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1.
Zhonghua Er Ke Za Zhi ; 62(7): 643-648, 2024 Jul 02.
Artigo em Chinês | MEDLINE | ID: mdl-38955682

RESUMO

Objective: To investigate the association between intestinal colonization of segmented filamentous bacteria (SFB) and the risk of rotavirus infection, and the possible mechanisms by which SFB resist rotavirus infection. Methods: This case-control study enrolled 50 children aged 0 to 5 years who present to the outpatient Department of Children's Hospital, Zhejiang University School of Medicine with diarrhea and positive stool tests for rotavirus. The children were divided into rotavirus enteritis group and control group consisting of 55 children with non-gastrointestinal and non-infectious surgical diseases.The age and sex composition of the two groups was matched. The DNA of the fecal flora was extracted and SFB was detected by real-time fluorescence quantitative PCR analysis. The children in the rotavirus enteritis group and the control group were subgrouped by age and sex to analyze the differences in SFB positivity rates between different groups, and further compare and analyze the differences in SFB positivity rates between these two groups of children in the ≤2 years old subgroup and the >2-5 years old subgroup. Neutralization test was performed with p3340 protein and rotavirus to determine the relationship between rotavirus infection rate and p3340 concentration in Vero cells. χ2 test or Fisher's exact probability method was used for comparison between the two groups. Results: There were 50 children in the rotavirus enteritis group with an age of (1.7±0.9) years, and 55 children in the control group with an age of (1.8±1.1) years. The positive rate of SFB in children with rotavirus enteritis showed a declining trend across ages groups, with the highest rate of 10/14 in the ≤1 year old group, followed by 67% (14/21) in the >1-2 years old group, 9/15 in the >2-5 years old group, and there was no statistically significant difference (P=0.867). The positive rate of SFB in the control group was 12/15 in the ≤1 year old group, 95% (19/20) in the >1-2 years old group, 50% (10/20) in the >2-5 years old group, with statistical significance (P=0.004). The positive rate of SFB in children with rotavirus enteritis was 74% (20/27) in males and 56% (13/23) in females (χ2=1.71, P=0.192). In the control group, it was 79% (22/28) in males and 70% (19/27) in females (χ2=0.49, P=0.485). The positive rate of SFB was 66% (33/50) in the rotavirus enteritis group and 75% (41/55) in the control group, with no statistically significant (χ2=0.56, P=0.454). In the children ≤2 years old, the SFB positivity rate was 69% (24/35) in the rotavirus enteritis group and 89% (31/35) in the control group, with a statistically significant difference (χ2=4.16, P=0.041). However, in the children >2-5 years old, no statistically significant difference was observed, with the positive rate of SFB being 9/15 in the rotavirus enteritis group and 50% (10/20) in the control group (P=0.734). Pearson correlation analysis revealed a negative correlation between rotavirus infection and SFB positivity (r=-0.87,P<0.001). As the concentration of the p3340 specific protein increased, the luminescence intensity of the luciferase in the Vero cells, which were suitable for cultivating rotavirus, exhibited a decreasing trend (F=4.17, P=0.001). Conclusions: SFB colonization in infants less than 2 years old is associated with a reduced risk of rotavirus infection. Cloning of specific SFB functional protein p3340 neutralizes rotavirus infection of Vero cells, and this mechanism of targeting rotavirus infection differs from the common antiviral mechanism.


Assuntos
Fezes , Infecções por Rotavirus , Rotavirus , Humanos , Lactente , Masculino , Feminino , Estudos de Casos e Controles , Pré-Escolar , Fezes/virologia , Fezes/microbiologia , Diarreia/virologia , Diarreia/microbiologia , Enterite/virologia , Enterite/microbiologia , Recém-Nascido , Intestinos/virologia , Intestinos/microbiologia , Animais
2.
PLoS One ; 19(7): e0304409, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38959220

RESUMO

BACKGROUND: Children with under-five year age disproportionally affected with foodborne illness. Campylobacteriosis is the most common foodborne disease next to Norovirus infection. Macrolides are commonly prescribed as the first line of treatment for Campylobacter gastroenteritis, with fluoroquinolone and tetracycline as secondary options. However, resistance to these alternatives has been reported in various regions worldwide. OBJECTIVE: To determine the prevalence, associated risk-factors and antimicrobial resistance of Campylobacter jejuni and C. coli among under-five children with diarrhea. METHODS: Institution-based cross-sectional study was conducted from November, 2022 to April 2023. The study sites were selected using a random sampling technique, while the study subjects were included using a convenient sampling technique. The data were collected using a structured questionnaire. Stool samples were inoculated onto modified charcoal cefoperazone deoxycholate agar and incubated for 48 hours. The suspected colonies were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry to confirm the species. Antimicrobial susceptibility testing was performed using a disc diffusion technique. All potential covariates (independent variables) were analyzed one by one using bivariate logistic regression model to identify candidate variables with P value < 0.25. Multivariable logistic analysis was used to identify potential associated factors using the candidate variables. A p value ≤ 0.05 at a 95% confidence interval was statistically significant. RESULT: Among the 428 samples, 7.0% (CI: 4.5-9.3) were confirmed Campylobacter species. The prevalence of C. jejuni and C. coli among under-five children was 5.1% (CI: 3.0-7.0) and 1.9% (CI: 0.7-3.3), respectively. C. jejuni (73.3%) was dominant over C. coli (26.7%). The resident, contact with domestic animals, and parents/guardians education level were significantly associated with campylobacteriosis among under-five children. One-third of the Campylobacter isolates (33.3%, 10/30) were resistant to ciprofloxacin and tetracycline whereas 10.0% (3/30) were resistant to erythromycin. Furthermore, 3.3% (1/30) of the Campylobacter were found to be multidrug-resistant. CONCLUSION: The prevalence of Campylobacter species was 7.0%. The resistance rate of Campylobacter species of ciprofloxacin and tetracycline-resistance strains was 33.3%. Peri-urban residence, contact with domestic animals, and low parental educational statuses were significantly associated factors with increased risk of Campylobacter infection. Continuous surveillance on antimicrobial resistance and health education of personal and environmental hygiene should be implemented in the community.


