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1
Hodges, M. "Diarrhoeal disease in early childhood: experiences from Sierra Leone." Parasitology 107, S1 (January 1993): S37—S51. http://dx.doi.org/10.1017/s0031182000075491.
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SUMMARYIn the Freetown area of Sierra Leone, the proportion of children under five years of age dying from diarrhoea-associated conditions has decreased since the 1970s from 4% to 3%. This reduction relates to children between 12 months and 5 years; deaths associated with diarrhoeal disease in infancy do not appear to have decreased significantly. Currently, 2% of children die in infancy and a further 1% before their fifth birthday from diarrhoeal diseases. Thirty-one percent of short-term growth-faltering in children under five years of age is attributed to diarrhoeal disease. Reasons for improvement in mortality may include the implementation of a National Diarrhoeal Diseases Control Programme and improved case management; some 55% of cases of acute diarrhoea in Freetown now receive oral rehydration therapy. Morbidity and mortality are influenced by the seasons. This is likely to be related to the fact that the nutritional status of children shows a significant deterioration in the early rainy season. At this time incidence of severe diarrhoea warranting hospital admission and diarrhoea mortality rates in hospital and at a Rehydration Center increased significantly. On the other hand, the presentation of dehydrating diarrhoea is greatest in the driest months of the year. Progress in the rural areas of Sierra Leone may not have been so evident although 60% of the population now have access to primary health units within 4 miles and efforts to increase host resistance have included the measles immunization programme which currently protects 60% of under-fives nation-wide. Efforts to reduce the transmission of pathogens have meant increasing access to safe water to 22% and to improved sanitation to 35% in rural areas of Sierra Leone. The sustainable prevention and control of diarrhoeal diseases in developing countries depends also upon increasing levels of adult literacy especially of women.
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Gupta, Ambrish, Prashant Maheshwari, and Y. K. Rao. "Role of single and mixed probiotics in acute diarrheal diseases in pediatric population." International Journal of Basic & Clinical Pharmacology 6, no. 11 (October 25, 2017): 2596. http://dx.doi.org/10.18203/2319-2003.ijbcp20174772.
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Background: The objective of present study was to analyse the effect of probiotics on various parameters of acute diarrhoeal disease and to compare single and mixed probiotic preparations in context to their role in acute diarrhoeal disease in paediatric population.Methods: A double blind controlled trial was conducted in children suffering from acute diarrhoeal disease at department of paediatrics jointly with department of pharmacology, G. S. V. M. Medical college, Kanpur, U.P., India. All enrolled children were divided into three groups having similar baseline characteristics. One group was given single probiotic preparation another mixed probiotic preparation and the third one (i.e. control group) placebo plus Zinc/ORS to all three groups. Various parameters such as frequency and consistency of stool, duration of diarrhoea were measured after doing intervention over a period of one week.Results: In our study duration of diarrhoea, stool frequency and total duration of hospital stay was found significantly less in probiotic groups compared to control group. However no significant difference was found between single and mixed probiotics in curtailing the acute diarrhoeal illness.Conclusions: Probiotics should be used judiciously in acute diarrhoeal diseases. There is no additional benefit of mixed probiotics in acute diarrhoeal diseases rather than increasing the cost of treatment.
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McCORMICK, B. J. J., W. J. ALONSO, and M. A. MILLER. "An exploration of spatial patterns of seasonal diarrhoeal morbidity in Thailand." Epidemiology and Infection 140, no. 7 (September 19, 2011): 1236–43. http://dx.doi.org/10.1017/s0950268811001919.
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SUMMARYStudies of temporal and spatial patterns of diarrhoeal disease can suggest putative aetiological agents and environmental or socioeconomic drivers. Here, the seasonal patterns of monthly acute diarrhoeal morbidity in Thailand, where diarrhoeal morbidity is increasing, are explored. Climatic data (2003–2006) and Thai Ministry of Health annual reports (2003–2009) were used to construct a spatially weighted panel regression model. Seasonal patterns of diarrhoeal disease were generally bimodal with aetiological agents peaking at different times of the year. There is a strong association between daily mean temperature and precipitation and the incidence of hospitalization due to acute diarrhoea in Thailand leading to a distinct spatial pattern in the seasonal pattern of diarrhoea. Model performance varied across the country in relation toper capitaGDP and population density. While climatic factors are likely to drive the general pattern of diarrhoeal disease in Thailand, the seasonality of diarrhoeal disease is dampened in affluent urban populations.
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Kelly, Paul. "Diarrhoeal disease." Clinical Medicine 11, no. 5 (October 2011): 488–91. http://dx.doi.org/10.7861/clinmedicine.11-5-488.
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Hart, C. A., and L. W. Umar. "Diarrhoeal Disease." Tropical Doctor 30, no. 3 (July 2000): 170–72. http://dx.doi.org/10.1177/004947550003000321.
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Pokhrel, Damodar, and Thiruvenkatachari Viraraghavan. "Diarrhoeal diseases in Nepal vis-à-vis water supply and sanitation status." Journal of Water and Health 2, no. 2 (June 1, 2004): 71–81. http://dx.doi.org/10.2166/wh.2004.0007.
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Diarrhoeal diseases are still a major challenge in Nepal because of inadequate safe water supply, poor sanitation and living conditions. However, several other factors such as the literacy rate, socio-economic status, and social, religious or personal perception of the cause of disease may influence the rate of morbidity and mortality of diarrhoeal diseases. A yearly minimum death of 30,000 and morbidity of 3.3 episodes per child was estimated due to diarrhoea. An environmental health education programme, along with water supply and sanitation intervention, is an effective mitigation measure to reduce diarrhoeal diseases in Nepal.
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Chandrashekhar, Karnam. "REVIEW ON THE PLANTS REPORTED IN THE ETHNOBOTANICAL PRACTICES FOR DIARRHEAL DISEASE IN UTTAR PRADESH, INDIA." International Journal of Research in Ayurveda and Pharmacy 12, no. 2 (May 5, 2021): 50–61. http://dx.doi.org/10.7897/2277-4343.120245.
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No need to say that diarrhoeal disease is one of the major health concerns of the entire world. Many treatment modalities are put forth and tried to achieve the best control over the morbidity and mortality caused by the diarrhoeal disease. The resistance to the anti-microbial drugs, development of carrier state, misuse of antimicrobial drugs by the common people and change in the course of the disease after the use of antimicrobial drugs are really the worrisome issues in treating diarrhoeal disease. On the top of it, the prevalence of diarrhoea in children is so much high and severe that addressing it with a proper therapy, in some cases and in some occasions becomes very difficult. Initial approach with effective herbs, sometimes, makes wonders. Tribal people staying away from the urban areas, have their own plant remedies for treating different diarrhoeas. Uttar Pradesh is one among such states of India that possesses enormous knowledge of traditional practices such as ethno-medicine and folklore practices. Their utility needs to be brought under the ambit of the main streams of health practices. For the reason, some of them, may turn in to the remarkable source of drugs or lead compounds or the drug candidates. This study is based mainly on the data published in the articles related to ethnobotany, folklore practice and local utilization of medicinal plants by the people of different zones of Uttar Pradesh. This review reveals 117 medicinal plants belonging to 53 different botanical families utilized in the ethnobotanical practices for treating diarrhoeal disease in Uttar Pradesh.
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Pazzaglia, G., A. L. Bourgeois, K. El Diwany, N. Nour, N. Badran, and R. Hablas. "Campylobacter diarrhoea and an association of recent disease with asymptomatic shedding in Egyptian children." Epidemiology and Infection 106, no. 1 (February 1991): 77–82. http://dx.doi.org/10.1017/s0950268800056466.
