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Etiology and epidemiology of persistent diarrhea in northeastern Brazil: a hospital-based, prospective, case-control

G D Fang1, A A Lima, C V Martins

  • 1Department of Medicine, University of Virginia School of Medicine, Charlottesville 22908, USA.

Journal of Pediatric Gastroenterology and Nutrition
|August 1, 1995
PubMed

Insights

Persistent diarrhea in children is often caused by pathogens, with enteroaggregative Escherichia coli (EAggEC) frequently identified. Multiple pathogens were common in both persistent and acute diarrhea cases, highlighting the complexity of pediatric diarrheal diseases.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Gastroenterology

Background:

  • Persistent diarrhea (> 14 days) is a growing concern in developing nations due to improved acute diarrhea treatments.
  • The exact causes and mechanisms of persistent diarrhea are not well understood.
  • Understanding the etiology is crucial for effective management and prevention strategies.

Purpose of the Study:

  • To investigate the etiologies of persistent diarrhea in young children in Brazil.
  • To compare the prevalence of specific pathogens in persistent diarrhea, acute diarrhea, and control groups.
  • To identify the role of enteroaggregative Escherichia coli (EAggEC) in persistent diarrhea.

Main Methods:

  • A prospective case-control study was conducted in Fortaleza, Brazil, involving children under 3 years old.
  • Participants included children with persistent diarrhea, acute diarrhea, and healthy controls.
  • Microbiological analysis was performed to identify potential pathogens, including EAggEC.

Main Results:

  • A high percentage of children with persistent diarrhea (91%) and acute diarrhea (90%) had identified pathogens, compared to controls (45%).
  • Multiple pathogens were found in 34% of persistent diarrhea cases and 38% of acute diarrhea cases.
  • Enteroaggregative Escherichia coli (EAggEC) was significantly more prevalent in children with persistent diarrhea (68%) and acute diarrhea (46%) than in controls (31%).

Conclusions:

  • Pathogens are frequently identified in children with persistent diarrhea, similar to acute diarrhea cases.
  • Enteroaggregative Escherichia coli (EAggEC) is a significant pathogen associated with both persistent and acute diarrhea in this population.
  • Further research into the pathogenesis of EAggEC is warranted for targeted interventions.

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