Assuntos
Antibacterianos , Infecções por Campylobacter , Campylobacter coli , Campylobacter jejuni , Diarreia , Humanos , Campylobacter jejuni/efeitos dos fármacos , Campylobacter jejuni/isolamento & purificação , Campylobacter coli/efeitos dos fármacos , Campylobacter coli/isolamento & purificação , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Pré-Escolar , Lactente , Feminino , Masculino , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/tratamento farmacológico , Etiópia/epidemiologia , Estudos Transversais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Prevalência , Testes de Sensibilidade Microbiana , Recém-Nascido , Fatores de Risco
3.
Sci Rep ; 14(1): 15375, 2024 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965273

RESUMO

Globally, 4.9 million under-five deaths occurred before celebrating their fifth birthday. Four in five under-five deaths were recorded in sub-Saharan Africa and Southern Asia. Childhood diarrhea is one of the leading causes of death and is accountable for killing around 443,832 children every year. Despite healthcare utilization for childhood diarrhea has a significant effect on the reduction of childhood mortality and morbidity, most children die due to delays in seeking healthcare. Therefore, this study aimed to assess healthcare utilization for childhood diarrhea in the top high under-five mortality countries. This study used secondary data from 2013/14 to 2019 demographic and health surveys of 4 top high under-five mortality countries. A total weighted sample of 7254 mothers of under-five children was included. A multilevel binary logistic regression was employed to identify the associated factors of healthcare utilization for childhood diarrhea. The statistical significance was declared at a p-value less than 0.05 with a 95% confidence interval. The overall magnitude of healthcare utilization for childhood diarrhea in the top high under-five mortality countries was 58.40% (95% CI 57.26%, 59.53%). Partner/husband educational status, household wealth index, media exposure, information about oral rehydration, and place of delivery were the positive while the number of living children were the negative predictors of healthcare utilization for childhood diarrhea in top high under-five mortality countries. Besides, living in different countries compared to Guinea was also an associated factor for healthcare utilization for childhood diarrhea. More than four in ten children didn't receive health care for childhood diarrhea in top high under-five mortality countries. Thus, to increase healthcare utilization for childhood diarrhea, health managers and policymakers should develop strategies to improve the household wealth status for those with poor household wealth index. The decision-makers and program planners should also work on media exposure and increase access to education. Further research including the perceived severity of illness and ORS knowledge-related factors of healthcare utilization for childhood diarrhea should also be considered by other researchers.


Assuntos
Mortalidade da Criança , Diarreia , Análise Multinível , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Diarreia/mortalidade , Feminino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Lactente , Pré-Escolar , Masculino , Mortalidade da Criança/tendências , Adulto , África Subsaariana/epidemiologia , Recém-Nascido , Adulto Jovem , Adolescente
4.
JAMA Netw Open ; 7(7): e2418129, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38967929

RESUMO

Importance: Probiotics are often considered in children to prevent antibiotic-associated diarrhea. However, the underlying mechanistic effects and impact of probiotics on antibiotic-induced microbiota changes are not well understood. Objective: To investigate the effects of a multispecies probiotic on the gut microbiota composition in children receiving antibiotics. Design, Setting, and Participants: This is a secondary analysis of a randomized, quadruple-blind, placebo-controlled clinical trial from February 1, 2018, to May 31, 2021, including 350 children receiving broad-spectrum antibiotics in the inpatient and outpatient settings. Patients were followed up until 1 month after the intervention period. Fecal samples and data were analyzed between September 1, 2022, and February 28, 2023. Eligibility criteria included 3 months to 18 years of age and recruitment within 24 hours following initiation of broad-spectrum systemic antibiotics. In total, 646 eligible patients were approached and 350 participated in the trial. Intervention: Participants were randomly assigned to receive daily placebo or a multispecies probiotic formulation consisting of 8 strains from 5 different genera during antibiotic treatment and for 7 days afterward. Main Outcomes and Measures: Fecal stool samples were collected at 4 predefined times: (1) inclusion, (2) last day of antibiotic use, (3) last day of the study intervention, and (4) 1 month after intervention. Microbiota analysis was performed by 16S ribosomal RNA gene sequencing. Results: A total of 350 children were randomized and collected stool samples from 88 were eligible for the microbiota analysis (54 boys and 34 girls; mean [SD] age, 47.09 [55.64] months). Alpha diversity did not significantly differ between groups at the first 3 times. Shannon diversity (mean [SD], 3.56 [0.75] vs 3.09 [1.00]; P = .02) and inverse Simpson diversity (mean [SD], 3.75 [95% CI, 1.66-5.82] vs -1.31 [95% CI, -3.17 to 0.53]; P = 1 × 10-4) indices were higher in the placebo group compared with the probiotic group 1 month after intervention. Beta diversity was not significantly different at any of the times. Three of 5 supplemented genera had higher relative abundance during probiotic supplementation, but this difference had disappeared after 1 month. Conclusions and Relevance: The studied probiotic mixture had minor and transient effects on the microbiota composition during and after antibiotic treatment. Further research is needed to understand their working mechanisms in manipulating the microbiome and preventing antibiotic-associated dysbiosis and adverse effects such as antibiotic-associated diarrhea. Trial Registration: ClinicalTrials.gov Identifier: NCT03334604.


