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Disease Severity and Common Etiology of Diarrhea among Children Under-five in Mirzapur, Rural Bangladesh

Sumon Kumar Das, Shahnawaz Ahmed, Farzana Ferdous, Fahmida Dil Farzana, Guddu Kaur, Mohammod Jobayer Chisti, Kaisar Ali Talukder, Mustafizur Rahman, Shamsun Nahar, Yasmin Ara Begum, Firdausi Qadri, Tahmeed Ahmed, Abu Syed Golam Faruque

International Journal of TROPICAL DISEASE & Health · pp. 82–93 · Published 17 Mar 2013

10.9734/IJTDH/2013/2662

Abstract

Aim: There is lack of information on the severity of diarrheal disease with etiology. Thus the study aimed to compare the etiology of under-five children with moderate-to-severe disease (MSD) and mild disease (MD). Study Design: Diarrheal disease surveillance. Place and Duration of Study: Mirzapur Kumudini Hospital, Tangail, rural Bangladesh, January 2010 – December 2011. Methodology: Overall, 2,324 under-5 diarrhea children were enrolled in the hospital who came from the demographic surveillance system (DSS) catchment area. Whole stool samples were collected from each enrolled child to detect rotavirus, Shigella, ETEC and V. cholerae. Information on socio-demographic and clinical characteristics was also collected. Results: Among all the study children, 1,098 (47%) were aged 0-11 months; 789 (34%) were 12-23 months, and 437 (19%) were 24-59 months. Rotavirus (33%) was mainly responsible for diarrhea amongst children under-5 and 90% of them were less than 2 years. Shigella represented 14%; of which, 45% were 24-59 months old. However, ETEC and V. cholerae represented only 3% and 2% respectively. Shigella was the most commonly detected pathogen (27%) for MSD followed by rotavirus (16%). Conversely, rotavirus (43%) was responsible for MD. MSD were most likely to be infected with Shigella flexneri [OR-9.81; 95% CI (6.38, 15.18)] and Shigella sonnei [6.29; (3.67, 10.87)] compared to their counterparts with MD. In logistic regression analysis, Shigella was responsible for a 2.25 times higher risk for MSD. Children with Shigella were 3.28 times at higher risk for bloody stool and 2.45 times more likely to have fever. However, rotavirus diarrhea was more likely to be presented with vomiting (OR-2.46) and fever (OR-1.28), and Vibrio cholerae, most often with watery diarrhea (OR-4.35). None of the clinical features were significantly associated with ETEC. Conclusion: Shigella was the leading pathogen that was detected most often in MSD, whereas rotavirus was often associated with MD.

Bangladesh diarrhea moderate-to-severe disease rural under-5 children.

References (37)

  1. 1 Diarrheagenic Escherichia coli [DOI]
  2. 2 Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000 [DOI]
  3. 3 Global Illness and Deaths Caused by Rotavirus Disease in Children [DOI]
  4. 4 Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis [DOI]
  5. 5 Global burden of Shigella infections: implications for vaccine development and implementation of control strategies.
  6. 6 Enterotoxigenic Escherichia coli in Developing Countries: Epidemiology, Microbiology, Clinical Features, Treatment, and Prevention [DOI]
  7. 7 Estimating child mortality due to diarrhoea in developing countries [DOI]
  8. 8 A Multicentre Study of Shigella Diarrhoea in Six Asian Countries: Disease Burden, Clinical Manifestations, and Microbiology [DOI]
  9. 9 Reducing deaths from diarrhoea through oral rehydration therapy.
  10. 10 The Global Enteric Multicenter Study (GEMS) of Diarrheal Disease in Infants and Young Children in Developing Countries: Epidemiologic and Clinical Methods of the Case/Control Study [DOI]
  11. 11 Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. [DOI]
  12. 12 Prevalence of Toxin Types and Colonization Factors in Enterotoxigenic Escherichia coli Isolated during a 2-Year Period from Diarrheal Patients in Bangladesh [DOI]
  13. 13 Prevalence of G2P[4] and G12P[6] Rotavirus, Bangladesh [DOI]
  14. 14 Systematic review of diarrhea duration and severity in children and adults in low- and middle-income countries [DOI]
  15. 15 Diarrhea Etiology in a Pediatric Emergency Department: A Case Control Study [DOI]
  16. 16 Polymorphonuclear leukocyte transmigration promotes invasion of colonic epithelial monolayer by Shigella flexneri. [DOI]
  17. 17 The Global Enteric Multicenter Study (GEMS): Impetus, Rationale, and Genesis [DOI]
  18. 18 Rotavirus gastroenteritis [DOI]
  19. 19 Shigellosis: An Old Disease in New Clothes? [DOI]
  20. 20 Phenotypic and Genotypic Characterization of Provisional Serotype Shigella flexneri 1c and Clonal Relationships with 1a and 1b Strains Isolated in Bangladesh [DOI]
  21. 21 Epidemiology of Rotavirus and Cholera in Children Aged Less Than Five Years in Rural Bangladesh [DOI]
  22. 22 A highly selective gelatin-taurocholate-tellurite medium for the isolation of Vibrio cholerae [DOI]
  23. 23 Shigellosis: Innate Mechanisms of Inflammatory Destruction of the Intestinal Epithelium, Adaptive Immune Response, and Vaccine Development [DOI]
  24. 24 Production, characterization, and application of monoclonal antibodies to Vibrio cholerae O139 synonym Bengal [DOI]
  25. 25 Bacterial enteric pathogens in children with acute dysentery in Thailand: increasing importance of quinolone-resistant Campylobacter.
  26. 26 Rapid diagnosis of cholera by coagglutination test using 4-h fecal enrichment cultures [DOI]
  27. 27 Rotavirus vaccines and pathogenesis: 2008 [DOI]
  28. 28 Changing species distribution and antimicrobial susceptibility pattern ofShigellaover a 29-year period (1980–2008) [DOI]
  29. 29 Pathogenic Microorganisms Associated With Childhood Diarrhea in Low-and-Middle Income Countries: Case Study of Yaoundé – Cameroon [DOI]
  30. 30 A comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan [DOI]
  31. 31 Some Epidemiologic, Clinical, Microbiologic, and Organizational Assumptions That Influenced the Design and Performance of the Global Enteric Multicenter Study (GEMS) [DOI]
  32. 32 Characteristics of rotavirus gastroenteritis in hospitalized children in Israel.
  33. 33 Diarrheal Diseases -- Disease Control Priorities in Developing Countries
  34. 34 Nutritional status and diarrhoeal pathogen in hospitalized children in Bangladesh [DOI]
  35. 35 Clinical characteristics and risk factors for Vibrio cholerae infection in children [DOI]
  36. 36 Childhood shigellosis at King Chulalongkorn Memorial Hospital, Bangkok, Thailand: a 5-year review (1996-2000).
  37. 37 Analysis of fecal leukocytes and erythrocytes in Shigella infections in urban Bangladesh.

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