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Case-Control Pilot Study on Acute Diarrheal Disease in a Geographically Defined Pediatric Population in a Middle
Ana E Farfán-García1, Chengxian Zhang2, Aamer Imdad2,3
1Grupo de Investigación en Manejo Clínico (CliniUDES), Programa de Bacteriología y Laboratorio Clínico, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Colombia.
Insights
A study in Colombia found that enteroaggregative E. coli, Norovirus, and Salmonella were the most common causes of acute diarrheal disease (ADD) in young children. Comprehensive pathogen detection is crucial for understanding ADD etiology in low-income settings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Acute diarrheal disease (ADD) is a significant cause of illness and death in children under five.
- Limited pathogen detection in low- and middle-income countries hinders understanding of ADD causes.
- A comprehensive approach is needed to identify enteric pathogens in children with ADD.
Purpose of the Study:
- To assess the feasibility of a detailed case-control study for surveying diarrheal pathogens.
- To identify common enteropathogens in children with and without moderate-to-severe ADD in Bucaramanga, Colombia.
Main Methods:
- Utilized microbiology and molecular techniques for detecting viral, bacterial, and parasitic enteropathogens.
- Conducted a case-control study involving 90 children under five (45 cases, 45 controls).
- Obtained Institutional Review Board approval and informed consent from guardians.
Main Results:
- 40% of the 90 children studied tested positive for at least one enteropathogen.
- Enteropathogens were detected in 44.4% of cases and 35.5% of controls.
- Enteroaggregative E. coli (10.0%), Norovirus (6.7%), and Salmonella spp. (5.6%) were the most prevalent pathogens.
Conclusions:
- Enteroaggregative E. coli was the most frequent pathogen, accounting for 18.8% of all infections.
- A significant proportion (50%) of ADD cases did not show detectable pathogens.
- Comprehensive pathogen surveillance is feasible and necessary for understanding ADD in diverse settings.
Introduction:
Acute diarrheal disease (ADD) is a common cause of morbidity and mortality in children under 5 years of age. Understanding of the etiology of ADD is lacking in most low and middle income countries because reference laboratories detect limited number of pathogens. The objective of this study was to determine the feasibility to conduct a comprehensive case-control study to survey diarrheal pathogens among children with and without moderate-to-severe ADD.
Materials And Methods:
Microbiology and molecular-based techniques were used to detect viral, bacterial, and parasitic enteropathogens. The study was conducted in Bucaramanga, Colombia, after Institutional Review Board approval was obtained.
Results:
Ninety children less than 5 years of age were recruited after a written informed consent was obtained from parents or guardians. Forty-five subjects served as cases with ADD and 45 as controls. Thirty-six subjects out of 90 (40.0%) were positive for at least one enteropathogen, that is, 20 (44.4%) cases and 16 (35.5%) controls.
Conclusions:
The three most common enteric pathogens were enteroaggregative E. coli (10.0%), Norovirus (6.7%), and Salmonella spp. (5.6%). The E. coli pathogens were 18.8% of all infections making them the most frequent pathogens. Half of ADD cases were negative for any pathogens.
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