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SUMMARYA hospital-based case-control diarrhoea survey was conducted in Cairo. Egypt to determine the age-specific frequency of campylobacter infection among diarrhoeic and non-diarrhoeic children aged new born to 5 years. Campylobacter was the most common bacterial enteropathogen isolated from diarrhoeic stools. The overall prevalence of campylobacter isolations was 25·9% from stools of 143 diarrhoeic children compared to 15·2% of 132 non-diarrhoeic control children (P= 0·028) during the 4-month period of study. Children less than 1 year of age were at greatest risk of campylobacter infection with 32·6% of diarrhoeic patients culture positive, compared to 14·3% of controls. Asymptomatic shedding in controls was positively associated with a recent diarrhoeal episode (P= 0·019) and may be an important source of new infections.
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ZIV, T., A. D. HEYMANN, J. AZURI, M. LESHNO, and D. COHEN. "Assessment of the underestimation of childhood diarrhoeal disease burden in Israel." Epidemiology and Infection 139, no. 9 (November 19, 2010): 1379–87. http://dx.doi.org/10.1017/s0950268810002554.
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SUMMARYWe determined the extent by which mandatory reporting on isolates of Shigella and Salmonella underestimates the burden of diarrhoeal diseases in individuals aged <17 years in Israel and examined paediatricians' knowledge, attitudes and practices related to patient visits with diarrhoeal diseases. Sources of data were a nationwide population-based telephone survey for presence of diarrhoeal diseases, Maccabi Healthcare Services databases and a mail survey among its paediatricians. Monte Carlo simulation and rate estimates for all stages, from visit to physician to reporting on a culture-confirmed case of shigellosis or salmonellosis, were used to determine the underestimation factor. Of 1492 children, 5·7% reported a diarrhoeal episode during the 2 weeks prior to interview. The rate of visiting a physician with and without fever was 86% and 16%, respectively. A stool culture was performed for around 20% of patients and the isolation rates were 7·1% for Shigella and 2·1% for Salmonella. Paediatricians (n=214) ranked very young age of patient and the complaint ‘bloody diarrhoea’ as the most important determinants. We estimated that one reported isolate of Shigella or Salmonella represented 152 diarrhoeal episodes of all aetiologies. This estimate is important for further assessments of the true burden of diarrhoeal diseases.
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Lohakpure, Vishesh R., and Vinod L. Vedpathak. "Study of diarrheal disease among under five children in a rural community: telephone based follow up study." International Journal Of Community Medicine And Public Health 6, no. 6 (May 27, 2019): 2533. http://dx.doi.org/10.18203/2394-6040.ijcmph20192317.
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Background: Acute diarrhoeal diseases are one of the leading causes of morbidity and mortality in the developing countries and a major contribution of malnutrition especially among infants and children under 5 years of age. Approximately two-thirds of the world population live in the developing countries characterized by a lack of potable drinking water, improper means of disposal of human faecal waste, intense crowding in houses and often primitive standards of personal hygiene. In India, diarrhoeal diseases are a major public health problem among children under 5 years. The objective of the study was to estimate number of episodes of diarrhoea in children under five years in a rural area.Methods: Community based longitudinal study conducted among 622 children.Results: The overall incidence of diarrhoeal disease was found to be 2.11 episode/child/year. It was observed that the diarrhoeal disease morbidity decreased with the increasing age of the child. Diarrhoeal disease morbidity increased in children from lower socioeconomic status 2.32 episodes/child/year.Conclusions: The lower incidence rate has been found in those children who were better nourished, had received immunization and had been breast fed. Hence there is a need to make efforts to still further improve and sustain immunization coverage, give importance to the nutrition of the children, encourage the mothers to breast feed their children for at least 2 years.
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Ali, Syed Mubashir, and Rizwan Ul-haq. "The Relationship between the WES Interventions and the Incidence of Diarrhoea." Pakistan Development Review 42, no. 4II (December 1, 2003): 555–68. http://dx.doi.org/10.30541/v42i4iipp.555-568.
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Access to clean drinking water and sanitation facilities have a direct positive impact on health through prevention of water-borne diseases, especially diarrhoeal morbidity of children. Lack of WES (Water and Environmental Sanitation) services and poor hygiene practices in Pakistan contribute significantly to the prevalence of diarrhoea, a major cause of infant death and children less than five years of age. The estimates show that about 30 percent of total deaths among children are attributed to diarrhoeal disease [Gallup (2001); UNICEF (2000)], and 4.1 years in life expectancy can be added if water borne diseases are eliminated [Ali and Haq (2003)]. Hence, reduction of diarrhoeal morbidity stands out as an important policy goal, which can ultimately lead to reduction in infant/child mortality. In this paper, we shall examine the relationship of WES interventions with that of the incidence of diarrhoea among children under age 10.
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Sobsey, M. D., T. Handzel, and L. Venczel. "Chlorination and safe storage of household drinking water in developing countries to reduce waterborne disease." Water Science and Technology 47, no. 3 (February 1, 2003): 221–28. http://dx.doi.org/10.2166/wst.2003.0199.
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Simple, effective and affordable methods are needed to treat and safely store non-piped, gathered household water. This study evaluated point-of-use chlorination and storage in special plastic containers of gathered household water for improving microbial quality and reducing diarrhoeal illness of consumers living under conditions of poor sanitation and hygiene. Community families were recruited and randomly divided into intervention (household water chlorination and storage in a special container) and control (no intervention) households. Microbes in stored household water were extensively inactivated by 1-5-mg/L doses of hypochlorite. Escherichia coli levels in stored household waters were <1/100 mL in most intervention households but readily detectable at high levels in control households. Stored water of intervention households was also lower in Clostridium perfringens and heterotrophic plate count bacteria than in control households. The intervention reduced household diarrhoeal illness. In Bolivia, monthly episodes of household diarrhoeal illness were 1.25 and 2.2 in intervention and control families, respectively (P = <0.002) indicating that 43% of community diarrhoea was preventable by using the intervention. In Bangladesh, mean episodes of child diarrhoea/1,000 d were 19.6 and 24.8 in intervention and control groups respectively (P = <0.03) indicating that about 24% of observed diarrhoea was preventable by using the intervention. Chlorine disinfection and storage in an appropriate container significantly improved the microbiological quality of non-piped household drinking water and reduced community diarrhoeal disease. Widespread use of this simple treatment and storage system for non-piped domestic water has the potential to dramatically reduce the global burden of waterborne diarrhoeal disease.
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Paruchuri, Anil Kumar, Gowri Edagotti, Ramu Pedada, and Haresh Morri. "Rotavirus Infection as Cause of Diarrhoea in Under-3- Years Children at Siddhartha Medical College, Vijayawada AP - A Hospital Based Cross Sectional Study." Journal of Evidence Based Medicine and Healthcare 8, no. 30 (July 26, 2021): 2731–37. http://dx.doi.org/10.18410/jebmh/2021/502.
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BACKGROUND Diarrhoeal diseases are significant public health problems that lead to morbidity and mortality of infants and children particularly in developing countries and developed countries too. Rotavirus is the most important virus responsible for severe diarrhoea among young children. India being a developing country, the incidence of diarrhoeal diseases is high. In this part of Andhra Pradesh, low socioeconomic status, bad feeding, and child-rearing practices along with malnutrition contribute to the high morbidity and mortality due to diarrhoeal disease caused by rotavirus infection. METHODS This cross-sectional hospital-based study was conducted from January 2018 to December 2018 in the Department of Paediatrics, Old Government Hospital, Siddhartha Medical College, Vijayawada, Andhra Pradesh after obtaining ethical clearance from Ethical and Research Committee of our institute. One hundred (100) children, fulfilling the selection criteria who were admitted in the three paediatric wards were the subjects of study. RESULTS In this present study, the incidence of rotavirus infection was high in children aged ≤ 12 months and least in children between the age group of 25 to 36 months. In our study, we found that majority of cases with rotavirus infection occurred from September to February (60 %). Reverse transcription – polymerase chain reaction (RT-PCR) test done for the 24-enzyme linked immuno sorbent assay (ELISA) test negative samples of this study group. Out of 24 ELISA negative samples, PCR detects 4 samples as positive as PCR test is more sensitive than ELISA. CONCLUSIONS Rotavirus diarrhoea is the most common cause of severe gastroenteritis (GE) in children below five years of age in most regions of India. In this part of Andhra Pradesh, the low socioeconomic status, bad feeding, and child-rearing practices along with malnutrition contribute to the high morbidity and mortality due to diarrhoeal disease caused by rotavirus infection. This data on rotavirus disease burden may likely support evidence-based decisions regarding any further intervention. KEYWORDS Rotavirus, Diarrhoea, Diarrhoeal Diseases, Gastroenteritis (GE) Children, RT-PCR
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Gupta, Dipak Kumar, and Poonam Kumari Sah. "Knowledge, Attitude and Practice of Mothers of Children Below Five Years Regarding Diarrhoea." Nepal Journal of Health Sciences 1, no. 1 (July 30, 2021): 16–20. http://dx.doi.org/10.3126/njhs.v1i1.38605.
