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Diarrheal morbidity and mortality in children in the Central African Republic
Insights
Diarrheal disease is a major health concern in Bangui, affecting children under 5. Rotavirus was significantly associated with diarrhea in infants, highlighting its role in childhood illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Diarrheal diseases pose a significant threat to child survival globally, particularly in resource-limited settings.
- High rates of diarrheal morbidity and mortality in children under five have been reported in Bangui, Central African Republic.
Purpose of the Study:
- To investigate the prevalence and incidence of diarrheal diseases in children under five in Bangui.
- To identify the etiologic agents responsible for diarrheal disease in this population.
- To determine the association between specific pathogens and diarrheal episodes.
Main Methods:
- A cluster survey design was employed in Bangui, Central African Republic.
- Stool specimens were collected from children with diarrhea and healthy controls for etiological analysis.
- Statistical methods were used to analyze the incidence, mortality rates, and pathogen isolation data.
Main Results:
- The estimated annual incidence of diarrhea was 7 episodes per child per year.
- Diarrhea was associated with 51.6% of deaths in children under five.
- Rotavirus was significantly more prevalent in infants with diarrhea (24%) compared to controls (0%).
- Other common enteric pathogens like Campylobacter jejuni, Entamoeba histolytica, and pathogenic E. coli showed no significant difference between cases and controls.
Conclusions:
- Diarrheal disease represents a critical public health issue in Bangui, contributing substantially to child mortality.
- Rotavirus is a key etiological agent implicated in infant diarrhea in this region.
- Further interventions targeting rotavirus may be crucial for reducing diarrheal burden in young children in Bangui.
Abstract:
Diarrheal morbidity and mortality in children less than 5 years old were studied in Bangui, Central African Republic, by a cluster survey. We found a high prevalence of diarrheal disease with an estimated annual incidence of 7 episodes of diarrhea per child per year. The estimated annual mortality rate for children less than 5 years old was 28.6 per 1,000 and 85.8 per 1,000 for infants; 51.6% of deaths were reported to be associated with diarrhea. During the survey, stool specimens were collected from 133 children with current diarrhea and 117 control children to study the etiologic agents of diarrheal disease in the community. An enteric pathogen was identified in 58% of diarrheal children's stools and 48% of stools of well children. A statistically significant association between diarrhea and rotavirus was found, with it being isolated from 8 of 33 (24%) of stools of infants with diarrhea compared to 0 of 25 (0%) of control infants. Isolation rates for Campylobacter jejuni, Entamoeba histolytica, pathogenic Escherichia coli, and other bacterial enteropathogens did not differ significantly between children with diarrhea and control children.