Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh
- PMID: 10523534
- PMCID: PMC85667
- DOI: 10.1128/JCM.37.11.3458-3464.1999
Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh
Abstract
The International Centre for Diarrhoeal Disease Research, Bangladesh, is a major center for research into diarrheal diseases. The center treats more than 100,000 patients a year. To obtain useful information representative of all patients, a surveillance system in which a 4% systematic sample of all patients is studied in detail, including etiological agents of diarrhea, was installed in October 1979. The first paper on etiology for the surveillance patients was published in 1982, which identified a potential enteric pathogen in 66% of patients. In subsequent years, several new agents of diarrhea have been identified. To assess the importance of a broader spectrum of diarrheal agents including the ones identified relatively recently, we studied 814 children with diarrhea. The children were up to 5 years of age and were part of the surveillance system. They were matched with an equal number of community controls without diarrhea. The study was conducted from February 1993 to June 1994. A potential enteric pathogen was isolated from 74.8% of diarrheal children and 43.9% of control children (P = 0.0001). Even though the first study was not a case-control study, it identified rotavirus, Campylobacter jejuni, enterotoxigenic Escherichia coli, Shigella spp. , and Vibrio cholerae O1 as major pathogens. The present study identified these pathogens as being significantly associated with diarrhea. In addition, the study also identified six additional agents, including enteropathogenic E. coli, Aeromonas spp., V. cholerae O139, enterotoxigenic Bacteroides fragilis, Clostridium difficile, and Cryptosporidium parvum, as being significantly associated with diarrhea. Plesiomonas shigelloides, Salmonella spp., diffusely adherent E. coli, enteroaggregative E. coli, Entamoeba histolytica, and Giardia lamblia were not significantly associated with diarrhea. Enteroinvasive E. coli, enterohemorrhagic E. coli, and Cyclospora cayetanensis were not detected in any of the children. The major burden of diseases due to most pathogens occurred in the first year of life. As in the previous study, seasonal patterns were seen for diarrhea associated with rotavirus, V. cholerae, and enterotoxigenic E. coli, and infections with multiple pathogens were common. With a few exceptions, these findings are in agreement with those from other developing countries. This knowledge of a broader spectrum of etiological agents of diarrhea in the surveillance patients will help us plan studies into various aspects of diarrheal diseases in this population.
Figures
Similar articles
-
Two-year survey of etiologic agents of diarrheal disease at San Lazaro Hospital, Manila, Republic of the Philippines.J Clin Microbiol. 1987 Jul;25(7):1143-7. doi: 10.1128/jcm.25.7.1143-1147.1987. J Clin Microbiol. 1987. PMID: 3038946 Free PMC article.
-
Two-year study of endemic enteric pathogens associated with acute diarrhea in New Caledonia.J Clin Microbiol. 1994 Jun;32(6):1532-6. doi: 10.1128/jcm.32.6.1532-1536.1994. J Clin Microbiol. 1994. PMID: 8077399 Free PMC article.
-
Bacterial, viral and parasitic enteric pathogens associated with acute diarrhea in hospitalized children from northern Jordan.FEMS Immunol Med Microbiol. 2000 Jul;28(3):257-63. doi: 10.1111/j.1574-695X.2000.tb01485.x. FEMS Immunol Med Microbiol. 2000. PMID: 10865179
-
Enteropathogens associated with acute diarrhoeal diseases.Indian J Public Health. 1994 Apr-Jun;38(2):29-32. Indian J Public Health. 1994. PMID: 7835992 Review.
-
Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part II: Vaccines for Shigella, Salmonella, enterotoxigenic E. coli (ETEC) enterohemorragic E. coli (EHEC) and Campylobacter jejuni.Hum Vaccin Immunother. 2015;11(3):601-19. doi: 10.1080/21645515.2015.1011578. Hum Vaccin Immunother. 2015. PMID: 25715096 Free PMC article. Review.
Cited by
-
Enteroaggregative Escherichia coli in mid-Norway: A prospective, case control study.PLoS One. 2024 Apr 18;19(4):e0301625. doi: 10.1371/journal.pone.0301625. eCollection 2024. PLoS One. 2024. PMID: 38635516 Free PMC article.
-
Shigella Detection and Molecular Serotyping With a Customized TaqMan Array Card in the Enterics for Global Health (EFGH): Shigella Surveillance Study.Open Forum Infect Dis. 2024 Mar 25;11(Suppl 1):S34-S40. doi: 10.1093/ofid/ofad574. eCollection 2024 Mar. Open Forum Infect Dis. 2024. PMID: 38532960 Free PMC article.
-
An estimation of global Aeromonas infection prevalence in children with diarrhoea: a systematic review and meta-analysis.BMC Pediatr. 2023 May 22;23(1):254. doi: 10.1186/s12887-023-04081-3. BMC Pediatr. 2023. PMID: 37217902 Free PMC article.
-
Etiology of Acute Diarrheal Disease and Antimicrobial Susceptibility Pattern in Children Younger Than 5 Years Old in Nepal.Am J Trop Med Hyg. 2022 Dec 5;108(1):174-180. doi: 10.4269/ajtmh.21-1219. Print 2023 Jan 11. Am J Trop Med Hyg. 2022. PMID: 36509064 Free PMC article.
-
Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1-24 Months in Low-Resource Settings.Life (Basel). 2022 Apr 19;12(5):607. doi: 10.3390/life12050607. Life (Basel). 2022. PMID: 35629275 Free PMC article.
References
-
- Albert M J, Kabir I, Azim T, Hossain A, Ansaruzzaman M, Unicomb L. Diarrhea associated with Cyclospora sp. in Bangladesh. Diagn Microbiol Infect Dis. 1994;19:47–49. - PubMed
-
- Baqui A, Sack R B, Black R E, Haider K, Hossain A, Alim A R M A, Yunus M, Chowdhury H R, Siddique A K. Enteropathogens associated with acute and persistent diarrhea in Bangladeshi children <5 years of age. J Infect Dis. 1992;166:792–796. - PubMed
-
- Bardhan P K, Albert M J, Alam N H, Faruque S M, Neogi P K B, Mahalanabis D. Small bowel and fecal microbiology in children suffering from persistent diarrhea in Bangladesh. J Ped Gastroenterol Nutr. 1998;26:9–15. - PubMed
-
- Bhan M K, Raj P, Levine M M, Kaper J B, Bhandari N, Srivastava R, Kumar R, Sazawal S. Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India. J Infect Dis. 1989;159:1061–1064. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous