title: Burden of Rotavirus and Enteric Bacterial Pathogens among Children under 5 Years of Age Hospitalized with Diarrhea in Suburban and Rural Areas in Kenya.
abstract: This cross-sectional descriptive study aimed to investigate the incidence of rotavirus and enteric bacterial infections among children up to 5 years old with diarrhea living in suburban and rural areas of Kenya. Between August 2011 and December 2013, a total of 1,060 diarrheal fecal specimens were obtained from 722 children at Kiambu County Hospital (KCH), located in a suburban area, and from 338 children from Mbita District Hospital (MDH), located in a rural part of western Kenya. Of the 1,060 isolates, group A rotavirus was detected in 29.6% (214/722) and 11.2% (38/338) fecal specimens from KCH and MDH, respectively. Diarrheagenic Escherichia coli (DEC) was found to be the most frequently isolated bacterial pathogens in both study areas (32.8% at KCH and 44.1% at MDH). Two different mixed infection patterns (virus/bacteria and bacteria/bacteria) were observed among patients. A significantly higher infection rate of rotavirus (17.6%, p = 0.001) and DEC (10.5%, p = 0.007) were observed during the dry season. Our study found that in both suburban and rural settings in Kenya, rotavirus and DEC are the principal cause of pediatric diarrhea and exhibit higher incidence during the dry season.
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.|Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine.|Leading Graduate School Program, Nagasaki University.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shah
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.
authors.forename: Erick
authors.initials: E
authors.lastname: Odoyo
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.|Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine.|Leading Graduate School Program, Nagasaki University.
authors.forename: Ernest
authors.initials: E
authors.lastname: Wandera
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Kathiiko
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.
authors.forename: Martin
authors.initials: M
authors.lastname: Bundi
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Miringu
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.
authors.forename: Sora
authors.initials: S
authors.lastname: Guyo
authors.affiliation: Department of Virology and Parasitology, School of Medicine, Fujita Health University.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Komoto
authors.affiliation: Centre for Virus Research, Kenya Medical Research Institute (KEMRI).
authors.forename: James
authors.initials: J
authors.lastname: Nyangao
authors.affiliation: Centre for Public Health Research, Kenya Medical Research Institute (KEMRI).
authors.forename: Mohamed
authors.initials: M
authors.lastname: Karama
authors.affiliation: Department Microbiology, School of Medicine, Fujita Health University.
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Virology and Parasitology, School of Medicine, Fujita Health University.
authors.forename: Koki
authors.initials: K
authors.lastname: Taniguchi
authors.affiliation: Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine.|Department of Virology, Nagasaki University Institute of Tropical Medicine.|Leading Graduate School Program, Nagasaki University.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Morita
authors.affiliation: Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project.|Centre for Infectious Disease Research in Asia and Africa, Nagasaki University Institute of Tropical Medicine.|Leading Graduate School Program, Nagasaki University.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ichinose
mesh_terms: D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology*; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004403:Dysentery / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology*; D012424:Rural Population; D012621:Seasons; D013383:Suburban Population
keywords: diarrhea; diarrheagenic E. coli; group A rotavirus; sociodemographic disparity ; suburban and rural settings