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[Etiologic profile of acute diarrhea in children in São Paulo]

Eloisa C Souza1, Marina B Martinez, Carla R Taddei

  • 1Universidade de São Paulo (USP), SP, Brazil.

Jornal De Pediatria
|December 4, 2003
PubMed

Insights

Bacteria, particularly Escherichia coli, were the most common cause of acute diarrhea in young children from low-income backgrounds. Mixed viral and bacterial infections increased the severity of symptoms and hospitalization rates.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Acute diarrhea remains a significant health concern in socioeconomically deprived populations.
  • Identifying the causative agents of acute diarrhea is crucial for effective treatment and prevention strategies.

Purpose of the Study:

  • To determine the etiologic profile of acute diarrhea in children under five years old from low-income communities.
  • To compare the prevalence of fecal pathogens in children with and without acute diarrhea.

Main Methods:

  • Stool samples from 154 children with acute diarrhea and 42 controls were analyzed over two years.
  • Microorganisms tested included rotavirus, various bacteria (e.g., Escherichia coli, Shigella, Salmonella), and protozoa (Giardia lamblia).
  • Detection methods included immunofluorescence, counterimmunoelectrophoresis, bacterial culture, serotyping, toxin detection, and microscopic examination.

Main Results:

  • Intestinal pathogens were identified in 72.8% of acute diarrhea cases versus 21.5% in controls.
  • Bacteria were the most frequent pathogens (34.4%), followed by rotavirus (20.8%).
  • Mixed viral and bacterial infections were associated with increased vomiting, dehydration, and hospitalization.

Conclusions:

  • Bacteria, especially Escherichia coli (predominantly non-EPEC strains), were the leading cause of acute diarrhea in this cohort.
  • Rotavirus was also a significant contributor, often co-occurring with bacterial infections.
  • Protozoa played a minor role in the etiology of acute diarrhea.

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