Assuntos
Antibacterianos , Diarreia , Fezes , Microbioma Gastrointestinal , Probióticos , Humanos , Probióticos/uso terapêutico , Feminino , Masculino , Antibacterianos/uso terapêutico , Antibacterianos/efeitos adversos , Microbioma Gastrointestinal/efeitos dos fármacos , Criança , Pré-Escolar , Fezes/microbiologia , Diarreia/induzido quimicamente , Diarreia/prevenção & controle , Diarreia/tratamento farmacológico , Diarreia/microbiologia , Adolescente , Lactente
5.
Sci Rep ; 14(1): 15494, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38969720

RESUMO

Anal swabs of 1-month-old Holstein calves with diarrhea were collected from an intensive cattle farm, and a highly pathogenic Escherichia coli strain was obtained by isolation and purification. To study the virulence and resistance genes of pathogenic E. coli that cause diarrhea in calves, a strain of E. coli E12 isolated from calf diarrhea samples was used as experimental material in this experiment, and the virulence of the E12 strain were identified by the mouse infection test, and the whole genome map of the E12 strain were obtained by whole-genome sequencing and analyzed for genome characterization. The results showed that the lethality of strain E12 was 100%, the total length of E12-encoded genes was 4,294,530 bp, Cluster of Orthologous Groups of proteins (COG) annotated to 4,194 functional genes, and the virulence genes of sequenced strain E12 were compared with the virulence genes of sequenced strain E12 from the Virulence Factors of Pathogenic Bacteria (VFDB), which contained a total of 366 virulence genes in sequenced strain E12. The analysis of virulence genes of E12 revealed a total of 52 virulence genes in the iron transferrin system, 56 virulence genes in the secretory system, 41 virulence genes in bacterial toxins, and a total of 217 virulence genes in the Adhesin and Invasins group. The antibiotic resistance genes of sequenced strain E12 were identified through the Antibiotic Resistance Genes Database (ARDB) and Comprehensive Antibiotic Research Database, and it was found that its chromosome and plasmid included a total of 127 antibiotic resistance genes in four classes, and that E12 carried 71 genes related to the antibiotic efflux pumps, 36 genes related to antibiotic inactivation, and 14 antibiotic target alteration and reduced penetration into antibiotics, and 6 antibiotic resistance genes, and the resistance phenotypes were consistent with the genotypes. The pathogenic E. coli that causes diarrhea in calves on this ranch contains a large number of virulence and resistance genes. The results provide a theoretical basis for the prevention and treatment of diarrhea and other diseases caused by E. coli disease.


Assuntos
Diarreia , Infecções por Escherichia coli , Escherichia coli , Genoma Bacteriano , Fatores de Virulência , Sequenciamento Completo do Genoma , Animais , Bovinos , Escherichia coli/genética , Escherichia coli/patogenicidade , Infecções por Escherichia coli/veterinária , Infecções por Escherichia coli/microbiologia , Fatores de Virulência/genética , Camundongos , Diarreia/microbiologia , Diarreia/veterinária , Virulência/genética , Doenças dos Bovinos/microbiologia , China , Farmacorresistência Bacteriana/genética , Antibacterianos/farmacologia
6.
BMC Pediatr ; 24(1): 433, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38969969

RESUMO

Under-five children's diarrhea is a significant public health threat and the World Health Organization (WHO) reported it as the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 diarrhea incidence. This study was therefore, conducted among all districts in the Central Gondar zone to assess the spatial, temporal, and spatiotemporal variation in diarrhea incidence among under-five children in the Central Gondar zone. The data for children under 5 years of age with diarrhea was obtained from Central Gondar Zone Health Department diarrhea reports from January 2019 to December 2022. All districts were included and geo-coded. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots and cold spots. The Poisson model was generated by applying the Kulldorff method in SaTScan™9.6 to analyse the the purely temporal, spatial, and space-time clusters. The study revealed spatial variation of under-5 diarrhea where Gondar City, Gondar Zuria, East Dembia, and Lay Armacho districts were the high-rate spatial clusters during the study period. A year search window for temporal scan statistic identified 01 January 2020-30 December 2021 as risk periods across all districts. Spatiotemporal scan statistics detected high-rate clusters at Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. In conclusion, there has been a spatial, temporal, and spatiotemporal variability of under-5 children's diarrhea in the Central Gondar Zone. Interventional and preventive strategies should be developed and given priority to the areas that has been detected as a hotspot in this study to reduce the mortality and morbidity of under 5 children.


Assuntos
Diarreia , Análise Espaço-Temporal , Humanos , Pré-Escolar , Incidência , Etiópia/epidemiologia , Lactente , Diarreia/epidemiologia , Feminino , Masculino , Recém-Nascido
7.
BMC Public Health ; 24(1): 1755, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956465

RESUMO

BACKGROUND: Norovirus gastroenteritis outbreaks were common in schools and kindergartens and were more related to faculty knowledge, attitude, and practice level. Gastroenteritis outbreaks caused by norovirus in educational institutions were the prominent cause of Public Health Emergency Events in China. This study aimed to explore the transformation in the contribution of KAP items related to outbreak prevention before and after intervention and the impact of demography factors on the intervention. METHODS: This study sampled 1095 kindergarten and 1028 school staff in Shenzhen, China. We created a questionnaire consisting of 35 items in 4 parts, and each item was rated on a scale of 1-5 according to the accuracy. Univariate analysis of non-parametric tests and binary logistic regression were used to estimate the score difference on demographic characteristics, each item and KAP. The odds ratios (OR) with 95% confidence and intervals (CI) for the association between statistical indicators were mainly used to explain the effects before and after intervention. RESULTS: Overall, 98.72% and 74.9% of the kindergarten and school participants were female, and all respondents had the highest scores difference of practice. Following intervention, univariate analysis indicated that primary school and female respondents achieved higher knowledge scores. Staff age beyond 35 (OR = 0.56, CI:0.34-0.92; OR = 0.67, CI:0.50-0.90) and with more than ten years of service (OR = 0.58, CI:0.36-0.91; OR = 0.38, CI:0.17-0.84) demonstrated a significantly lower post-intervention score for attitude and practice in both kindergartens and schools. The staff members exhibited a general lack of familiarity with the transmission of aerosols and the seasonal patterns of NoVs diarrhea pandemics. Item analysis revealed that kindergarten staff aged 26 and above demonstrated superior performance in terms of the efficacy of medical alcohol for inactivation (OR = 1.93, CI:1.13-3.31) and management strategies for unexplained vomiting among students (OR = 1.97, CI:1.21-3.18). Private school personnel displayed more significant improvement in their practices following educational interventions. School administrators' negative attitudes were primarily evident in their perspectives on morning inspections (OR = 0.11, CI:0.05-0.84). CONCLUSIONS: The potential negative impact of faculty age on NoVs-related knowledge can be mitigated by the positive attitudes fostered through seniority. Furthermore, it is imperative to urgently address the lack of knowledge among administrators, and the identification and treatment of vomiting symptoms should be emphasized as crucial aspects of school prevention strategies. Therefore, education authorities should implement comprehensive public health interventions in the future.


Assuntos
Infecções por Caliciviridae , Surtos de Doenças , Conhecimentos, Atitudes e Prática em Saúde , Norovirus , Instituições Acadêmicas , Humanos , Feminino , Masculino , Infecções por Caliciviridae/prevenção & controle , Infecções por Caliciviridae/epidemiologia , Adulto , China/epidemiologia , Inquéritos e Questionários , Surtos de Doenças/prevenção & controle , Diarreia/prevenção & controle , Diarreia/epidemiologia , Gastroenterite/prevenção & controle , Gastroenterite/epidemiologia , Gastroenterite/virologia , Professores Escolares/psicologia , Professores Escolares/estatística & dados numéricos , Pessoa de Meia-Idade
8.
BMC Pediatr ; 24(1): 444, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987716

RESUMO

Trichohepatoenteric syndrome (THES), also known as phenotypic diarrhea or syndromic diarrhea, is a rare autosomal recessive genetic disorder caused by mutations in SKIC2 (THES-type 2) or SKIC3 (THES-type 1) and is characterized by early onset diarrhea, woolly brittle hair, facial dysmorphic features and liver disease. We report the case of a 24-month-old girl who presented with chronic diarrhea since the neonatal period along with intrauterine growth restriction (IUGR), developmental delay, dysmorphic features, congenital heart defects, liver disease, and recurrent infections. The diagnosis was made through whole-exome sequencing analysis, which detected a homozygous variant (c.4070del, p.Pro1357Leufs*10) in the SKIC3 gene. The patient required parenteral nutrition and was hospitalized for the first 10 months of life and then discharged on PN after showing improvement. She remained stable on PN after discharge despite a few admissions for central line infections. Recent follow-up at the age of 2 years revealed that she was stable on long-term parenteral nutrition and that she had advanced chronic liver disease.


Assuntos
Diarreia , Doenças do Cabelo , Homozigoto , Humanos , Feminino , Diarreia/genética , Doenças do Cabelo/genética , Doenças do Cabelo/diagnóstico , Pré-Escolar , Diarreia Infantil/genética , Mutação , Nutrição Parenteral , Hepatopatias/genética , Hepatopatias/diagnóstico , Sequenciamento do Exoma , Retardo do Crescimento Fetal/genética , DNA Helicases , Fácies
9.
PLoS One ; 19(7): e0302712, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39008515

RESUMO

BACKGROUND: Every year, 60% of deaths from diarrhoeal disease occur in low and middle-income countries due to inadequate water, sanitation, and hygiene. In these countries, diarrhoeal diseases are the second leading cause of death in children under five, excluding neonatal deaths. The approximately 100,000 people residing in the Bentiu Internally Displaced Population (IDP) camp in South Sudan have previously experienced water, sanitation, and hygiene outbreaks, including an ongoing Hepatitis E outbreak in 2021. This study aimed to assess the gaps in Water, Sanitation, and Hygiene (WASH), prioritise areas for intervention, and advocate for the improvement of WASH services based on the findings. METHODS: A cross-sectional lot quality assurance sampling (LQAS) survey was conducted in ninety-five households to collect data on water, sanitation, and hygiene (WASH) coverage performance across five sectors. Nineteen households were allocated to each sector, referred to as supervision areas in LQAS surveys. Probability proportional to size sampling was used to determine the number of households to sample in each sector block selected using a geographic positioning system. One adult respondent, familiar with the household, was chosen to answer WASH-related questions, and one child under the age of five was selected through a lottery method to assess the prevalence of WASH-related disease morbidities in the previous two weeks. The data were collected using the KoBoCollect mobile application. Data analysis was conducted using R statistical software and a generic LQAS Excel analyser. Crude values, weighted averages, and 95% confidence intervals were calculated for each indicator. Target coverage benchmarks set by program managers and WASH guidelines were used to classify the performance of each indicator. RESULTS: The LQAS survey revealed that five out of 13 clean water supply indicators, eight out of 10 hygiene and sanitation indicators, and two out of four health indicators did not meet the target coverage. Regarding the clean water supply indicators, 68.9% (95% CI 60.8%-77.1%) of households reported having water available six days a week, while 37% (95% CI 27%-46%) had water containers in adequate condition. For the hygiene and sanitation indicators, 17.9% (95% CI 10.9%-24.8%) of households had handwashing points in their living area, 66.8% (95% CI 49%-84.6%) had their own jug for cleansing after defaecation, and 26.4% (95% CI 17.4%-35.3%) of households had one piece of soap. More than 40% of households wash dead bodies at funerals and wash their hands in a shared bowl. Households with sanitary facilities at an acceptable level were 22.8% (95% CI 15.6%-30.1%), while 13.2% (95% CI 6.6%-19.9%) of households had functioning handwashing points at the latrines. Over the previous two weeks, 57.9% (95% CI 49.6-69.7%) of households reported no diarrhoea, and 71.3% (95% CI 62.1%-80.6%) reported no eye infections among children under five. CONCLUSION: The camp's hygiene and sanitation situation necessitated immediate intervention to halt the hepatitis E outbreak and prevent further WASH-related outbreaks and health issues. The LQAS findings were employed to advocate for interventions addressing the WASH gaps, resulting in WASH and health actors stepping in.


