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New and old agents in diarrhea: a prospective study of an indigenous adult African population
Abstract:
We conducted a prospective study 77 indigenous African adults with acute diarrhea seeking care at the major hospital in Nairobi, Kenya, to determine the major pathogens responsible for this syndrome in adults. Fecal and blood specimens were collected and examined for enteric bacterial pathogens, viruses, and parasites. In 13 (26%) inpatients and 11 (49%) outpatients Shigella was found, and heat-labile and heat-stable forms of enterotoxigenic Escherichia coli were found in 9 (18%) inpatients and 1 (4%) outpatient. Human revirus-like agent titers rose significantly in another 3 (6%). Amebic dysentery was not seen although hemagglutination-inhibition tests for invasive Entamoeba histolytica were positive in 4 inpatients. An etiologic agent was found in 65% of patients.
Insights
Shigella and enterotoxigenic Escherichia coli were the primary bacterial pathogens identified in adults with acute diarrhea in Nairobi, Kenya. Etiologic agents were identified in 65% of the study participants.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Acute diarrhea poses a significant health burden in adults, particularly in resource-limited settings.
- Identifying causative pathogens is crucial for effective treatment and control strategies.
Purpose of the Study:
- To determine the predominant enteric pathogens responsible for acute diarrhea in adult patients in Nairobi, Kenya.
- To assess the prevalence of bacterial, viral, and parasitic agents in this population.
Main Methods:
- Prospective study of 77 adult patients with acute diarrhea admitted to or seeking care at a major Nairobi hospital.
- Collection and examination of fecal and blood specimens for enteric bacterial pathogens, viruses, and parasites.
Main Results:
- Shigella was identified in 26% of inpatients and 49% of outpatients.
- Enterotoxigenic Escherichia coli (ETEC) was found in 18% of inpatients and 4% of outpatients.
- An etiologic agent was identified in 65% of all patients, with Shigella and ETEC being the most common.
Conclusions:
- Shigella and enterotoxigenic E. coli are major bacterial causes of acute diarrhea in adults in Nairobi.
- A significant proportion of adult diarrhea cases remain undiagnosed, highlighting the need for further etiological investigations.