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1.
BMC Infect Dis ; 19(1): 1018, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791267

RESUMO

BACKGROUND: Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group. METHODS: During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed. RESULTS: Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants. CONCLUSION: The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Diarreia/diagnóstico , Diarreia/etiologia , Resistência Microbiana a Medicamentos/genética , Tipagem Molecular/métodos , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Pré-Escolar , Ciprofloxacino/uso terapêutico , Estudos Transversais , Diarreia/epidemiologia , Diarreia/microbiologia , Resistência Microbiana a Medicamentos/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Fluoroquinolonas/uso terapêutico , Gastroenterite/diagnóstico , Gastroenterite/tratamento farmacológico , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Técnicas de Diagnóstico Molecular/métodos , Prevalência , Centros de Atenção Terciária
2.
BMC Infect Dis ; 19(1): 1008, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779589

RESUMO

BACKGROUND: Despite substantial global effort and updated clinical management guidelines, diarrhea continues to be among leading worldwide causes of morbidity and mortality in children. Infectious diarrhea, the most common form of diarrhea causes substantial morbidity and mortality among children in developing countries, and the muddled use of antibiotics needs caution due to potential problems of drug-resistance. The aim of this study is to identify etiologies of diarrhea and drug susceptibility patterns of bacterial isolates in under-five children in refugee camps in Gambella Region, Ethiopia. METHODS: An institution- based matched case control study was conducted using a questionnaire-based interview from June to December 2017 in Pugnido and Teirkidi refugee camps. Stool samples were collected and parasites causing diarrhea were identified by wet mount microscopy. Conventional culture supplemented with API 20E identification kit was used to identify Salmonella and Shigella species. Antibiotic susceptibility of bacterial isolates was investigated by using the disk diffusion method. The association between etiologies and diarrhea was analyzed using McNemar test or Fisher exact test with 95% confidence interval at a level of significance of P < 0.05. RESULTS: The overall prevalence of enteric pathogens were 55 (41.0%) in diarrhea cases and 18 (13.4%) in healthy controls. The detected etiologies include Giardia lambia (28), Shigella spp. (16), E. hystolyotica/dispar (13), Ascaris lumbricoides (10), Salmonella spp. (6), Cryptosporidium parvum (6), Hymenolepis nana (4) and Isospora belli (3). All isolates were sensitive to kanamycine and ceftazidime. The high resistance rate was observed against ampicillin (100%), amoxicillin (100%), erythromycin (52%), chloramphenicol (47.5%), tetracycline (40.5%), cotrimoxazole (34.8%) and amoxicillin-clavulanic acid (33%). The majorities of the isolates had a low rate of resistance to ciprofloxacin (8.7%), naldxic acid (8.7%) and amikacin (13%). CONCLUSIONS: Giardia lamblia, E. Hystolytica/dispar, and Shigella spp are the common etiologies of diarrhea in children in the studied refugee camps. The study also showed that significant numbers of bacterial isolates were resistant to the commonly used antimicrobial drugs. Therefore, improving clinical laboratory services and promoting evidence-based drug prescription may reinforce proper use of antibiotics and reduce the emergence of microbial resistance.


Assuntos
Bacteriemia/diagnóstico , Diarreia/diagnóstico , Adolescente , Antibacterianos/farmacologia , Bacteriemia/complicações , Bacteriemia/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Diarreia/epidemiologia , Diarreia/etiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Etiópia/epidemiologia , Fezes/microbiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Campos de Refugiados , Salmonella/isolamento & purificação , Shigella/isolamento & purificação , Inquéritos e Questionários
3.
BMC Infect Dis ; 19(1): 978, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752744

