Bacteria, parasitic agents and rotaviruses associated with acute diarrhoea in hospital in-patient Indonesian children.

Faeces from children (aged from one month to 12 years) with acute diarrhoea admitted to hospital in Yogyakarta, Indonesia, from June 1978 to June 1979, were examined for the presence of enteric pathogens. One or more recognized enteropathogens were identified in 56% of children. Rotaviruses were identified in 38% of all children. Toxigenic coliforms (predominantly Escherichia coli) were isolated from 12% of children. Salmonella sp. (6%), Shigella sp. (4%) and enteropathogenic parasites (predominantly Trichuris trichiura) from 3.5% of children. Mixed infections with two or more enteric pathogens were found in 7.6% of children. The incidence rate of each pathogen was correlated with age of the child, socio-economic level of the family and duration of breast feeding. Toxigenic coliforms were equally common in all age groups from both well-to-do and poor families. Enteropathogenic parasites appeared in increasing frequency with age. They were more common in artificially fed children and in children from families of low socio-economic level. The occurrence of multiple infection with mixtures of enteric pathogens increased with increasing age. Mixtures of parasites and other enteric pathogens only occurred in children with acute diarrhoea. These results provide baseline data about the relative importance of different enteropathogens in Indonesian children.

Acute diarrhea and rotavirus infection in newborn babies and children in Yogyakarta, Indonesia, from June 1978 to June 1979.

A longitudinal study of acute diarrhea in children in Yogyakarta, Indonesia (June 1978 to June 1979), showed little variation throughout most months of the year in numbers of children admitted to hospital and in numbers infected with rotaviruses. Both decreased during November and December coincidentally with seasonal change from dry to wet conditions. Rotavirus particles were identified by electron microscopy in fecal specimens from 126 of 334 (38%) infants and children with acute diarrhea. Nosocomial rotavirus infections occurred in 11% of control children admitted to hospital for other reasons. Socioeconomic level and preexisting nutritional status did not influence the incidence of rotavirus excretion. Rotavirus infections were most common in children aged 6 to 24 months. There was a low incidence of infection in infants less than 6 months old. Rotavirus infection was seldom observed in newborn babies delivered in an urban hospital nursery, in a rural health center, or at home. One of 72 newborn babies with diarrhea excreted rotavirus. One of 53 healthy newborn babies excreted rotavirus. It is concluded that, in Indonesia, rotavirus infection is a major cause of childhood diarrhea throughout the year, but is an uncommon cause of diarrhea in newborn babies.

The use of antibiotics in childhood diarrhea.

PIP: A comparative study was undertaken in Indonesia to assess the effect of antibiotic therapy in the treatment of acute diarrheal disease in infants. 120 children, age 2-60 months, suffering form acute gastroenteritis with varying degrees of dehydration who were treated at the Gadjah Mada University Hospital in Yogyakarta, Indonesia, between August and December 1975, were included in the study. Approximately 1/2 the group was treated with antibiotics; the other 1/2 was not. Both groups received oral rehydration therapy. No significant differences were found between the 2 groups as to duration of the diarrhea and duration of hospitalization. It is concluded that antibiotics are not generally indicated in cases of acute diarrheal disease. The only requirements in treatment seems to be maintenance of the fluid electrolyte balance.^ieng