Assuntos
Higiene , Saneamento , Humanos , Saneamento/normas , Higiene/normas , Sudão do Sul/epidemiologia , Estudos Transversais , Feminino , Masculino , Adulto , Amostragem para Garantia da Qualidade de Lotes , Abastecimento de Água/normas , Diarreia/epidemiologia , Diarreia/prevenção & controle , Campos de Refugiados , Lactente , Pré-Escolar , Inquéritos e Questionários , Características da Família
10.
Trials ; 25(1): 483, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014428

RESUMO

BACKGROUND: Diarrheal disease is a significant cause of morbidity and mortality in under-fives in many low- and middle-income countries. Changes in food safety, hygiene practices, and nutrition around the weaning period may reduce the risk of disease and improve infant development. The MaaCiwara study aims to evaluate the effectiveness of a community-based educational intervention designed to improve food safety and hygiene behaviours, as well as child nutrition. This update article describes the statistical analysis plan for the MaaCiwara study in detail. METHODS AND DESIGN: The MaaCiwara study is a parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures, involving 120 clusters of rural and urban communities. These clusters are randomised to either receive the community-based behaviour change intervention or to the control group. The study participants will be mother-child pairs, with children aged between 6 and 36 months. Data collection involves a day of observation and interviews with each participating mother-child pair, conducted at baseline, 4 months, and 15 months post-intervention. The primary analysis aims to estimate the effectiveness of the intervention on changes to complementary food safety and preparation behaviours, food and water contamination, and diarrhoea. The primary outcomes will be analysed generalised linear mixed models, at individual level, accounting for clusters and rural/urban status to estimate the difference in outcomes between the intervention and control groups. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. In addition, structural equation analysis will be conducted to examine the causal relationships between the different outcomes. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN) register: ISRCTN14390796 . Registered on 13 December 2021.


Assuntos
Inocuidade dos Alimentos , Higiene , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Lactente , Mali , Pré-Escolar , Feminino , Fenômenos Fisiológicos da Nutrição do Lactente , Estado Nutricional , Interpretação Estatística de Dados , Masculino , Diarreia/prevenção & controle , Diarreia/epidemiologia
11.
BMJ Glob Health ; 9(7)2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977402

RESUMO

INTRODUCTION: The relative priority received by issues in global health agendas is subjected to impressionistic claims in the absence of objective methods of assessment of priority. To build an approach for conducting structured assessments of comparative priority health issues receive, we expand the public arenas model (2021) and offer a framework for future assessments of health issue priority in global and national health agendas. METHODS: We aimed to develop a more comprehensive set of measures for conducting multiyear priority comparisons of health issues in six agenda-setting arenas by identifying possible measures and data sources, selecting indicators based on feasibility and comparability of measures and gathering the data on selected indicators. We applied these measures to four communicable diseases-tuberculosis (TB), malaria, diarrhoeal diseases and dengue fever-given their differing impressionistic claims of priority. Where possible, we analysed the annual and/or 5-year trends from 2000 through 2022. RESULTS: We observed that TB and malaria received the highest priority for most periods in the past two decades in most arenas. However, a stagnation in development funding for these two conditions over the last 8-10 years may have fuelled the neglect claims. Despite having a higher disease burden, diarrhoea has been slipping in global priority with reduced spending, fewer clinical trials and stagnating publications. Dengue remains a low-priority condition but has witnessed a sharp rise in attention from the pharmaceutical industry. DISCUSSIONS: We expanded the arenas model by including a transnational arena (international representation) and additional measurements for various arenas. This analysis presents an approach to enable comparative trend analysis of the markers of agenda status over a multiyear period. More such analyses can bring much-desired objectivity in understanding how attention to global or national health issues changes over time in different arenas, potentiating a more equitable allocation of resources.


Assuntos
Dengue , Diarreia , Saúde Global , Prioridades em Saúde , Malária , Tuberculose , Humanos , Dengue/epidemiologia , Tuberculose/epidemiologia
12.
J Dig Dis ; 25(5): 279-284, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38973129

RESUMO

OBJECTIVES: We aimed to evaluate the clinical response to cholestyramine in patients with functional chronic diarrhea and a high clinical suspicion of bile-acid diarrhea (BAD) investigated with 75-selenium homocholic acid taurine (SeHCAT) test. METHODS: Adult patients attending our outpatient clinic between January and December 2021 for chronic diarrhea with suspicion of BAD were proposed SeHCAT testing and a therapeutic trial of cholestyramine 4-8 g daily. Clinical response to cholestyramine was evaluated at 1, 3, 6, and 12 months. Clinical and demographic data were analyzed according to SeHCAT test results. RESULTS: Among the 50 patients with chronic diarrhea and clinical suspicion of BAD, 13 (26.0%) refused either SeHCAT testing or cholestyramine therapy. Finally, 37 patients (31 females, age 44 ± 14 years) agreed to undergo SeHCAT and were started on cholestyramine (median follow-up 14 months [interquartile range 6-16 months]). Initial response to cholestyramine was similar in patients with positive and negative SeHCAT test results, but improved over time in those with a positive test result. Long-term response (100% vs 65.2%, P = 0.02) and necessity of maintenance therapy for symptom control were more common in those with positive SeHCAT test result (71.4% vs 26.1%, P = 0.02). However, response to cholestyramine was also frequent in patients with a negative test result. CONCLUSIONS: The SeHCAT test accurately identifies patients with BAD who benefit from long-term cholestyramine treatment. Nevertheless, cholestyramine may be also effective in patients with chronic diarrhea but negative SeHCAT test result.


Assuntos
Ácidos e Sais Biliares , Resina de Colestiramina , Diarreia , Humanos , Feminino , Resina de Colestiramina/uso terapêutico , Diarreia/tratamento farmacológico , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Doença Crônica , Ácidos e Sais Biliares/metabolismo , Ácido Taurocólico/análogos & derivados , Síndromes de Malabsorção/diagnóstico , Síndromes de Malabsorção/tratamento farmacológico , Resultado do Tratamento , Radioisótopos de Selênio
13.
Ann Afr Med ; 23(2): 132-139, 2024 Apr 01.
Artigo em Francês, Inglês | MEDLINE | ID: mdl-39028160

RESUMO

BACKGROUND: Diarrheagenic Escherichiacoli (DEC) infections constitute the leading causes of morbidity and mortality among children in Sub-Saharan Africa. However, little has so far been done to properly reveal the pathogenic endowments of DEC in these populations. AIMS AND OBJECTIVES: We evaluated 4 DEC strains among children under 5 years. MATERIALS AND METHODS: A cross-sectional study design was employed among 384 positive cases. RESULTS: There was a significant decline in infections associated with DEC as the children grew older (χ2[12] = 87.366: P = [0.000]. A total of 56 (14.6%) cases were 0-12 months, 168 (43.8%) were 13-24 months, 88 (22.9%) were 25-36 months, 40 (10.4%) were 37-48 months, and 32 (8.3%) were 49-60 months. A total of 248 (64.6%) male subjects exhibited more susceptibility to DEC infections than their female counterparts (n = 136 [35.4%]) (χ2[3] =13.313: P = [0.004]. Subjects from urban areas (n = 248 [64.6%]), significantly bored the brunt of infections than those from rural areas (n = 136 [35.4%]) (χ2[3] = 35.147: P = [0.000]. The prevalence of DEC appeared significantly higher during rainy seasons (n = 269 [70.1%]). CONCLUSION: Young age, male gender, crowding, and rainy season play a central role in the transmission of DEC pathotypes.


Résumé Contexte:Les infections à Escherichia coli entéropathogène (DEC) constituent les principales causes de morbidité et de mortalité chez les enfants en Afrique subsaharienne. Cependant, jusqu'à présent, peu de choses ont été faites pour révéler correctement les caractéristiques pathogènes de DEC dans ces populations.Objectifs:Nous avons évalué 4 souches de DEC chez les enfants de moins de 5 ans.Matériel et méthodes:Un plan d'étude transversal a été utilisé parmi 384 cas positifs.Résultats:Il y a eu une diminution significative des infections associées à DEC à mesure que les enfants grandissaient (χ2 [12] = 87,366 : P = [0,000]). Un total de 56 (14,6 %) cas avaient entre 0 et 12 mois, 168 (43,8 %) avaient entre 13 et 24 mois, 88 (22,9 %) avaient entre 25 et 36 mois, 40 (10,4 %) avaient entre 37 et 48 mois, et 32 (8,3 %) avaient entre 49 et 60 mois. Un total de 248 (64,6 %) sujets masculins ont montré une plus grande susceptibilité aux infections à DEC que leurs homologues féminins (n = 136 [35,4 %]) (χ2 [3] = 13,313 : P = [0,004]). Les sujets des zones urbaines (n = 248 [64,6 %]) ont significativement supporté le fardeau des infections par rapport à ceux des zones rurales (n = 136 [35,4 %]) (χ2 [3] = 35,147 : P = [0,000]). La prévalence de DEC semblait significativement plus élevée pendant la saison des pluies (n = 269 [70,1 %]).Conclusion:L'âge jeune, le sexe masculin, la surpopulation et la saison des pluies jouent un rôle central dans la transmission des pathotypes de DEC.


Assuntos
Diarreia , Infecções por Escherichia coli , Humanos , Masculino , Feminino , Estudos Transversais , Lactente , Pré-Escolar , Diarreia/epidemiologia , Diarreia/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/transmissão , Prevalência , Recém-Nascido , Escherichia coli/isolamento & purificação , População Urbana , Fatores Socioeconômicos , População Rural , Distribuição por Idade , Fatores de Risco , Distribuição por Sexo , Estações do Ano , Fezes/microbiologia
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 45(7): 969-976, 2024 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-39004969

RESUMO

Objective: To understand the infection status, epidemiological characteristics and drug resistance of Diarrheagenic Escherichia coli (DEC) in Shanghai and provide evidence for the disease surveillance. Methods: The epidemiological data of diarrhea cases in Shanghai from 2016 to 2022 were collected from Shanghai Diarrhea Comprehensive Surveillance System, and stool samples were collected from the cases for DEC detection. The drug resistance data was obtained from Chinese Pathogen Identification Network. Statistical analysis was conducted by using χ2 and fisher test. Results: In 24 883 diarrhea cases detected during 2016-2022, the DEC positive rate was 9.13% (2 271/24 883), the single DEC positive rate was 8.83% (2 197/24 883) and the mixed DEC positive rate was 0.30% (74/24 883). The main type of DEC was Enterotoxigenic Escherichia coli (ETEC) [4.33% (1 077/24 883)]. The DEC positive rate was highest in people aged ≤5 years 18.48% (22/119). The annual peak of DEC positive rate was observed during July - September [5.91% (1 470/24 883)]. The DEC positive rate were 9.47% (554/5 847) and 9.02% (1 717/19 036) in urban area and in suburbs, respectively, Enteroaggregative Escherichia coli (EAEC) [3.98% (233/5 847)] and ETEC [4.56% (868/19 036)] were mainly detected. From 2016 to 2019, the DEC positive rate was 9.42% (1 821/19 330), while it was 8.10% (450/5 553) from 2020 to 2022, the main DEC types were ETEC (4.87%, 941/19 330) and EAEC (4.70%, 261/5 553). The multi-drug resistance rate was 40.21% (618/1 537). The top three antibiotics with high drug resistance rates were ampicillin [64.74% (995/1 537)], nalidixic acid [58.49% (899/1 537)] and tetracycline [45.09% (693/1 537)]. Conclusions: Compared with 2016- 2019, a decrease in DEC detection rate was observed during 2020-2022, and the main type of DEC detected shifted from ETEC to EAEC. The prevalence of multi-drug resistance was severe. Therefore, it is necessary to further strengthen the surveillance for DEC drug resistance and standardize the use of clinical antibiotics.