RESUMO

BACKGROUND: Acute diarrhea is a leading cause of morbidity and mortality in children particularly in developing countries of Asia and Africa. The present study was conducted to detect the two most important pathogens, rotavirus and Campylobacter Jejuni in children suffering with diarrhea in Rawalpindi and Islamabad, Pakistan in 2014. The clinical and epidemiological aspects of the disease were also investigated. METHODS: A total of 500 stool samples were collected from children presented with clinical signs and symptoms of acute diarrhea. The samples were initially screened for the presence of rotavirus A (RVA) via ELISA (Enzyme-linked immunosorbent assay) and RT-PCR (Reverse Transcriptase PCR) and then were analysed for C. jejuni by using species specific PCR assay. RESULTS: The detection rate of RVA was 26.4% (132/500) while, Campylobacter was detected in 52% (260/500) of samples with C. jejuni accounted for 48.2% (241/500) of all study cases. Co-infection of C. jejuni with RVA was identified in 21.8% of all cases. Children with RVA and C. jejuni co-infection showed a higher probability (p = 0.01) to be dehydrated. A significant association (p = 0.02) was found between C. jejuni positive status and fever in children. The median age of children with both RVA and C. jejuni infection was 6-11 months. The RVA detection rate was high in winter months of the year while, C. jejuni infections were documented high in summer over 1 year study period. CONCLUSIONS: The overall results have demonstrated the high prevalence of C. jejuni in Rawalpindi, Islamabad, Pakistan in 2014. The results of present study will not only help to calculate disease burden caused by C. jejuni and rotavirus but also will provide critical information to health authorities in planning public health care strategies against these pathogens.


Assuntos
Infecções por Campylobacter/microbiologia , Campylobacter jejuni/isolamento & purificação , Diarreia/microbiologia , Diarreia/virologia , Infecções por Rotavirus/virologia , Rotavirus/isolamento & purificação , Infecções por Campylobacter/epidemiologia , Campylobacter jejuni/classificação , Campylobacter jejuni/genética , Pré-Escolar , Cidades , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/virologia , Diarreia/epidemiologia , Fezes/microbiologia , Fezes/virologia , Feminino , Humanos , Lactente , Masculino , Paquistão/epidemiologia , Prevalência , Rotavirus/classificação , Rotavirus/genética , Infecções por Rotavirus/epidemiologia
4.
Parasit Vectors ; 12(1): 515, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685003

RESUMO

BACKGROUND: Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. The aim of this study was to determine the prevalence, geographical distribution, epidemiological aspects, symptoms and other health indicators of Strongyloides stercoralis infections in patients from 27 provinces of northern Vietnam attending the Hanoi Medical University Hospital during 2016 and 2017. METHODS: Blood samples of 2000 patients were analyzed for S. stercoralis infection with an IgG ELISA test. Seroprevalence was analyzed by gender, age group, locality of origin (rural or urban areas) and symptoms. Stools from the seropositive patients were examined for the detection of worms which were subsequently used for species identification by morphology and rDNA ITS1 sequencing. RESULTS: A seroprevalence of 20% was detected, showing an increasing prevalence from young to older age groups but without significant gender difference. Seroprevalence was higher in rural areas than in urban areas, both in general and individually in all provinces without exception, and lower in the mountainous areas than in the large valley lowlands. The follow-up of the 400 patients showed eosinophilia in 100% of cases, diarrhoea in 64.5%, digestion difficulties in 58.0%, stomachache in 45.5%, stomach and duodenal ulcers in 44.5%, itching in 28.0% and fever in 9.5%. The prevalence of symptoms and signs were also higher in older age groups than in younger age groups. Worms were detected in stools of 10.5% of the patients. Sequencing of a 501-bp nuclear ribosomal DNA ITS1 fragment allowed for the verification of infection by Strongyloides stercoralis. CONCLUSIONS: To our knowledge, this study is the largest survey of human strongyloidiasis in Vietnam so far and the first molecular identification of this nematode species in this country. Long-term chronicity may probably be usual in infected subjects, mainly in the older age groups.


