Giardia duodenalis and cryptosporidia by immunochromatographic assay in stool samples from patients living in the Greater Cairo Region, Egypt

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