Assuntos
Diarreia , Escherichia coli Enterotoxigênica , Infecções por Escherichia coli , Humanos , Diarreia/microbiologia , Diarreia/epidemiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , China/epidemiologia , Escherichia coli Enterotoxigênica/efeitos dos fármacos , Escherichia coli Enterotoxigênica/isolamento & purificação , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Fezes/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Farmacorresistência Bacteriana , Pré-Escolar , Criança , Lactente , Adolescente , Adulto
15.
Clin Infect Dis ; 79(Supplement_1): S43-S52, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38996036

RESUMO

BACKGROUND: Healthcare seeking behavior (HSB) and community perception on cholera can influence its management. We conducted a cross-sectional survey to generate evidence on cholera associated HSB and disease perception in populations living in cholera hotspots in Ethiopia. METHODS: A total of 870 randomly selected households (HHs) in Shashemene Town (ST) and Shashemene Woreda (SW) participated in our survey in January 2022. RESULTS: Predominant HHs (91.0%; 792/870) responded "primary health center" as the nearest healthcare facility (HCF). Around 57.4% (247/430) of ST HHs traveled <30 minutes to the nearest HCF. In SW, 60.2% (265/440) of HHs travelled over 30 minutes and 25.9% (114/440) over 4 km. Two-thirds of all HHs paid

Assuntos
Cólera , Diarreia , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Cólera/epidemiologia , Etiópia/epidemiologia , Estudos Transversais , Adulto , Feminino , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Diarreia/epidemiologia , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde , Criança , Pré-Escolar , Lactente , Inquéritos e Questionários
16.
Clin Infect Dis ; 79(Supplement_1): S8-S19, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38996039

RESUMO

BACKGROUND: The Ethiopian government has developed the multisectoral cholera elimination plan (NCP) with an aim of reducing cholera incidence and case fatality rate (CFR). To better understand and monitor the progress of this plan, a comprehensive review of national cholera epidemiology is needed. METHODS: Reported data on cholera/acute watery diarrhea (AWD) cases in the past 20 years were extracted from the Ethiopian Public Health Institute and World Health Organization databases. Descriptive statistics, Pearson χ2, and logistic regression analyses were conducted. RESULTS: From January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092-1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5-11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006-2010 and 14.83/100 000 in 2016-2020. Another resurgence of outbreaks occured in 2021-2023 (mean AR, 8.63/100 000). In 2015-2023, 54.0% (53 990/99 945) of cases were aged 15-44 years. National cholera CFR (3.13% [95% CI: 2.1-4.5]) was the highest in 2022. The 2015-2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (≥45 years), severe dehydration, peak rainy season (June-August), and outpatients were associated with higher risk of death. CONCLUSIONS: Cholera has been a public health problem in Ethiopia with case fatalities still above the global target. Case management needs to be improved particularly in outpatients and older populations. Outbreak preparedness should be rolled out well in advance of the typical rainy seasons. Significant investments are essential to advance the cholera surveillance system at healthcare setting and community level. Underlying factors of cholera deaths per areas should be further investigated to guide appropriate interventions to meet the NCP target by 2028.


Assuntos
Cólera , Diarreia , Surtos de Doenças , Estações do Ano , Humanos , Cólera/epidemiologia , Cólera/mortalidade , Etiópia/epidemiologia , Incidência , Diarreia/epidemiologia , Diarreia/mortalidade , Diarreia/microbiologia , Adolescente , Adulto , Estudos Retrospectivos , Adulto Jovem , Pré-Escolar , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Lactente , Idoso
17.
Trop Anim Health Prod ; 56(6): 211, 2024 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-39001969

RESUMO

Bovine coronavirus (BCoV) is one of the important causes of diarrhoea in cattle. The virus is responsible for the high fatality rate associated with acute diarrhoea in calves. Rapid and accurate tests need to be conducted to detect the virus and minimise economic losses associated with the disease. Nucleic acid-based detection assays including PCR is an accurate test for detecting pathogens. However, these tests need skilled personnel, time and expensive devices. In this study, we developed a novel assay for the detection of BCoV in clinical cases. This novel assay combined reverse transcription-recombinase polymerase amplification with CRISPR/Cas13 and conducted a rapid visualisation of cleavage activity using a Lateral Flow Device. A conserved sequence of the BCV M gene was used as a target gene and the assays were tested in terms of specificity, sensitivity and time consumption. The result showed the specificity of the assay as 100% with no false positives being detected. Ten copies of the input RNA were enough to detect the virus and perform the assay. It took up to forty minutes for reading the results. Conducted together, the assay should be used as a rapid test to clinically diagnose infectious pathogens including bovine coronavirus. However, the assay needed the RNA to be extracted from the clinical sample in order to detect the virus. Therefore, more studies are needed to optimise the assay to be able to detect the virus in the clinical sample without extracting the RNA.


Assuntos
Sistemas CRISPR-Cas , Doenças dos Bovinos , Coronavirus Bovino , Diarreia , Sensibilidade e Especificidade , Animais , Bovinos , Coronavirus Bovino/isolamento & purificação , Coronavirus Bovino/genética , Diarreia/veterinária , Diarreia/virologia , Diarreia/diagnóstico , Doenças dos Bovinos/virologia , Doenças dos Bovinos/diagnóstico , Infecções por Coronavirus/veterinária , Infecções por Coronavirus/virologia , Infecções por Coronavirus/diagnóstico
18.
BMC Public Health ; 24(1): 1864, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38997671

