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CHARACTERISTICS OF DIARRHEAL DISEASE COMPLICATED WITH HEMOLYTIC UREMIC SYNDROME AMONG CHILDREN IN GEORGIA, 2009-2016
O Chokoshvili1, N Vepkhvadze1, T Davitaia1
1Infectious Diseases, AIDS and Clinical Immunology Research Center; Tbilisi State Medical University; M. Iashvili Children's Central Hospital; 4National Center for Disease Control and Public Health, Tbilisi, Georgia.
Georgian Medical News
|December 6, 2018
Summary
Shiga toxin-producing E. coli (STEC) causes severe illness, including bloody diarrhea and hemolytic uremic syndrome (HUS). In Georgia, ice cream, dairy, beef, fruits, and vegetables were identified as risk factors for these conditions in children.
Area of Science:
- Pediatric infectious diseases
- Gastroenterology
- Public health surveillance
Background:
- Shiga toxin-producing Escherichia coli (STEC) infections can lead to severe outcomes like bloody diarrhea and hemolytic uremic syndrome (HUS) in children.
- Surveillance for HUS and bloody diarrhea is lacking in Georgia, necessitating an investigation into the incidence and epidemiology of these diseases.
Purpose of the Study:
- To determine the annual incidence of diarrheal diseases in children under 15 in Georgia.
- To assess the epidemiological characteristics, etiology, and risk factors associated with diarrhea and HUS in this population.
- To identify potential foodborne sources contributing to STEC infections and related illnesses.
Main Methods:
- Retrospective data collection on diarrheal diseases, bloody diarrhea, and HUS in children (2009-2016).
- Laboratory, clinical, and epidemiological data were compiled into an electronic database.
- Statistical analysis using R software to calculate incidence rates, relative risks (RR), and identify risk factors.
Main Results:
- A total of 316 bloody diarrhea cases, with 64 complicated by HUS, were identified in children under 15.
- The average annual incidence rates were 0.3 per 100,000 for HUS and 2 per 100,000 for bloody diarrhea.
- High relative risks were associated with consuming local ice-creams (RR 4.23), dairy products (RR 2.79), ground beef (RR 4.52), fruits (RR 6.19), and vegetables (RR 3.45).
- Enteric pathogens, including STEC, were detected as causative agents. Inadequately washed produce, undercooked foods, and ice cream were implicated as risk factors.
Conclusions:
- STEC infections and associated HUS pose a significant public health concern for children in Georgia.
- Food products such as ice cream, dairy, beef, fruits, and vegetables are potential vehicles for pathogen transmission.
- Improved food safety practices, including thorough washing of produce and adequate cooking of food, are crucial for preventing STEC infections and HUS.
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