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Background: The public health problem of diarrhoeal diseases is widespread. In order to reduce related mortality and morbidity, caretakers must play an active role and need to determine to what extent they are empowered.
Method: A cross sectional descriptive study was conducted from March 7- April 6, 2021 among 113 mothers of children below five years who visited hospital-seeking treatment for diarrhoeal diseases of their children. A self-structured questionnaire regarding knowledge, attitude and practice regarding was used to generate data on interview basis.
Results: Knowledge regarding the diarrhoeal disease was found to be of good level (88.4% correctly defining diarrhoea). Majority of mothers has good attitude towards diarrhoea. However, far few mothers correctly recognised signs of dehydration, 23 recognizing dry mucosa and 44 recognizing sunken eyes. Out of total, 81% participants knew about oral rehydrate solutions.
Conclusion: Despite good knowledge and attitudes towards diarrhoea among mothers with children under five years of age, the standard of home-based management was found to be unsatisfactory based on the results of the study.
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Ajjampur, S. S. R., P. Rajendran, S. Ramani, I. Banerjee, B. Monica, P. Sankaran, V. Rosario, et al. "Closing the diarrhoea diagnostic gap in Indian children by the application of molecular techniques." Journal of Medical Microbiology 57, no. 11 (November 1, 2008): 1364–68. http://dx.doi.org/10.1099/jmm.0.2008/003319-0.
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A large proportion of diarrhoeal illnesses in children in developing countries are ascribed to an unknown aetiology because the only available methods, such as microscopy and culture, have low sensitivity. This study was aimed at decreasing the diagnostic gap in diarrhoeal disease by the application of molecular techniques. Faecal samples from 158 children with and 99 children without diarrhoea in a hospital in South India were tested for enteric pathogens using conventional diagnostic methods (culture, microscopy and enzyme immunoassays) and molecular methods (six PCR-based assays). The additional use of molecular techniques increased identification to at least one aetiological agent in 76.5 % of diarrhoeal specimens, compared with 40.5 % using conventional methods. Rotavirus (43.3 %), enteropathogenic Escherichia coli (15.8 %), norovirus (15.8 %) and Cryptosporidium spp. (15.2 %) are currently the most common causes of diarrhoea in hospitalized children in Vellore, in contrast to a study conducted two decades earlier in the same hospital, where bacterial pathogens such as Shigella spp., Campylobacter spp. and enterotoxigenic E. coli were more prevalent. Molecular techniques significantly increased the detection rates of pathogens in children with diarrhoea, but a more intensive study, testing for a wider range of infectious agents and including more information on non-infectious causes of diarrhoea, is required to close the diagnostic gap in diarrhoeal disease.
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Ørskov, Frits, and Ida Ørskov. "Escherichia coli serotyping and disease in man and animals." Canadian Journal of Microbiology 38, no. 7 (July 1, 1992): 699–704. http://dx.doi.org/10.1139/m92-115.
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Serotyping of Escherichia coli is useful, but complex, with 173 O antigens, 80 K antigens, and 56 H antigens, which can all be subdivided into partial antigens. The O, K, and H antigens can be found in nature in many of the possible combinations. The final number of E. coli serotypes is very high, 50 000 – 100 000 or more. The number of frequent pathogenic serotypes is, however, limited. Two main groups of such frequent serotypes are (i) serotypes from diarrhoeal disease and (ii) serotypes from extraintestinal disease. Serotypes from diarrhoeal diseases are mostly species specific, and could at present be used as epidemiological markers for bacterial clones equipped with special virulence markers, such as toxins and adhesins. Their O-antigen lipopolysaccharides may be regarded as virulence factors. These strains are not inhabitants of the normal intestine. Serotypes from extraintestinal diseases constitute a different set of clones, which are good colonizers of the intestinal tract, that under certain conditions succeed in invading host tissues. They are characterized by virulence factors different from those found in strains from diarrhoeal disease. Thus, the two groups of pathogenic E. coli are both composed of a limited number of clones for which the O:K:H serotypes are excellent, although not faultless, markers. Key words: Escherichia coli, serotype, extraintestinal, diarrhoea, disease.
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Abdad, Mohammad Yazid, Kevin Soli, Bang Pham, Grace Bande, Tobias Maure, Marinjo Jonduo, Debbie Kisa, et al. "Diarrhoeal disease surveillance in Papua New Guinea: findings and challenges." Western Pacific Surveillance and Response Journal 11, no. 1 (March 31, 2020): 7–12. http://dx.doi.org/10.5365/wpsar.2018.9.2.006.
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Diarrhoeal diseases are among the leading causes of morbidity and mortality in the Western Pacific Region. However, data on the major causes of infectious diarrhoea are limited in many countries within the Region, including Papua New Guinea. In 2013–2014, we conducted surveillance for acute diarrhoeal illness in four provinces in Papua New Guinea. One rural health clinic from each province participated in the surveillance activity. Samples were sent to central laboratories and batch analysed for bacterial and viral gastrointestinal pathogens that are commonly associated with diarrhoea. Across the four sites, the most commonly detected pathogens were Shigella spp., Campylobacter spp. and rotavirus. In this paper, we report the results of the surveillance activity and the challenges that we faced. The lessons learnt may be applicable to other parts of the Region with a similar socioeconomic status.
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Chen, Xi, Bin Zhang, Hua Yue, Yong Wang, Fang Zhou, Qiang Zhang, and Cheng Tang. "A novel astrovirus species in the gut of yaks with diarrhoea in the Qinghai–Tibetan Plateau, 2013." Journal of General Virology 96, no. 12 (December 1, 2015): 3672–80. http://dx.doi.org/10.1099/jgv.0.000303.
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The yak (Bos grunniens) is an iconic symbol in the high-altitude region of the Qinghai–Tibetan Plateau. Diarrhoea is a common disease in yaks, resulting in major economic losses. To investigate the diversity of viral species, we reported the metagenomics-derived virome in a pooled faecal sample of 20 diarrhoeic yaks. The nine viruses found in the pooled diarrhoeic samples, in order of abundance of nucleic acid sequence, were influenza A virus, bovine viral diarrhoea virus (BVDV), rotavirus, ungulate tetraparvovirus 1 (bovine hokovirus), astrovirus (AstV), bovine enterovirus, hepatitis E virus, kobuvirus and woodchuck hepatitis virus. Compared with healthy yaks, only AstV had a significantly higher prevalence rate in diarrhoeal samples, indicating a correlation with the clinical symptoms of diarrhoea in yaks. To further investigate the molecular characterization of yak AstV, a near-full genome was obtained from a diarrhoeic sample. It was 6243 bp in length and shared 46.4–66.2 % similarity with other related bovine AstVs from faeces. Phylogenetic analysis of the genome demonstrated that the yak AstV fell within the bovine AstVs cluster, but was located in a unique lineage, suggesting a novel AstV species was identified in yaks. Interestingly, the ORF2 region of yak AstV had closer similarity and genetically relationship with deer AstV strain CcAstV-2 than that of the bovine AstVs. Further analysis showed that one possible interspecies recombination event occurred in ORF2. In summary, this study expanded our understanding of the viral communities of diarrhoeal yaks and identified a novel AstV that was associated with diarrhoea in yaks.