RESUMO

BACKGROUND: Diarrheal diseases substantially affect public health impact in low- and middle-income countries (LMIC), particularly in Africa, where previous studies have indicated a lack of comprehensive data. With a growing number of primary studies on enteric infections in Africa, this study aimed to estimate the incidence and mortality of diarrheal pathogens across all ages in Africa in the year 2020. We also explored different methodological assumptions to allow comparison with other approaches. METHODS: Through a systematic review and meta-analysis of data from African LMICs, we estimated the etiology proportions for diarrheal diseases and deaths. We combined the etiology proportions with incidence data collected from a population survey in Africa from 2020 and mortality data from the Global Health Observatory of WHO. RESULTS: We estimated 1,008 billion diarrhea cases (95% UI 447 million-1,4 billion) and 515,031 diarrhea deaths (95% UI 248,983-1,007,641) in the African region in 2020. In children under five, enteroaggregative E. coli (EAEC) (44,073 cases per 100,000 people, 95% UI 18,818 - 60,922) and G. lamblia (36,116 cases per 100,000 people, 95% UI 15,245 - 49,961) were the leading causes of illness. Enteroinvasive E. coli (EIEC) (155 deaths per 100,000 people, 95% UI 106.5-252.9) and rotavirus (61.5 deaths per 100,000 people, 95% UI 42.3-100.3) were the primary causes of deaths. For children over five and adults, Salmonella spp. caused the largest number of diarrheal cases in the population of children ≥ 5 and adults (122,090 cases per 100,000 people, 95% UI 51,833 - 168,822), while rotavirus (16.4 deaths per 100,000 people, 95% UI 4.2-36.7) and enteroaggregative E. coli (EAEC) (14.6 deaths per 100,000 people, 95% UI 3.9-32.9) causing the most deaths. Geographically, the highest incidence of diarrhea was in Eastern Africa for children under five (114,389 cases per 100,000 people, 95% UI 34,771 - 172,884) and Central Africa for children over five and adults (117,820 cases per 100,000 people, 95% UI 75,111-157,584). Diarrheal mortality was highest in Western Africa for both children below five and above (children < 5: 194.5 deaths per 100,000 people, 95% UI 120-325.4; children ≥ 5 and above: 33.5 deaths per 100,000 people, 95% UI 12.9-75.1). CONCLUSION: These findings provide new information on the incidence and mortality of sixteen pathogens and highlight the need for surveillance and control of diarrheal infectious diseases in Africa. The cause-specific estimates are crucial for prioritizing diarrheal disease prevention in the region.


Assuntos
Diarreia , Humanos , Incidência , Diarreia/epidemiologia , Diarreia/mortalidade , África/epidemiologia , Pré-Escolar , Lactente , Criança
19.
Nutrients ; 16(13)2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38999739

RESUMO

Diarrhea of college students (DCS) is a prevalent issue among college students, affecting their daily lives and academic performance. This study aims to explore the potential effect of Bifidobacterium breve BB05 supplements on the DCS. Initially, fifty healthy and fifty diarrheal students were recruited in the observational experiment and allocated into control and diarrhea groups, respectively. Subsequently, one hundred diarrheal students were newly recruited in the intervention experiment and randomly allocated into placebo and probiotic groups, both treated for 2 weeks. Questionnaires (BSS, HAMA-14, and HDRS-17) were performed to assess the students' diarrheal states and mental health at baseline and post-treatment. Fecal samples underwent 16S rRNA sequencing and Enzyme-Linked Immunosorbent Assay to evaluate gut microbiota and fecal metabolite alternations. Results indicated that B. breve BB05 supplementation significantly enriched (p < 0.05) the reduced gut microbial diversity caused by diarrhea. Diarrhea resulted in notable alterations in gut microbiota composition, as exhibited by elevated Collinsella and Streptococcus, alongside substantially decreased Bifidobacterium, Bacteroides, and Prevotella, while B. breve BB05 supplementation partially restored the compromised gut microbiota at both the phylum and genus levels, particularly by increasing Bifidobacterium and Roseburia (p < 0.05). Importantly, questionnaire results suggested that B. breve BB05 administration achieved superior efficacy in relieving diarrhea symptoms and the associated anxiety and depression in college students. An increased fecal concentration of 5-hydroxytryptamine (5-HT) was also observed in the probiotic group, while Acetylcholine (ACH), Epinephrine (EPI), and Noradrenaline/Norepinephrine (NANE) reduced, revealing the potential of B. breve BB05 in alleviating anxiety and depression via modulating the microbiota-gut-brain axis. Furthermore, correlation analysis suggested that the altered microbiota and fecal neurotransmitters were closely associated with the mental symptoms. These results endorse B. breve BB05 intervention as a promising and innovative approach to alleviate both diarrhea and mental health conditions among college students.


Assuntos
Bifidobacterium breve , Diarreia , Fezes , Microbioma Gastrointestinal , Probióticos , Estudantes , Humanos , Diarreia/microbiologia , Diarreia/terapia , Probióticos/uso terapêutico , Probióticos/administração & dosagem , Método Duplo-Cego , Masculino , Estudantes/psicologia , Feminino , Adulto Jovem , Fezes/microbiologia , Universidades , Adulto
20.
Nutrients ; 16(13)2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-38999829

RESUMO

Microscopic colitis (MC) and coeliac disease (CD) are common associated gastrointestinal conditions. We present the largest study assessing hospitalisation in patients with MC and the effect of a concomitant diagnosis of CD. Data were retrospectively collected between January 2007 and December 2021 from all patients diagnosed with MC and compared to a database of patients with only CD. In total, 892 patients with MC (65% female, median age 65 years (IQR: 54-74 years) were identified, with 6.4% admitted to hospital due to a flare of MC. Patients admitted were older (76 vs. 65 years, p < 0.001) and presented with diarrhoea (87.7%), abdominal pain (26.3%), and acute kidney injury (17.5%). Treatment was given in 75.9% of patients, including intravenous fluids (39.5%), steroids (20.9%), and loperamide (16.3%). Concomitant CD was diagnosed in 3.3% of patients and diagnosed before MC (57 versus 64 years, p < 0.001). Patients with both conditions were diagnosed with CD later than patients with only CD (57 years versus 44 years, p < 0.001). In conclusion, older patients are at a higher risk of hospitalisation due to MC, and this is seen in patients with a concomitant diagnosis of CD too. Patients with MC are diagnosed with CD later than those without.


Assuntos
Doença Celíaca , Colite Microscópica , Hospitalização , Humanos , Doença Celíaca/diagnóstico , Doença Celíaca/complicações , Doença Celíaca/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Hospitalização/estatística & dados numéricos , Colite Microscópica/epidemiologia , Colite Microscópica/diagnóstico , Prognóstico , Fatores de Risco , Diarreia/etiologia , Adulto , Fatores Etários
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