Aetiology of diarrhoea in a birth cohort of children aged 0-2 year(s) in rural Mirzapur, Bangladesh.
The incidence of aetiology-specific diarrhoea and the pathogenicity of infectious agents in a birth cohort (n=252) in rural Bangladesh were determined. Stool specimens or rectal swabs were collected from diarrhoeal cases over two years and routinely on a monthly basis. Stool samples from children with diarrhoea were compared with stool samples from children without diarrhoea to calculate rates of isolation and pathogenicity of agents. In total, 1750 stool specimens from diarrhoea patients and 5679 stool specimens from children without diarrhoea were tested. An infectious agent was identified in 58% of the stool specimens from diarrhoea patients and 21.6% of the stool specimens from children without diarrhoea. The most commonly-isolated pathogens from all specimens were enterotoxigenic Escherichia coli (ETEC), enteroadherent E. coli, Shigella, Campylobacter jejuni, Giardia, and rotavirus. ETEC (ST and LT-ST toxin), enterotoxigenic Bacteroides fragilis, Shigella, and rotavirus were associated more with disease than with asymptomatic infections. Aetiology-specific infections were associated with acute episodes. The isolated enteropathogens were essentially the same as those found in other tropical rural settings. Enterotoxigenic B. fragilis was also identified as a pathogen. Ongoing vaccine efforts focusing on Shigella, rotavirus, and ETEC would be useful.
Hasan
Khundkar Z
KZ
Public Health Sciences Division, ICDDR,B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh. Zahid@icddrb.org
Pathela
Preeti
P
Alam
Korshed
K
Podder
Goutam
G
Faruque
Shah M
SM
Roy
Eliza
E
Haque
A K M Fazlul
AK
Haque
Rashidul
R
Albert
M John
MJ
Siddique
Abul K
AK
Sack
R Bradley
RB
D001424:Bacterial Infections / Q000150:complications / Q000453:epidemiology*; D001459:Bangladesh / Q000453:epidemiology; D015331:Cohort Studies; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D004403:Dysentery / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012400:Rotavirus Infections / Q000150:complications / Q000453:epidemiology*