Assuntos
Strongyloides stercoralis/genética , Estrongiloidíase/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Animais , Anticorpos Anti-Helmínticos/sangue , DNA de Helmintos/análise , DNA de Helmintos/química , DNA Ribossômico/análise , DNA Ribossômico/química , Diarreia/epidemiologia , Diarreia/parasitologia , Eosinofilia/epidemiologia , Eosinofilia/parasitologia , Feminino , Geografia , Humanos , Imunoglobulina G/sangue , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Estudos Soroepidemiológicos , Strongyloides stercoralis/imunologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/parasitologia , Vietnã/epidemiologia , Adulto Jovem
5.
Pan Afr Med J ; 33: 269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693717

RESUMO

Rotaviruses are one of the leading etiological agents of gastroenteritis in young children, for which a monovalent G1P(8) vaccine has been provided for free in Kenyan since July 2014. The main objective was to estimate the post vaccine prevalence and seasonal distribution of rotavirus diarrhea in children less than 5 years in Nairobi County, Kenya. Rotavirus positive samples were collected from children below 5 years of age in two hospitals within Nairobi County where vaccination status was card-confirmed. The children were examined and the demographic and clinical profiles of the children were recorded. Fecal specimens were analyzed for rotavirus antigen using an ELISA kit, followed by characterization by PAGE. Out of the total 323 samples, 49 had detectable rotavirus infection, representing 15.2% prevalence. Age distribution of rotavirus prevalence was as follows: ≤ 6 months-8.5%, 7-12 months-27.4%, 13-24 months - 41.4%, 25-36 months - 16.4% while 36-65 months had 6.3%. Rotavirus diarrhea was more common in wet and cold months of the year, the highest prevalence being observed in August (24.5%), 12.3% in both July and March, while April scored a prevalence of 10.2%. Out of the 49 rotavirus positive children, 48 had vomiting and abdominal cramps while all had fever and watery stool. The prevalence of Rotaviral diarrhea in children less than 5 years in Nairobi County Kenya has greatly reduced following the vaccine introduction and is more common during the wet and cold seasons of the year.


Assuntos
Diarreia/epidemiologia , Gastroenterite/epidemiologia , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus/administração & dosagem , Distribuição por Idade , Pré-Escolar , Diarreia/virologia , Feminino , Gastroenterite/virologia , Humanos , Lactente , Quênia/epidemiologia , Masculino , Prevalência , Infecções por Rotavirus/prevenção & controle , Estações do Ano
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1269-1273, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658529

RESUMO

Objective: To analyze the spatial-temporal characteristics of other infectious diarrhea (OID) in Jiangsu province from 2010 to 2017, and to provide evidence for setting up prevention and control programs of the disease. Methods: Data was from the Chinese Center for Disease Control and Prevention and the Statistics Bureau of Jiangsu province. Descriptive methods were used to illustrate the epidemiological characteristics of OID from 2010 to 2017. Global autocorrelation statistics method (Moran's I) was used to detect the spatial autocorrelation of OID, annually. Kulldorff M spatiotemporal scan statistics was used to analyze the spatial-temporal clustering of OID. ArcGIS 10.0 software, SaTScan 9.4 software and Excel 2017 software were also applied. Results: A total of 126 341 OID cases were found in Jiangsu province from 2010 to 2017 with an average annual incidence as 19.96/100 000. Children under five accounted for 55.08% (69 590/126 341) of the total cases. Obvious seasonal backshift with the increasing trends of the OID was noticed. There appeared four areas with high incidence of OID in the whole province, including Wuxi, Suzhou, Yancheng and Xuzhou. OID showed positive spatial autocorrelation at the county level with higher Moran's I from 0.19 to 0.33 (P<0.01). There appeared four positive clusters, all occurred in the high incidence period of OID, including the cluster area from the intersection areas of Changzhou and Wuxi (RR=7.61, LLR=2 605.80, P<0.01), respectively. Conclusion: With the increasing trends and the seasonal backshift of OID cases, pathogen surveillance programs set for those scattered children under five, in clustered regions and epidemic seasons should be strengthened.