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Unsworth, D. J., and J. A. Walker-Smith. "Autoimmunity in Diarrhoeal Disease." Journal of Pediatric Gastroenterology and Nutrition 4, no. 3 (June 1985): 375–80. http://dx.doi.org/10.1097/00005176-198506000-00009.
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Tomkins, A. "Diarrhoeal disease and malnutrition." Gut 27, no. 9 (September 1, 1986): 1113. http://dx.doi.org/10.1136/gut.27.9.1113.
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Harb, Ali, Mark O’Dea, Sam Abraham, and Ihab Habib. "Childhood Diarrhoea in the Eastern Mediterranean Region with Special Emphasis on Non-Typhoidal Salmonella at the Human–Food Interface." Pathogens 8, no. 2 (May 6, 2019): 60. http://dx.doi.org/10.3390/pathogens8020060.
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Diarrhoeal disease is still one of the most challenging issues for health in many countries across the Eastern Mediterranean region (EMR), with infectious diarrhoea being an important cause of morbidity and mortality, especially in children under five years of age. However, the understanding of the aetiological spectrum and the burden of enteric pathogens involved in diarrhoeal disease in the EMR is incomplete. Non-typhoidal Salmonella (NTS), the focus of this review, is one of the most frequently reported bacterial aetiologies in diarrhoeal disease in the EMR. Strains of NTS with resistance to antimicrobial drugs are increasingly reported in both developed and developing countries. In the EMR, it is now widely accepted that many such resistant strains are zoonotic in origin and acquire their resistance in the food-animal host before onward transmission to humans through the food chain. Here, we review epidemiological and microbiological aspects of diarrhoeal diseases among children in the EMR, with emphasis on the implication and burden of NTS. We collate evidence from studies across the EMR on the zoonotic exposure and antimicrobial resistance in NTS at the interface between human and foods of animal origin. This review adds to our understanding of the global epidemiology of Salmonella with emphasis on the current situation in the EMR.
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Bani, Ibrahim Ahmed, Abdallah Abdul Wahid Saeed, and Abdul Aziz Mohammed Al Othman. "Diarrhoea and child feeding practices in Saudi Arabia." Public Health Nutrition 5, no. 6 (December 2002): 727–31. http://dx.doi.org/10.1079/phn2002354.
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AbstractObjective:The aim of the study was to estimate the prevalence of diarrhoea in children less than two years old and study the relationship between diarrhoeal episodes and action taken for these episodes by their mothers.Design:The prevalence of diarrhoeal episodes among children and its associations with sociodemographic information and anthropometric measurements of the subjects was examined. Predictive factors for morbidity-associated diarrhoeal disease and actions taken for this were explored.Setting:Primary health care centres (PHCCs) in Riyadh, Kingdom of Saudi Arabia.Subjects:Children less than two years of age.Results:Nearly a quarter of the children contracted diarrhoea during the two weeks preceding the data collection point, giving about six episodes of diarrhoea per child per year. Diarrhoea was more common in children over 6 months of age, in children who had no vaccination or follow-up cards, and in those who were taken care of by friends and neighbours if their mothers were working outside the home. The mothers of the affected children were young, married before 25 years of age with 2–6 years of formal schooling. During diarrhoeal episodes, about 25% of mothers stopped or decreased breast-feeding, 11.3% reduced the volume of fluids given to their children, and 22.7% of children were fed less solid/semi-solid foods. Mothers used oral rehydration salt in more than 40% of diarrhoeal episodes and unprescribed antibiotics were used in 17% of cases. The mothers who were not taking appropriate action included young mothers with low education level and those working outside the home.Conclusion:Diarrhoea is common in children less than two years old in Riyadh City, and intervention based in PHCCs needs to be undertaken to correct the faulty practices of mothers during diarrhoeal episodes in their children. Health education messages should emphasise feeding during diarrhoeal episodes.
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Mutalik, Anirudh V., and Vaishali V. Raje. "Relationship between maternal education and socioeconomic status on knowledge, attitude and practice of mother and her child regarding acute diarrhoeal diseases." International Journal Of Community Medicine And Public Health 4, no. 12 (November 23, 2017): 4472. http://dx.doi.org/10.18203/2394-6040.ijcmph20175155.
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Background: In India, diarrhoea caused more than 130,000 child deaths in 2013. This also accounts for roughly one-fourth of all global diarrhoea deaths among children under five years of age. The incidence of diarrhoeal disease in rural India is 12% and in urban India is 9%.Acute diarrheal disease is both preventable and treatable. Untreated severe diarrhoea leads to fluid loss and it may be life-threatening especially in young children and among the people who are high risk like malnourished or have impaired immunity. Methods: A cross sectional study was carried out among the secondary high school children (8th std) Azad high school, Kasegaon to find out the relationship between maternal education and socioeconomic status on knowledge, attitude and practice of mother and her child regarding acute diarrhoeal diseases. A pre-structured and pretested questionnaire was used to get the information regarding definition, causes, signs, symptoms, treatment, preparation of ORS, prevention of diarrheal etc. Results: Nearly 57% of the mothers had school education and 10% had college education and illiteracy was 36%. As per the occupation 46.6% were farmers, 30.6% were labours and 14% were housewives. Mother’s education was significantly associated with children Knowledge, attitude whereas practice was not associated. Illiterate mothers had significant poor knowledge and attitude. Conclusions: Maternal education and maternal socio economic status has important role is ascertaining the knowledge, attitude and practice of her children regarding acute diarrhoeal diseases.
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Maduemem, Kene E., Muhammad Rizwan, Nnaemeka Akubue, and Ioana D. Maris. "Perceptions and practices of oral rehydration therapy among caregivers in Cork, Ireland." International Journal Of Community Medicine And Public Health 4, no. 10 (September 22, 2017): 3536. http://dx.doi.org/10.18203/2394-6040.ijcmph20174216.
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Background: The use of oral rehydration therapy (ORT) remains limited despite international guidelines for diarrhoeal disease management. This study was done to assess the perception and practice of ORT among caregivers in the management of diarrhoeal disease. Methods: A descriptive cross-sectional study was conducted in the Paediatric Department of Cork University Hospital, Ireland. The study population consisted of parents/guardians of children attending the Paediatric Day Ward or Paediatric Outpatient Department. A questionnaire consisting of 30 questions was originally designed by the first author to include all the study variables, and was given to the participants. Results: Out of 402 respondents, 76.6% (n=308) could describe diarrhoea correctly and perceived it as a serious illness. 81.3% (n=327) of participants knew about ORT but only 27.2% (n=89) agreed it was an ideal first line of management of diarrhoeal disease. Diarrhoeal episodes in the preceding 12 months were reported predominantly in children under the age of 5 years (p<0.001). Only 8.7% (n=17) of caregivers used ORT for diarrhoeal management. Conclusions: Poor uptake of ORT appears to be due to caregivers’ negative perceptions of ORT. This emphasizes the need for correct and adequate education.
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Guttman, Julian Andrew, Ann En-Ju Lin, Yuling Li, John Bechberger, Christian C. Naus, A. Wayne Vogl, and B. Brett Finlay. "Gap junction hemichannels contribute to the generation of diarrhoea during infectious enteric disease." Gut 59, no. 2 (October 14, 2009): 218–26. http://dx.doi.org/10.1136/gut.2008.170464.
