title: Aetiology of diarrhoea in a birth cohort of children aged 0-2 year(s) in rural Mirzapur, Bangladesh.
abstract: 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.
authors.affiliation: Public Health Sciences Division, ICDDR,B: Centre for Health and Population Research, GPO Box 128, Dhaka 1000, Bangladesh. Zahid@icddrb.org
authors.forename: Khundkar Z
authors.initials: KZ
authors.lastname: Hasan
authors.forename: Preeti
authors.initials: P
authors.lastname: Pathela
authors.forename: Korshed
authors.initials: K
authors.lastname: Alam
authors.forename: Goutam
authors.initials: G
authors.lastname: Podder
authors.forename: Shah M
authors.initials: SM
authors.lastname: Faruque
authors.forename: Eliza
authors.initials: E
authors.lastname: Roy
authors.forename: A K M Fazlul
authors.initials: AK
authors.lastname: Haque
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.forename: M John
authors.initials: MJ
authors.lastname: Albert
authors.forename: Abul K
authors.initials: AK
authors.lastname: Siddique
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Sack
mesh_terms: 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*