Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh.
In October 1979 a surveillance system was set up at the International Centre for Diarrhoeal Disease Research, Bangladesh, Hospital at Dacca to study a 4% systematic sample of the 100 000 patients with diarrhoea who come to the hospital for care each year. From December 1979 to November 1980 inclusive, 3550 patients were studied. A recognised pathogenic organism was identified for 66% of patients screened for all pathogens, one-third of whom had a mixed infection with two or more agents. Enterotoxigenic Escherichia coli was the most common enteropathogen detected in all age groups (detection rate 20%), followed by rotavirus (19%), Campylobacter jejuni (14%), and Shigella (12%). Infants and young children (up to 5 years) were most often infected with rotavirus, enterotoxigenic E coli, and C jejuni and older children (5-14 years) had more infections with enterotoxigenic E coli, Shigella, and E histolytica. Surveillance has helped to define the range of disease among patients attending the Dacca Hospital. Sixty-five per cent of patients complained of watery diarrhoea, a presentation that was significantly more common in patients with Vibrio cholerae 0:1 (91%), enterotoxigenic E coli (78%), rotavirus (77%), and C jejuni (71%) than in all patients studied. Dysentery, defined as a history of diarrhoea with blood, was the presenting complaint of 20% of all patients but 55% of those with Shigella. Only patients with V cholerae 0:1 and enterotoxigenic E coli were at increased risk for severe dehydration. In addition surveillance has been used to identify areas where patient care can be improved and to generate new ideas for research.
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000150:complications; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D005440:Fluid Therapy; D006373:Helminthiasis / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012400:Rotavirus Infections / Q000150:complications; D012621:Seasons