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ObjectiveThe attaching and effacing (A/E) pathogens enterohaemorrhagic Escherichia coli, enteropathogenic E coli and Citrobacter rodentium colonise intestinal tracts, attach to enterocytes, collapse infected cell microvilli and alter numerous host cell processes during infection. Enterocyte alterations result in numerous small molecules being released from host cells that likely contribute to diarrhoeal phenotypes observed during these infections. One possible route for small molecules to be released from intestinal cells may be through functional gap junction hemichannels. Here we examine the involvement of these hemichannels during the diarrhoeal disease caused by A/E pathogens in vivo.DesignMice were infected with the diarrhoea-causing murine A/E pathogen C rodentium for 7 days. Connexin43 (Cx43) protein levels and immunolocalisation in the colon were initially used to determine alterations during A/E bacterial infections in vivo. Connexin mimetic peptides and connexin permeable tracer molecules were used to gage the presence and function of unpaired connexin hemichannels. The role of Cx43 in diarrhoea generation was assessed by comparing infections of wild-type mice to Cx43 mutant mice and determining the water abundance in the colonic luminal material.ResultsWe demonstrate that Cx43 protein levels are increased in colonocytes during in vivo A/E bacterial infections, resulting in functionally open connexon hemichannels in apical membranes of infected cells. Moreover, infected Cx43 +/− mice do not suffer from diarrhoeal disease.ConclusionsThis study provides the first evidence that functional connexon hemichannels can occur in the intestine and are a novel molecular mechanism of water release during infectious diarrhoea.
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PAUL, R. C., A. S. G. FARUQUE, M. ALAM, A. IQBAL, K. ZAMAN, N. ISLAM, A. SOBHAN, et al. "Incidence of severe diarrhoea due toVibrio choleraein the catchment area of six surveillance hospitals in Bangladesh." Epidemiology and Infection 144, no. 5 (September 22, 2015): 927–39. http://dx.doi.org/10.1017/s0950268815002174.
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SUMMARYCholera is an important public health problem in Bangladesh. Interventions to prevent cholera depend on their cost-effectiveness which in turn depends on cholera incidence. Hospital-based diarrhoeal disease surveillance has been ongoing in six Bangladeshi hospitals where a systematic proportion of patients admitted with diarrhoea were enrolled and tested forVibrio cholerae.However, incidence calculation using only hospital data underestimates the real disease burden because many ill persons seek treatment elsewhere. We conducted a healthcare utilization survey in the catchment areas of surveillance hospitals to estimate the proportion of severe diarrhoeal cases that were admitted to surveillance hospitals and estimated the population-based incidence of severe diarrhoea due toV. choleraeby combining both hospital surveillance and catchment area survey data. The estimated incidence of severe diarrhoea due to cholera ranged from 0·3 to 4·9/1000 population in the catchment area of surveillance hospitals. In children aged <5 years, incidence ranged from 1·0 to 11·0/1000 children. Diarrhoeal deaths were most common in the Chhatak Hospital's catchment area (18·5/100 000 population). This study provides a credible estimate of the incidence of severe diarrhoea due to cholera in Bangladesh, which can be used to assess the cost-effectiveness of cholera prevention activities.
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Long, Kurt Z., Jorge L. Rosado, Herbert L. DuPont, Ellen Hertzmark, and Jose Ignacio Santos. "Supplementation with vitamin A reduces watery diarrhoea and respiratory infections in Mexican children." British Journal of Nutrition 97, no. 2 (February 2007): 337–43. http://dx.doi.org/10.1017/s0007114507257757.
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Previous clinical vitamin A trials have found no consistent effect on diarrhoeal disease and respiratory tract infection. These inconsistent results may be due to the distinct effects vitamin A supplementation has among children stratified by factors related to socio-economic status, nutritional status and season. We evaluated the effect of supplementation on the overall incidence of diarrhoeal disease and respiratory tract infections and on the incidence among children stratified by these factors. A total of 188 children, aged 6–15 months, from periurban, marginalized communities of Mexico City were assigned to receive vitamin A ( < 12 months of age, 20 000 IU retinol; ≥ 12 months, 45 000 IU retinol) or a placebo every 2 months, and were followed for up to 15 months. Project personnel visited households twice a week to determine the onset and duration of diarrhoeal disease and respiratory tract infections. Vitamin A supplementation had no significant effect on risk of overall diarrhoeal disease but reduced mild watery diarrhoea (incidence rate ratio (RR) 0·69; 95 % CI 0·50, 0·93) and cough with fever (RR 0·69; 95 % CI 0·48, 0·98). Vitamin A supplementation decreased diarrhoeal disease during the summer (RR 0·74; 95 % CI 0·57, 0·94), among non-stunted children (RR 0·69; 95 % CI 0·52, 0·93) and among children from households with better socio-economic measures. Heterogeneity in the response to vitamin A supplementation may reflect heterogeneity in the aetiology and epidemiology of diarrhoeal disease and respiratory tract infections and the impact that supplementation has on the immune response.
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Kapwata, Thandi, Angela Mathee, Wouter le Roux, and Caradee Wright. "Diarrhoeal Disease in Relation to Possible Household Risk Factors in South African Villages." International Journal of Environmental Research and Public Health 15, no. 8 (August 6, 2018): 1665. http://dx.doi.org/10.3390/ijerph15081665.
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Diarrhoeal disease is a significant contributor to child morbidity and mortality, particularly in the developing world. Poor sanitation, a lack of personal hygiene and inadequate water supplies are known risk factors for diarrhoeal disease. Since risk factors may vary by population or setting, we evaluated the prevalence of diarrhoeal disease at the household level using a questionnaire to better understand household-level risk factors for diarrhoea in selected rural areas in South Africa. In a sub-sample of dwellings, we measured the microbial quality of drinking water. One in five households had at least one case of diarrhoea during the previous summer. The most widespread source of drinking water was a stand-pipe (inside yard) (45%) followed by an indoor tap inside the dwelling (29%). Storage of water was common (97%) with around half of households storing water in plastic containers with an opening large enough to fit a hand through. After adjusting for confounders, the occurrence of diarrhoea was statistically significantly associated with sourcing water from an indoor tap (Adjusted Odds Ratio (AOR): 2.73, 95% CI: 2.73, 1.14–6.56) and storing cooked/perishable food in non-refrigerated conditions (AOR: 2.17, 95% CI: 2.17, 1.44–3.26). The highest total coliform counts were found in water samples from kitchen containers followed by stand-pipes. Escherichia coli were most often detected in samples from stand-pipes and kitchen containers. One in four households were at risk of exposure to contaminated drinking water, increasing the susceptibility of the study participants to episodes of diarrhoea. It is imperative that water quality meets guideline values and routine monitoring of quality of drinking water is done to minimise diarrhoea risk in relevant rural communities. The security of water supply in rural areas should be addressed as a matter of public health urgency to avoid the need for water storage.
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Kumar, SG, and L. Subita. "Diarrhoeal Diseases in Developing Countries: A Situational Analysis." Kathmandu University Medical Journal 10, no. 2 (January 3, 2013): 83–88. http://dx.doi.org/10.3126/kumj.v10i2.7351.
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Recent data showed that there is no much reduction in diarrhoea related morbidity in developing countries. This is important in view of the Millennium Developmental Goal (MDG) to be achieved by 2015. This study reviewed and analyzed after gathering the recent literature information from Pubmed, internet and other sources. The authors discussed public health issues related to diarrhoeal diseases that include problem burden, determinants, intervention strategies, management, prevention and recent developments for control of diarrhoea among under-five children in developing countries. The study emphasizes the need for strengthening of comprehensive diarrhoeal disease prevention strategy at primary level including improvement of water quality, hygiene and sanitation, along with provision of oral rehydration solution and zinc supplements, and research in the field of vaccine and cost effective interventions. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 83-88 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7351
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Thomas, Rowan R., Heather J. L. Brooks, and Rory O'Brien. "Prevalence of Shiga toxin-producing and enteropathogenic Escherichia coli marker genes in diarrhoeic stools in a New Zealand catchment area." Journal of Clinical Pathology 70, no. 1 (October 3, 2016): 81–84. http://dx.doi.org/10.1136/jclinpath-2016-203882.
