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Diarrhoeal disease in children in Gaza
S Sallon1, R el-Shawwa, M Khalil
1Department of Medical Microbiology, University of Liverpool, U.K.
Insights
Cryptosporidium and rotavirus were the main causes of diarrhea in young children in Gaza. Cryptosporidiosis, prevalent in malnourished children under two, was linked to overcrowding and prolonged illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Diarrheal diseases pose a significant threat to children under five globally.
- Identifying key enteropathogens is crucial for effective treatment and prevention strategies.
Purpose of the Study:
- To investigate the prevalence and clinical significance of enteropathogens causing diarrhea in young children in Gaza.
- To identify risk factors and outcomes associated with specific infections.
Main Methods:
- A 1-year prospective study was conducted in Gaza.
- Diarrheal cases in children under five were compared with non-diarrheal controls.
- Pathogen identification included Salmonella spp., Cryptosporidium, Campylobacter spp., and rotavirus.
Main Results:
- Salmonella spp., Cryptosporidium, Campylobacter spp., and rotavirus were identified as major pathogens.
- Only Cryptosporidium and rotavirus showed a significant association with diarrhea compared to controls.
- Cryptosporidiosis occurred in children under two, with a higher incidence of malnutrition and longer diarrhea duration (14.9 days).
- Rotavirus infection was associated with vomiting and shorter diarrhea duration (5.9 days).
- Overcrowding increased cryptosporidiosis risk, while breastfeeding offered protection.
- Cryptosporidium was detected in 38% of children who died from diarrhea.
Conclusions:
- Cryptosporidium and rotavirus are significant contributors to childhood diarrhea in Gaza.
- Malnutrition and overcrowding are key risk factors for cryptosporidiosis.
- Early diagnosis and intervention are critical, especially for vulnerable populations.
Abstract:
A 1-year prospective study in Gaza of diarrhoeal disease in children aged < 5 years demonstrated that Salmonella spp. (18.5% of cases), Cryptosporidium (14.6%), Campylobacter spp. (8.3%) and rotavirus (6.8%) were the major pathogens. However, when compared with non-diarrhoeic controls, only Cryptosporidium and rotavirus were significantly associated with diarrhoea. Cryptosporidiosis was found only in children aged < 2 years and significantly more children with cryptosporidiosis were malnourished. This malnutrition may have been due to the infection, since children with cryptosporidiosis tended to have had diarrhoea for relatively long periods prior to admission. It was not possible to distinguish between the different enteropathogens on clinical grounds. However, more children with rotavirus infection vomited and cryptosporidial diarrhoea lasted significantly longer (14.9 days) than rotavirus diarrhoea (5.9 days). Overcrowding was linked with an increased risk of cryptosporidiosis and breast feeding was associated with some protection. Twenty-one of the 29 children who died during the study died with diarrhoea and Cryptosporidium was detected in eight (38%) of these 21 children.