title: Acute diarrhoea in children treated in an outpatient setting in Athens, Greece.
abstract: OBJECTIVE
  To describe the epidemiology and aetiology of acute diarrhoea among children treated exclusively in an outpatient setting in Greece.
  
  
  METHODS
  During 1999, children with acute diarrhoea who attended the emergency department of our hospital were prospectively studied. Patients requiring hospitalization were excluded. Stool specimens were tested microscopically, for bacterial enteropathogens by standard and selective medium cultures and for rotavirus and adenovirus by latex agglutination test.
  
  
  RESULTS
  One hundred and thirty-two children (median age: 2 years) were included in the study; an enteropathogen was detected in 63 (48%) of them. Isolates included rotavirus (19 patients), Salmonella sp (12), Campylobacter sp (10), Aeromonas sp (9), enteropathogenic Escherichia coli (6), adenovirus (6), Giardia lamblia (4), Yersinia enterocolitica (2) and Shigella sp (1). Half of the bacterial cases occurred from August to October, and two rotavirus-associated peaks occurred during February and August. Acute diarrhoea caused by viruses affected exclusively children under six years of age, mainly those attending day care centres. Macroscopic blood in stools was reported only among patients with a bacterial infection. Socioeconomic characteristics were not helpful in differentiating disease due to specific enteropathogens.
  
  
  CONCLUSIONS
  Bacterial enteropathogens account for a significant proportion of acute diarrhoea in children treated in the outpatient setting in Greece. Rotavirus is also a frequent cause affecting mostly younger children and those attending day care centers. The presence of blood in stools and the seasonality of bacterial infections may enable their presumptive diagnosis.
authors.affiliation: University of Athens Second Department of Pediatrics, P. & A. Kyriakou Children's Hospital, Athens, Greece.
authors.forename: H C
authors.initials: HC
authors.lastname: Maltezou
authors.forename: A
authors.initials: A
authors.lastname: Zafiropoulou
authors.forename: M
authors.initials: M
authors.lastname: Mavrikou
authors.forename: E
authors.initials: E
authors.lastname: Bozavoutoglou
authors.forename: G
authors.initials: G
authors.lastname: Liapi
authors.forename: M
authors.initials: M
authors.lastname: Foustoukou
authors.forename: D A
authors.initials: DA
authors.lastname: Kafetzis
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012621:Seasons; D012959:Socioeconomic Factors