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BackgroundShiga toxin-producing (STEC) and enteropathogenic (EPEC) Escherichia coli are gastrointestinal pathogens causing diarrhoeal and extraintestinal disease. Due to lack of EPEC screening and use of Sorbitol-MacConkey (SMAC) agar in faecal screening, the true prevalence of EPEC and non-O157 STEC in New Zealand diarrhoeal cases is unknown.MethodsDiarrhoeic stools sourced from Dunedin hospital were pre-enriched, DNA extracted with Chelex-100 resin and screened using a multiplex TaqMan quantitative PCR assay amplifying stx1, sxt2 and EPEC (eae) gene markers.ResultsOf the 522 diarrhoeic samples surveyed, 8 (1.53%) were PCR positive for stx1/stx2 and 23 (4.41%) were positive for eae. Six (75%) of the stx+ samples were uncommon non-O157 serotypes, and the remainder were found to be positive for both O103 and O157 STEC somatic antigens.ConclusionsResults revealed shortcomings in current screening protocols for pathogenic E. coli; SMAC is not sufficiently discriminatory to detect emergent STEC serotypes and EPEC likely has an unappreciated role in cases of diarrhoea in New Zealand.
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Unger, Carla Chan, Shumona Sharmin Salam, Md Shafiqul Alam Sarker, Robert Black, Alejandro Cravioto, and Shams El Arifeen. "Treating diarrhoeal disease in children under five: the global picture." Archives of Disease in Childhood 99, no. 3 (November 6, 2013): 273–78. http://dx.doi.org/10.1136/archdischild-2013-304765.
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Rates of childhood mortality due to diarrhoea remain unacceptably high and call for renewed global focus and commitment. Affordable, simple and effective diarrhoeal treatments have already been available for many years, yet a shift in international health priorities has seen coverage of recommended treatments slow to a near-standstill since 1995. This article reviews coverage of recommended childhood diarrhoeal treatments (low-osmolarity oral rehydration solution (ORS) and zinc), globally and regionally, and provides an overview of the major barriers to wide-scale coverage. It is argued that to ensure smooth supply and equitable distribution of ORS and zinc, adequate financing, relevant policy changes, strong public, private and non-government organisation (NGO) collaboration, local manufacturing of pharmaceuticals, mass media awareness and campaigning, in conjunction with strong government support, are necessary for successful treatment scale-up.
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Overbey, Katie N., Kellogg J. Schwab, and Natalie G. Exum. "Comparison of 1-week and 2-week recall periods for caregiver-reported diarrhoeal illness in children, using nationally representative household surveys." International Journal of Epidemiology 48, no. 4 (March 25, 2019): 1228–39. http://dx.doi.org/10.1093/ije/dyz043.
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Abstract Background Diarrhoeal outcomes in children are often ascertained using caregiver-reported symptoms, which are subject to a variety of biases and methodological challenges. One source of bias is the time window used for reporting diarrhoeal illness and the ability of caregivers to accurately recall episodes in children. Methods Diarrhoea period prevalence in children under five was determined using two similarly administered, nationally representative household surveys: Performance Monitoring and Accountability 2020 (PMA2020) (1-week recall, N = 14 603) and Demographic and Health Surveys (DHS) (2-week recall, N = 66 717). Countries included in the analysis were the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya and Uganda. Diarrhoea period prevalence estimates were compared and water, sanitation and hygiene risk factors were analysed. Results Childhood diarrhoea prevalence using 1-week recall (PMA2020) pooled across countries was 21.4% [95% confidence interval (CI): 19.9%, 22.9%] versus 16.0% using 2-week recall (DHS) (95% CI: 15.4%, 16.5%). In stratified analyses for all five countries, the number of diarrhoea cases detected was consistently higher using 1-week recall versus 2-week recall. The key risk factors identified in the PMA2020 data that were not associated with diarrhoeal episodes or were attenuated in the DHS data included: the main sanitation classifications for households, disposal method used for child faeces, number of household members and wealth quintiles. Conclusions For nationally representative household surveys assessing childhood diarrhoea period prevalence, a 2-week recall period may underestimate diarrhoea prevalence compared with a 1-week period. The household sanitation facility and practices remain key risk factors for diarrhoeal disease in children under five.
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Mukherjee, Avik K., Punam Chowdhury, Krishnan Rajendran, Tomoyoshi Nozaki, and Sandipan Ganguly. "Association betweenGiardia duodenalisand Coinfection with Other Diarrhea-Causing Pathogens in India." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/786480.
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Giardia duodenalis, is often seen as an opportunistic pathogen and one of the major food and waterborne parasites. Some insights ofGiardiainfestation in a diarrhoea-prone population were investigated in the present study. Our primary goal was to understand the interaction of this parasite with other pathogens during infection and to determine some important factors regulating the diarrhoeal disease spectrum of a population.Giardiashowed a steady rate of occurrence throughout the entire study period with a nonsignificant association with rainfall(P>0.05). Interestingly coinfecting pathogens likeVibrio choleraeand rotavirus played a significant(P≤0.001)role in the occurrence of this parasite. Moreover, the age distribution of the diarrhoeal cases was very much dependent on the coinfection rate ofGiardiainfection. As per our findings,Giardiainfection rate seems to play a vital role in regulation of the whole diarrhoeal disease spectrum in this endemic region.
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Morse, Tracy, Elizabeth Tilley, Kondwani Chidziwisano, Rossanie Malolo, and Janelisa Musaya. "Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial." International Journal of Environmental Research and Public Health 17, no. 8 (April 13, 2020): 2648. http://dx.doi.org/10.3390/ijerph17082648.
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Diarrhoeal disease in children under five in low income settings has been associated with multiple environmental exposure pathways, including complementary foods. Conducted from February to December 2018 in rural Malawi, this before and after trial with a control used diarrhoeal disease as a primary outcome, to measure the impact of a food hygiene intervention (food hygiene + handwashing) relative to a food hygiene and water, sanitation and hygiene (WASH) intervention (food hygiene + handwashing + faeces management + water management). The 31-week intervention was delivered by community-based coordinators through community events (n = 2), cluster group meetings (n = 17) and household visits (n = 14). Diarrhoeal disease was self-reported and measured through an end line survey, and daily diaries completed by caregivers. Difference-in-differences results show a 13-percentage point reduction in self-reported diarrhoea compared to the control group. There were also significant increases in the presence of proxy measures in each of the treatment groups (e.g., the presence of soap). We conclude that food hygiene interventions (including hand washing with soap) can significantly reduce diarrhoeal disease prevalence in children under five years in a low-income setting. Therefore, the promotion of food hygiene practices using a behaviour-centred approach should be embedded in nutrition and WASH policies and programming.
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Kumar, Naresh, and Supriya Malik. "Prospective study to assess maternal knowledge, attitude and practices regarding childhood diarrhoea." International Journal of Contemporary Pediatrics 5, no. 3 (April 20, 2018): 804. http://dx.doi.org/10.18203/2349-3291.ijcp20181414.