Assuntos
Diarreia/epidemiologia , China/epidemiologia , Análise por Conglomerados , Humanos , Incidência , Estações do Ano , Análise Espaço-Temporal
7.
Aust Vet J ; 97(10): 418-421, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556108

RESUMO

This study reports the prevalence of potential faecal pathogens in the microbiome detected in a cohort of cats and dogs with diarrhoea in Perth, Western Australia. Records from a commercial diagnostic laboratory using faecal PCR testing between July 2014 and August 2015 were reviewed.Of 289 feline faecal samples reviewed, Salmonella spp. (1.7%), Campylobacter spp. (47.6%), Clostridium perfringens (81.3%), Giardia spp. (11.1%), Toxoplasma gondii (1.2%), Tritrichomonas foetus (4.8%), panleukopenia virus (6.5%) and coronavirus (39.5%) were detected. In dogs, Salmonella spp. (5.4%), Campylobacter spp. (36.3%), C. perfringens (85.4%), Giardia spp. (6.2%), parvovirus (9.4%), coronavirus (4.7%) and distemper virus (1.5%) were detected.


Assuntos
Doenças do Gato/microbiologia , Diarreia/veterinária , Doenças do Cão/microbiologia , Microbioma Gastrointestinal , Animais , Doenças do Gato/epidemiologia , Gatos , Coronavirus/isolamento & purificação , Diarreia/epidemiologia , Diarreia/microbiologia , Doenças do Cão/epidemiologia , Cães , Fezes/microbiologia , Feminino , Giardia/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Masculino , Reação em Cadeia da Polimerase/veterinária , Austrália Ocidental/epidemiologia
8.
Ned Tijdschr Geneeskd ; 1632019 09 09.
Artigo em Holandês | MEDLINE | ID: mdl-31556502

RESUMO

OBJECTIVE To determine the size and causative pathogen of the outbreak and to identify risk factors for developing gastroenteritis among participants of the Survivalrun in Udenhout in September 2016. Design Retrospective cohort study. METHODS We sent an invitation to go to an online questionnaire to participants and volunteers of the Survivalrun by email. The link to the questionnaire was also shared on the Facebook page and website of the Survivalrun. We calculated attack rates (AR) and relative risks (RR) for several exposures to identify risk factors for developing diarrhoea and/or vomiting within 3 days after the run. In addition, stool samples of six participants were tested for common gastrointestinal pathogens. RESULTS A total of 444 people completed the questionnaire. Symptoms of gastroenteritis were reported by 163 study participants (37%). Five participants reported symptoms of gastroenteritis in the week before and three participants during the Survivalrun. Multivariate analysis identified the following risk factors for developing gastroenteritis: participation on the second day of the run(RR 2.4: 95% CI 1.1-5.3), ingesting water (RR 1.7: 95% CI 1.3-2.3) and ingesting mud (RR 1.3: 95% CI 1.1-1.6). Four out of six stool samples tested positive for norovirus (various types). CONCLUSION This outbreak investigation shows that pathogens, such as norovirus, can easily spread during sporting events where participants have to move through water and mud. Specific methods and knowledge of the circumstances are essential for a thorough outbreak investigation.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Gastroenterite/epidemiologia , Vigilância da População/métodos , Esportes , Água/efeitos adversos , Adulto , Diarreia/epidemiologia , Diarreia/microbiologia , Fezes/microbiologia , Feminino , Gastroenterite/etiologia , Humanos , Incidência , Masculino , Norovirus/crescimento & desenvolvimento , Estudos Retrospectivos , Fatores de Risco , Vômito/epidemiologia , Vômito/microbiologia , Microbiologia da Água
9.
Artigo em Inglês | MEDLINE | ID: mdl-31522662

RESUMO

A cluster of gastrointestinal illness was detected following receipt of a complaint of becoming ill after a multi-course dinner at a restaurant in Canberra, Australian Capital Territory (ACT), Australia. The complaint led to an investigation by ACT Health. Food samples retained by the restaurant for microbiological analysis returned an unsatisfactory level of Bacillus cereus in beef (19,000 colony forming units/gram [cfu/g]) and a satisfactory level in arancini (50 cfu/g). These positive samples underwent whole genome sequencing and genes encoding diarrhoeal toxins were detected with no laboratory evidence of the emetic toxin. No stool specimens were collected. A cohort study was undertaken and 80% (33/41) of patrons took part in a structured interview. There was no significant difference in age or sex between those ill and not ill. Due to universal exposure most foods were unable to be statistically analysed and no significant results were found from the food history. The ill cohort diverged into two distinct groups based on incubation period and symptoms suggesting this outbreak involved B. cereus intoxication with both diarrhoeal and potentially emetic toxins. Some hygiene practices during food preparation were noted to be inadequate and heating and cooling procedures were unverified when questioned. A combination of the incubation periods and symptom profile, food laboratory evidence, and genomic sequencing of the B. cereus diarrhoeal gene suggest a probable aetiology of B. cereus intoxication. Public health action included the restaurant rectifying hygiene practices and documenting heating/cooling procedures.


