title: Diarrhoeagenic Escherichia coli and other causes of childhood diarrhoea: a case-control study in children living in a wastewater-use area in Hanoi, Vietnam.
abstract: A case-control study was conducted to identify the aetiology of diarrhoeal diseases in pre-school children in a suburban area of Hanoi where the use of untreated wastewater in agriculture and aquaculture is a common practice. Stool specimens and clinical information were collected from 111 pairs of children with diarrhoea and healthy controls. A total of 73 cases (66 %) and 41 controls (36 %) had an enteric pathogen. The pathogens most often associated with diarrhoea were rotavirus (17 % of cases) and Entamoeba histolytica (15 %), followed by Shigella (5 %). Diarrhoeagenic Escherichia coli (DEC) was found in 23 % of both patients and controls. Characterization of DEC by serotyping, antimicrobial susceptibility test and PFGE showed that DEC represented by different pathotypes belonged to various serotypes. Except for three enterotoxigenic E. coli strains, typing by PFGE revealed no correlation between pathotype and serotype of DEC strains. This suggests a high prevalence of a variety of DEC subtypes in this area. For this particular region, vaccine development strategies targeting rotavirus and Shigella are likely to be of public health benefit, whereas the role of DEC and preventive measures need to be further elaborated.
authors.affiliation: Department of Veterinary Pathobiology, Faculty of Life Science, Copenhagen University, Frederiksberg, Denmark.|Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Bui Thi Thu
authors.initials: BTT
authors.lastname: Hien
authors.affiliation: Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Do Thuy
authors.initials: DT
authors.lastname: Trang
authors.affiliation: International Escherichia and Klebsiella Centre (WHO), Department of Bacteriology, Mycology, and Parasitology, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Scheutz
authors.affiliation: Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Phung Dac
authors.initials: PD
authors.lastname: Cam
authors.affiliation: Department of Epidemiology, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Kåre
authors.initials: K
authors.lastname: Mølbak
authors.affiliation: Department of Veterinary Pathobiology, Faculty of Life Science, Copenhagen University, Frederiksberg, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Dalsgaard
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology; D004748:Entamoeba histolytica / Q000302:isolation & purification*; D004749:Entamoebiasis / Q000453:epidemiology* / Q000469:parasitology; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D051639:Gardening; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D012401:Rotavirus / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology; D012703:Serotyping; D012760:Shigella / Q000302:isolation & purification*; D013383:Suburban Population; D014744:Vietnam / Q000453:epidemiology; D018505:Waste Management
chemical_list: D000900:Anti-Bacterial Agents