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Background: Diarrhoea is one of the major and most frequently encounter problem by the paediatrician. Diarrhoeal disease is the second leading cause of death n children under 5 yrs and is responsible for killing around 5,25,000 children every year. In low income counties, children under three years old, experience on an average three episodes of diarrhoea every year. Each episode deprives the child of the nutrition necessary for growth. Current study was conducted to assess maternal knowledge, attitude over practice regarding diarrhoeal disease.Methods: The present study is a prospective study, carried out at department of paediatrics, at Sri Guru Ram Das University of Medical Sciences and Research Amritsar from Jan 2016—Jan 2018 over period of 2 years. Total 25-0 mothers were intervened to assess their knowledge, attitude and practices during episodes of diarrhoea on basis of educational qualification of mothers, data were divided into three categories: Illiterate, moderately educated including mothers having qualification up to graduation, highly educated-mothers who did post-graduation or some professional education.Results: Total 250 mothers were included in the study with prior informed consent and question were asked as per preformed questionnaire and vernacular language and English too. In present study, it was observed that maximum number of diarrhoea causes 77.76% were seen in first year of life and there was higher incidence (74.4%) among male children. Incidence of diarrhoea was 67.6% among children of illiterate mother in contrast to 12% among a mother of having higher qualification.Conclusions: Finding of present study indicated low proportion of maternal knowledge and practice about etiologies and management of diarrhoeal disease among children under 5 years of age. Programme should focus on provided awareness to patients and education of mother should focus on symptoms of dehydration, knowledge on ORS, hoe to prepare an ORS, prevention on danger sign and diseases. rural population.
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Afitiri, Abdul-Rahaman, Frederick Ato Armah, Bernard Ekumah, Florence Esi Nyieku, David Oscar Yawson, and Justice O. Odoi. "Cumulative effects of environmental factors on household childhood diarrhoea in Ghana." Water Practice and Technology 15, no. 4 (August 15, 2020): 1032–49. http://dx.doi.org/10.2166/wpt.2020.083.
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Abstract Many children under five years still die from diarrhoeal diseases globally even though much progress has been made. The threat to public health posed by diarrhoeal diseases warrants the need to understand the interaction of the disease determinants from a spatio-temporal perspective to inform policy and intervention design. In this study, a pooled regression analysis was carried out using the Ghana Demographic and Health Survey data on 15,808 children under five years, to assess the combined effect of environmental factors on childhood diarrhoea prevalence and morbidity over a 21-year period. Childhood diarrhoea prevalence declined steadily from 20% to 16% from 1993 to 2003 but increased to 20% in 2008 and finally decreased significantly to 12% in 2014. The strength of the association between diarrhoea prevalence and each of the predictors presented in decreasing order of magnitude were as follows: current age of child, geographical region, religion, mother's highest educational level, ethnicity, source of drinking water and toilet facility, residential wellbeing, birth order, age of mother, and sex of child. Regional and temporal heterogeneities in prevalence, rate and distribution of diarrhoea were observed, indicating the need for context-specific interventions and policies.
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Mahmud, Imteaz, Subhasish Das, Soroar Hossain Khan, A. S. G. Faruque, and Tahmeed Ahmed. "Gender disparity in care-seeking behaviours and treatment outcomes for dehydrating diarrhoea among under-5 children admitted to a diarrhoeal disease hospital in Bangladesh: an analysis of hospital-based surveillance data." BMJ Open 10, no. 9 (September 2020): e038730. http://dx.doi.org/10.1136/bmjopen-2020-038730.
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IntroductionDespite economic development and augmented literacy rates, Bangladeshi households are still discriminating against girls when it comes to seeking medical care. We examined gender disparities in diarrhoeal disease severity and the treatment outcomes of under-5 children.SettingA tertiary level diarrhoeal disease hospital in Dhaka, Bangladesh.Participants13 361 under-5 children admitted to the hospital between January 2008 and December 2017.Outcome variables and methodsThe primary outcome of interest was severity of diarrhoea, defined as ‘dehydrating diarrhoea’ or ‘non-dehydrating diarrhoea’. Multivariable logistic regression analyses were performed to assess the association between ‘gender’ and admission to hospital for dehydrating diarrhoea.ResultsData on 13 321 children under 5 years of age were analysed, of whom 61.5% were male and 38.5% were female. The mean (±SD) age of children with diarrhoea was 5.63 (±3.49) months. The median distance travelled to come to the hospital for admission was 10 miles (IQR: 6–25) and was significantly higher for boys (10 miles, IQR: 6–25) than girls (9.5 miles, IQR: 6–23) (p<0.001). Girls had 1.11 times higher odds (adjusted OR: 1.11, 95% CI 1.03 to 1.20, p=0.007) of presenting with dehydrating diarrhoea than boys at the time of hospital admission. Almost 20% of children received two or more medications during the period of hospital admission and this did not differ by gender. The median duration of hospital stay was 11 hours and was similar in both sexes. No gender-based disparity was observed in the management of diarrhoea and in the hospital outcome of children.ConclusionWe found that girls were more likely to have dehydrating diarrhoea when they were presented to the Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh. No gender-based disparity was observed in the hospital outcome of children.
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Hunter, Paul R. "Drinking water and diarrhoeal disease due to Escherichia coli." Journal of Water and Health 1, no. 2 (June 1, 2003): 65–72. http://dx.doi.org/10.2166/wh.2003.0008.
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Escherichia coli has had a central place in water microbiology for decades as an indicator of faecal pollution. It is only relatively recently that the role of E. coli as pathogen, rather than indicator, in drinking water has begun to be stressed. Interest in the role of E. coli as a cause of diarrhoeal disease has increased because of the emergence of E. coli O157:H7 and other enterohaemorrhagic E. coli, due to the severity of the related disease. There are enterotoxigenic, enteropathogenic, enterohaemorrhagic, enteroinvasive, enteroaggregative and diffusely adherent strains of E. coli. Each type of E. coli causes diarrhoeal disease through different mechanisms and each causes a different clinical presentation. Several of the types cause diarrhoea by the elaboration of one or more toxins, others by some other form of direct damage to epithelial cells. This paper discusses each of these types in turn and also describes their epidemiology, with particular reference to whether they are waterborne or not.
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FERDOUS, F., S. AHMED, F. D. FARZANA, J. DAS, M. A. MALEK, S. K. DAS, M. A. SALAM, and A. S. G. FARUQUE. "Aetiologies of diarrhoea in adults from urban and rural treatment facilities in Bangladesh." Epidemiology and Infection 143, no. 7 (September 15, 2014): 1377–87. http://dx.doi.org/10.1017/s0950268814002283.
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SUMMARYThe objective of our analysis was to describe the aetiology, clinical features, and socio-demographic background of adults with diarrhoea attending different urban and rural diarrhoeal disease hospitals in Bangladesh. Between January 2010 and December 2011, a total of 5054 adult diarrhoeal patients aged ⩾20 years were enrolled into the Diarrhoeal Disease Surveillance Systems at four different hospitals (two rural and two urban) of Bangladesh. Middle-aged [adjusted odds ratio (aOR) 0·28, 95% confidence interval (CI) 0·23–0·35,P < 0·001] and elderly (aOR 0·15, 95% CI 0·11–0·20,P < 0·001) patients were more likely to present to rural diarrhoeal disease facilities than urban ones.Vibrio choleraewas the most commonly isolated pathogen (16%) of the four pathogens tested followed by rotavirus (5%), enterotoxigenicEscherichia coli(ETEC) (4%), andShigella(4%). Of these pathogens,V. cholerae(19%vs. 11%,P < 0·001), ETEC (9%vs. 4%,P < 0·001), and rotavirus (5%vs. 3%,P = 0·013) were more commonly detected from patients presenting to urban hospitals than rural hospitals, butShigellawas more frequently isolated from patients presenting to rural hospitals than urban hospitals (7%vs. 2%,P< 0·001). The isolation rate ofShigellawas higher in the elderly than in younger adults (8%vs. 3%,P < 0·001). Some or severe dehydration was higher in urban adults than rural adults (P< 0·001). Our findings indicate that despite economic and other progress made, conditions facilitating transmission ofV. choleraeandShigellaprevail in adults with diarrhoea in Bangladesh and further efforts are needed to control these infections.
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Baldi, Fabio, Maria Antonia Bianco, Gerardo Nardone, Alberto Pilotto, and Emanuela Zamparo. "Focus on acute diarrhoeal disease." World Journal of Gastroenterology 15, no. 27 (2009): 3341. http://dx.doi.org/10.3748/wjg.15.3341.