Assuntos
Bacillus cereus/isolamento & purificação , Toxinas Bacterianas/toxicidade , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Gastroenterite/epidemiologia , Carne Vermelha/microbiologia , Animais , Território da Capital Australiana/epidemiologia , Bacillus cereus/genética , Bovinos , Estudos de Coortes , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/mortalidade , Eméticos , Feminino , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/mortalidade , Gastroenterite/microbiologia , Gastroenterite/mortalidade , Humanos , Masculino , Restaurantes , Estudos Retrospectivos , Inquéritos e Questionários
10.
BMC Infect Dis ; 19(1): 804, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519160

RESUMO

BACKGROUND: Globally, diarrhea is the leading cause of morbidity and mortality among less than 5 years old children and it contributes to the deaths of approximately one million children every year. In Ethiopia, diarrhea is the second cause of under-five mortality and morbidity. However, in the study area, studies were limited. Therefore, this study has assessed the prevalence of diarrhea and associated factors among < 5 years of age in Jamma district, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted from August 15 to September 15, 2017, in Jamma district, South Wello zone, northeast Ethiopia. A Systematic random sampling technique was used to select 614 households and a pretested structured questionnaire was used to collect the data. A multivariable logistic regression analysis was used to investigate factors associated with diarrheal disease. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) for variables with P-value < 0.05 was used to show statistically significant association. RESULTS: In this study, the prevalence of diarrhea among under-five children was 23.1% (95% CI: (19.4, 26.5). Child's age 6 to 23 months [AOR: 2.46, 95% CI: (1.49, 4.05)], Living in rural area [AOR: 2.75, 95% CI: (1.33,5.66)], absence of latrine [AOR: 4.80, 95% CI: (2.39,9.60)], absence of handwashing facility [AOR: 2.45, 95% CI: (1.53,3.93], unprotected drinking water source [AOR:2.68, 95% CI: (1.54,4.68)], and Improper waste disposal practices [AOR:3.86, 95% CI: (2.38,6.26)] were associated with diarrhea disease. CONCLUSION: There was a high prevalence of diarrheal disease among children in the study area. Child age, rural residence, availability of latrine and handwashing facility, source of drinking water, and improper waste disposal were notably associated with childhood diarrheal disease. Therefore, improving handwashing practices and pure water supply, proper waste disposal including the availability of latrines would minimize the burden of diarrheal disease.


Assuntos
Diarreia/epidemiologia , Meio Ambiente , Pré-Escolar , Estudos Transversais , Diarreia/mortalidade , Água Potável/normas , Etiópia/epidemiologia , Características da Família , Feminino , Desinfecção das Mãos , Habitação , Humanos , Lactente , Masculino , Razão de Chances , Prevalência , População Rural/estatística & dados numéricos , Inquéritos e Questionários , Toaletes/estatística & dados numéricos
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 880-882, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484247

RESUMO

The recent developed diarrhea and acute respiratory infections surveillance systems were a breakthrough of the infectious disease surveillance and monitoring in Shanghai. This series "Infectious Disease Surveillance in Shanghai" briefly introduced current experiences of the updated surveillance systems, in order to provide evidences for promotion in other disease surveillance and to enhance the connection between different surveillance systems.


