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Aetiological factors of infantile diarrhoea: a community-based study
W E Loening1, Y M Coovadia, J van den Ende
1Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, South Africa.
Insights
Rotavirus is the leading cause of diarrhea in children, followed by bacterial pathogens like enteropathogenic E. coli. Environmental factors and home remedies complicate diarrhea management in developing communities.
Area of Science:
- Pediatrics
- Infectious Diseases
- Environmental Health
Background:
- Diarrhea remains a significant health challenge for children in developing communities.
- Understanding causative agents and contributing factors is crucial for effective intervention.
Purpose of the Study:
- To compare the microbial causes of diarrhea in children from formal housing versus deprived environments.
- To assess the role of "home remedies" in childhood diarrhea.
Main Methods:
- Community-based study involving children with diarrhea and symptom-free controls.
- Microbiological analysis to identify bacterial, viral, and parasitic pathogens.
- Questionnaires or assessments regarding the use of home remedies.
Main Results:
- Rotavirus was the most common agent (15% of cases), significantly higher than in controls (9%).
- Bacterial pathogens, notably enteropathogenic E. coli (9%), Shigella (4%), and Campylobacter jejuni (4%), were prevalent.
- Giardia lamblia (6%) and Cryptosporidium (3%) were also detected; over 90% used home remedies.
Conclusions:
- Diarrhea etiology in developing communities is complex, involving multiple pathogens.
- Environmental factors and the widespread use of home remedies significantly influence diarrhea incidence and management.
- Further research is needed to address these multifaceted issues.
Abstract:
A community-based study was undertaken to compare the organisms responsible for diarrhoea in children living in formal housing with indoor water supply and sanitation with those from a deprived environment. The role of "home remedies" was also assessed. Among 373 children with diarrhoea, rotavirus was detected in 15% (in 371 symptom-free controls, 9%), and proved to be the single most common causative agent. Bacterial pathogens were found in 20% of patients, with enteropathogenic Escherichia coli (EPEC) being isolated most frequently (9%; controls 3%), followed by Shigella species (4%; controls 1%), Campylobacter jejuni (4%; controls 1%), Salmonella species (2%; controls 1%) and enterotoxigenic E. coli (ETEC) (2%; controls 1%). Giardia lamblia and cryptosporidium were detected in 6% (controls 6%) and 3% (controls 1%) of patients, respectively; 7% (controls 1%) harboured more than one enteropathogen and no pathogens were detected in 58% (controls 78%). The vast majority (greater than 90%) of both patients and controls received some form of "home remedy" which included disinfectants and traditional herbs. The findings of this study therefore confirm the extremely complex nature of diarrhoea in developing communities and indicate that environmental factors are compounded by other issues.