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Summer diarrhoea in African infants and children
Insights
Enteropathogenic Escherichia coli (EPEC) is a significant cause of acute summer diarrhea in South African infants and children. This study highlights the polymicrobial nature of pediatric diarrhea in developing communities.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Acute diarrhea is a major cause of childhood morbidity and mortality in developing countries.
- Identifying causative agents is crucial for effective management and prevention strategies.
Purpose of the Study:
- To investigate the spectrum of enteropathogens causing acute summer diarrhea in black South African infants and children.
- To assess the prevalence of specific pathogens, including enteropathogenic Escherichia coli (EPEC), and the role of polymicrobial infections.
Main Methods:
- A study was conducted on 70 black South African infants and children presenting with acute summer diarrhea.
- Microbiological investigations were performed to identify various enteropathogens.
- Age-matched controls were included for comparison.
Main Results:
- Enteropathogenic Escherichia coli (EPEC) serogroups were detected in 43% of cases.
- Other identified pathogens included enterotoxigenic Gram-negative bacilli (19%), Salmonella sp. (17%), Shigella sp. (9%), and rotaviruses (4%).
- Polymicrobial infections occurred in 19% of patients, and 31% had no pathogen detected. Campylobacter fetus was found in 15% of unselected patients.
Conclusions:
- The study underscores the polymicrobial etiology of pediatric diarrhea in this developing community.
- Enteropathogenic Escherichia coli (EPEC) remains a significant and persistent pathogen in this setting.
- Effective control measures should consider the diverse range of causative agents and the potential for co-infections.
Abstract:
Of 70 black South African infants and children with acute summer diarrhoea, 30 (43%) were infected with enteropathogenic serogroups of Escherichia coli (EPEC), 13 (19%) with enterotoxigenic Gram-negative bacilli, 12 (17%) with Salmonella sp., 6 (9%) with Shigella sp., and 3 (4%) with rotaviruses. 13 (19%) patients were infected simultaneously with more than one enteropathogen, and no pathogen was detected in 22 (31%). In addition, 6 (15%) of 41 unselected patients were excreting Campylobacter fetus. Of 30 age-matched controls drawn from the same population, 5 (17%) were infected with EPEC serotypes, and 1 each with Salmonella sp. and rotavirus. This study stresses the polymicrobial nature of paediatric diarrhoea in a developing community and shows the continued importance of EPEC in this setting.