Assuntos
Diarreia/epidemiologia , Controle de Infecções/métodos , Vigilância da População/métodos , Vigilância em Saúde Pública/métodos , Doença Aguda , China/epidemiologia , Doenças Transmissíveis/epidemiologia , Surtos de Doenças , Humanos , Infecções Respiratórias/epidemiologia , Vigilância de Evento Sentinela
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 883-888, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484248

RESUMO

Objective: To investigate the epidemiologic characteristics of Norovirus among adult patients suffering from infectious diarrhea in Shanghai, so as to provide evidence for developing related strategies on prevention and control of the disease. Methods: Diarrheal outpatients were monitored at the 'Intestinal clinic' from 22 hospitals involved in the sentinel surveillance program in Shanghai. Information on demographic and epidemiologic features of the patients was collected while data and clinical, fecal specimens were collected and sent to the district CDC for Norovirus detection. Positive rates of Norovirus were also compared in various populations and seasons during 2013-2018. Multivariate logistic regression model was adopted to fit into the comparisons between non-Norovirus and Norovirus groups. Results: 19.28% of the 12 083 diarrheal cases were found to have carried the Norovirus, with GⅡgroup the most commonly identified genotype. Rates of detection was seen higher in males (20.78%) than in females (17.73%). 30-44 year-old were found having the highest positive rate (21.51%). The positive rates were found the highest (23.60%) in the year of 2015. All the above shown differences were statistically significant (P<0.05). Diarrheal patients affected with Norovirus would present watery stool (75.94%) and vomiting (35.84%). Data from the multivariate logistic analysis showed that factors as: being males, 30-44 years old, officials/clerks, in winter season and with histories of travelling etc., were related to higher risks on Norovirus infection. Conclusions: Infectious diarrhea caused by Norovirus occurred all year round, with seasonal peaks seen in winter and spring, in Shanghai. Specific prevention and control measures should be taken on Norovirus- caused infectious diarrhea, according to the difference on age, gender and season.


Assuntos
Infecções por Caliciviridae/epidemiologia , Diarreia/epidemiologia , Disenteria/epidemiologia , Fezes/virologia , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adulto , Infecções por Caliciviridae/diagnóstico , China/epidemiologia , Diarreia/diagnóstico , Diarreia/virologia , Disenteria/diagnóstico , Disenteria/virologia , Feminino , Gastroenterite/virologia , Humanos , Masculino , Norovirus/genética , Vigilância de Evento Sentinela
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 889-894, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484249

RESUMO

Objective: To understand the seasonality and etiological characteristics of infectious diarrhea in adults from Shanghai. Methods: Adult patients with diarrhea who had visited the enteric disease clinics in 22 hospitals that carrying on the Diarrhea Comprehensive Surveillance sentinel programs in Shanghai during 2014-2017, were surveyed. Stool specimens were collected according to the different intervals of sampling and detected for 12 bacteria and 5 viruses. Concentration ratio and circular distribution method were used for data analysis. Results: From 2014 to 2017, a total of 9 573 stool specimens were collected from the targeted diarrhea patients ≥18 years old (n=96 067), through the Shanghai Diarrhea Comprehensive Surveillance program. The positive rate of detection was 46.44%. Seasonal peaks of infectious diarrhea were both seen in summer (bacteria peak, diarrheagenic Escherichia coli and Vibrio parahaemolyticus, etc.) and in winter (virus peak, Norovirus, etc.). Both bacterial and viral infections presented seasonal concentration (Raleigh's test P<0.001) but more obvious with bacterial infection. Viral infection accounted for 60.19% of the cause of infectious diarrhea. The top five predominant pathogens appeared as Norovirus, Rotavirus, diarrheagenic Escherichia coli, Vibrio parahaemolyticus, and Salmonella spp.. Conclusions: Among the adult outpatients with infectious diarrhea in Shanghai, obvious seasonality was seen, with peaks in both summer and winter. Viral infection with Norovirus in particular, appeared as the predominant source of infection. Active, continuous and comprehensive diarrhea-related surveillance programs would be able to monitor the changing dynamic of pathogen spectrum, and lead to the adoption of targeted preventive measures.