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Vesikari, Timo. "Rotavirus vaccines against diarrhoeal disease." Lancet 350, no. 9090 (November 1997): 1538–41. http://dx.doi.org/10.1016/s0140-6736(97)03254-6.
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Littlewood, Jenny, and Durga Pokhrel. "Mapping diarrhoeal disease in Nepal." Journal of Child Health Care 3, no. 4 (December 1999): 17–20. http://dx.doi.org/10.1177/136749359900300404.
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Borriello, S. "Microbial Toxins and Diarrhoeal Disease." Journal of Clinical Pathology 38, no. 8 (August 1, 1985): 962–63. http://dx.doi.org/10.1136/jcp.38.8.962-b.
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Forrest, Bruce D. "Diarrhoeal disease and vaccine development." Transactions of the Royal Society of Tropical Medicine and Hygiene 87 (December 1993): 39–41. http://dx.doi.org/10.1016/0035-9203(93)90536-y.
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Kilpatrick, M. E. "Diarrhoeal disease—a military perspective." Transactions of the Royal Society of Tropical Medicine and Hygiene 87 (December 1993): 47–48. http://dx.doi.org/10.1016/0035-9203(93)90538-2.
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Cutting, W. A. M. "Microbial toxins and diarrhoeal disease." Parasitology Today 2, no. 5 (May 1986): 153. http://dx.doi.org/10.1016/0169-4758(86)90187-0.
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Vijayan, Bevin, and Mala Ramanathan. "Prevalence and clustering of diarrhoea within households in India: some evidence from NFHS-4, 2015–16." Journal of Biosocial Science 53, no. 1 (March 4, 2020): 108–20. http://dx.doi.org/10.1017/s0021932020000073.
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AbstractDiarrhoeal disease is one of the major causes of morbidity and mortality in children and is usually measured at individual level. Shared household attributes, such as improved water supply and sanitation, expose those living in the same household to these same risk factors for diarrhoea. The occurrence of diarrhoea in two or more children in the same household is termed ‘diarrhoea clustering’. The aim of this study was to examine the role of improved water supply and sanitation in the occurrence of diarrhoea, and the clustering of diarrhoea in households, among under-five children in India. Data were taken from the fourth round of the National Family and Health Survey (NFHS-4), a nationally representative survey which interviewed 699,686 women from 601,509 households in the country. If any child was reported to have diarrhoea in a household in the 2 weeks preceding the survey, the household was designated a diarrhoeal household. Household clustering of diarrhoea was defined the occurrence of diarrhoea in more than one child in households with two or more children. The analysis was done at the household level separately for diarrhoeal households and clustering of diarrhoea in households. The presence of clustering was tested using a chi-squared test. The overall prevalences of diarrhoea and clustering of diarrhoea were examined using exogenous variables. Odds ratios, standardized to allow comparison across categories, were computed. The household prevalence of diarrhoea was 12% and that of clustering of diarrhoea was 2.4%. About 6.5% of households contributed 12.6% of the total diarrhoeal cases. Access to safe water and sanitation was shown to have a great impact on reducing diarrhoeal prevalence and clustering across different household groups. Safe water alone had a greater impact on reducing the prevalence in the absence of improved sanitation when compared with the presence of improved sanitation. It may be possible to reduce the prevalence of diarrhoea in households by targeting those households with more than one child in the under-five age group with the provision of safe water and improved sanitation.
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Cryan, B., M. Lynch, and D. Whyte. "Rotavirus in Ireland." Eurosurveillance 2, no. 2 (February 1, 1997): 15–16. http://dx.doi.org/10.2807/esm.02.02.00182-en.
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Acute diarrhoeal disease is the commonest single cause of morbidity and mortality worldwide. Infectious diarrhoea has been estimated to cause at least 5 million deaths each year in the developing world. Very young children are particularly susceptible to
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Magwalivha, Mpho, Jean-Pierre Kabue Ngandu, Afsatou Ndama Traore, and Natasha Potgieter. "Prevalence and Genetic Characterisation of Human Sapovirus from Children with Diarrhoea in the Rural Areas of Vhembe District, South Africa, 2017–2020." Viruses 13, no. 3 (March 1, 2021): 393. http://dx.doi.org/10.3390/v13030393.
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Diarrhoeal disease is considered an important cause of morbidity and mortality in developing areas, and a large contributor to the burden of disease in children younger than five years of age. This study investigated the prevalence and genogroups of human sapovirus (SV) in children ≤5 years of age in rural communities of Vhembe district, South Africa. Between 2017 and 2020, a total of 284 stool samples were collected from children suffering with diarrhoea (n = 228) and from children without diarrhoea (n = 56). RNA extraction using Boom extraction method, and screening for SV using real-time PCR were done in the lab. Positive samples were subjected to conventional RT-PCR targeting the capsid fragment. Positive sample isolates were genotyped using Sanger sequencing. Overall SV were detected in 14.1% (40/284) of the stool samples (16.7% (38/228) of diarrhoeal and 3.6% (2/56) of non-diarrhoeal samples). Significant correlation between SV positive cases and water sources was noted. Genogroup-I was identified as the most prevalent strain comprising 81.3% (13/16), followed by SV-GII 12.5% (2/16) and SV-GIV 6.2% (1/16). This study provides valuable data on prevalence of SV amongst outpatients in rural and underdeveloped communities, and highlights the necessity for further monitoring of SV circulating strains as potential emerging strains.
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Das, Sumon Kumar, Shahnawaz Ahmed, Farzana Ferdous, Fahmida Dil Farzana, Mohammod Jobayer Chisti, Jonathan Ross Latham, Kaisar Ali Talukder, et al. "Etiological diversity of diarrhoeal disease in Bangladesh." Journal of Infection in Developing Countries 7, no. 12 (December 15, 2013): 900–909. http://dx.doi.org/10.3855/jidc.3003.
Full textAbstract:
Background: This study compared the diversity of common diarrhoeal pathogens and antimicrobial susceptibility in four hospitals in Bangladesh. Methodology: A total of 13,959 diarrhoea patients, comprising rural Mirzapur [2,820), rural Matlab (2,865), urban Dhaka (5,287) and urban Mirpur (2,987) were included under the diarrhoeal disease surveillance system of icddr,b during 2010-2011; stool specimens were tested for Shigella spp., Vibrio cholerae, enterotoxigenic Escherichia coli and rotavirus. Results: Rotavirus was highest in Mirzapur (28%) followed by Dhaka (24%), Matlab (19%) and Mirpur (18%). Overall, Shigella was significantly more prevalent in rural sites (Mirzapur 13% and Matlab 7%), than in urban sites (Dhaka 3% and Mirpur 3%). Vibrio cholerae was more common in the urban sites of Dhaka (14%) and Mirpur (12%). 72% of Shigella isolates were susceptible to ciprofloxacin in Mirzapur, and 88% to mecillinam. In Dhaka, the figures for Shigella were 65% and 50%, in Matlab 65% and 85%, and in Mirpur 59% and 92% respectively. Susceptibility of Shigella to azithromycin and ceftriaxone in Dhaka was 74% and 95%, and in Mirpur 88% and 92% respectively. Vibrio cholerae showed the highest resistance to trimethoprim-sulfamethoxazole (100% in Mirpur) and lowest resistance to ciprofloxacin (0% in Dhaka, Matlab and Mirpur) and azithromycin (30% in Dhaka to 7% in Mirzapur). Multidrug resistance (≥ 3 antibiotics) for Shigella were: Mirzapur (50%); Dhaka (36%); Matlab (23%) and Mirpur (37%); and for V. cholerae it was 26%, 37%, 49% and 23% respectively. Conclusion: The isolation rates and antimicrobial susceptibility of Shigella spp. and V. cholerae along with rotavirus differed significantly in certain geographical sites.