Surveillance Study of Acute Gastroenteritis Etiologies in Hospitalized Children in South Lebanon (SAGE study)

Abstract

PurposeAcute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon.MethodsWe prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon.ResultsMales had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032).ConclusionOur findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.

Aetiologies of Acute Gastroenteritis in Hospitalized Children

“…Rotavirus mainly spread through contact with infected persons, contaminated environmental surfaces or via ingestion of contaminated food and water. 23.08% of the children in our study showed mixed infection mostly were parasitic and bacterial while unidentified group was 55.62% which was quite higher than the study by Ghssein G et al [16] . Who reported it as 42.4%.…”

“…In other study by Gebreegziabher G et al the overall prevalence of Salmonella species was 7.3% and 6.9% Shigella species were isolated from children with diarrhoea [15] . Rotaviral infections found in our study was 23.08% it was 19 % in a study by Ghssein G et al [16] . Many studies have reported rotavirus is a leading cause of paediatric AGE, accounting for 27-51% of all diarrheal cases in children less than 5 years of age [17] .…”

“…Diarrhoea, vomiting and fever was observed in 91.12%, 21.89% and 79.88 % respectively. Findings observed by Ghssein G et al [16] . Fever in 76.8%, vomiting in 71.2% and diarrhoea in 93.4%.We reported that in amoebiasis and unidentified pathogens group, there was an elevated CRP in comparison to viral groups which means that in the unidentified pathogens group is highly suggestive of an invasive infection.…”

Prevalence, risk factors and seasonal variations of different Enteropathogens in Lebanese hospitalized children with acute gastroenteritis

“…A recent study performed by our team in South Lebanon evaluated common causes of AGE among hospitalized children during the period of summer 2014. Results from this study indicated that 40.4% of all hospitalized cases in children were due to AGE, with rotavirus and E. histolytica being the major identified disease-causing pathogens [20]. To widen our knowledge regarding the incidence, age distribution, etiologies, AGE incidence throughout the different months of the year for each pathogen involved, protective factors, and correlation between AGE causes and severity of the disease among hospitalized children in Southern Lebanon, we performed this current study with a larger sample size, to cover most of the South district.…”

Human Enteric Circulating Viruses and Co-infections Among Hospitalized Children with Severe Acute Gastroenteritis in Chihuahua, Mexico, During 2010 - 2011

“…The use of new technologies has strengthened diagnostic systems, leading to identifying other viral agents present in feces that were not previously identified (4)(5)(6).…”