Assuntos
Bactérias/isolamento & purificação , Diarreia/diagnóstico , Diarreia/etiologia , Disenteria/diagnóstico , Disenteria/etiologia , Fezes , Pacientes Ambulatoriais/estatística & dados numéricos , Vigilância da População/métodos , Vírus/isolamento & purificação , Adolescente , Adulto , Bactérias/classificação , Criança , Pré-Escolar , China/epidemiologia , Diarreia/epidemiologia , Disenteria/epidemiologia , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Fezes/virologia , Humanos , Pessoa de Meia-Idade , Norovirus/isolamento & purificação , Rotavirus/isolamento & purificação , Salmonella/classificação , Salmonella/isolamento & purificação , Estações do Ano , Vibrio parahaemolyticus/isolamento & purificação , Vírus/classificação
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 900-903, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484251

RESUMO

Objective: To understand the epidemiological characteristics and antibiotic resistance profiles of Campylobacter spp. in Shanghai from 2013 to 2016. Methods: Stool samples collected from diarrhea outpatients were cultured for Campylobacter spp., using the membrane filter method in 23 hospitals under the sentinel programs, from 2013 to 2016. All the strains were identified by biochemical tests and PCR. Broth microdilution method was used to investigate the antibiotic resistance of 179 Campylobacter spp. strains that including azithromycin, ciprofloxacin, erythromycin, gentamicin, tetracycline, nalidixic acid, telycin, klinthromycin and flurbenicol. Results: A total of 179 Campylobacter spp. strains were isolated from 10 444 stool samples (1.7%). Campylobacter jejuni and Campylobacter coli appeared as the predominant ones (94.4% and 5.6%). The incidence rate was higher in children than that in adults, with peaks of infections mainly from April to June and October to December. Campylobacter jejuni strains seemed highly resistant to ciprofloxacin (96.4%), tetracycline (83.4%) and nalidixic acid (81.7%). The resistant rates appeared higher on Campylobacter coli strains that isolated from patients. Some strains were resistant to multi-drugs. Conclusions: Campylobacter spp. seemed one of the important pathogens that isolated from outpatients with diarrhea, in Shanghai. Both age and season related characteristics of Campylobacter spp. were seen. Campylobacter spp. isolated from patients was highly resistant to ciprofloxacin, tetracycline and nalidixic acid.


Assuntos
Antibacterianos/farmacologia , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/epidemiologia , Campylobacter/efeitos dos fármacos , Campylobacter/isolamento & purificação , Diarreia/microbiologia , Fezes/microbiologia , Adolescente , Adulto , Distribuição por Idade , Antibacterianos/uso terapêutico , Campylobacter/classificação , Infecções por Campylobacter/diagnóstico , Infecções por Campylobacter/microbiologia , Campylobacter coli/efeitos dos fármacos , Campylobacter coli/isolamento & purificação , Criança , Pré-Escolar , China/epidemiologia , Diarreia/epidemiologia , Farmacorresistência Bacteriana , Humanos , Incidência , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Vigilância da População
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 960-964, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484261

RESUMO

Objective: To study the lag effect of temperature and the source of heterogeneity on other infectious diarrhea (OID) in Zhejiang province, so as to identify related vulnerable populations at risk. Methods: Data on OID and meteorology in Zhejiang province from 2014 to 2016 were collected. A two-stage model was conducted, including: 1) using the distributed lag non-linear model to estimate the city-specific lag effect of temperature on OID, 2) applying the multivariate Meta- analysis to pool the estimated city-specific effect, 3) using the multivariate Meta-regression to explore the sources of heterogeneity. Results: There were 301 593 cases of OID in Zhejiang province during the study period. At the provincial level, temperature that corresponding to the lowest risk of OID was 16.7 ℃, and the temperature corresponding to the highest risk was 6.2℃ (RR=2.298, 95%CI: 1.527- 3.459). 16.7 ℃ was recognized as the reference temperature. P(5) and P(95) of the average daily temperature represented low and high temperature respectively. When the temperature was cold, the risk was delayed by 2 days, with the highest risk found on the 5(th) day (RR=1.057, 95%CI: 1.030-1.084) before decreasing to the 23(rd) day. When the temperature got hot, the risk of OID occurred on the first day (RR=1.081, 95%CI: 1.045-1.118) and gradually decreasing to the 8(th) day. Differences on heterogeneous sources related to the risks of OID in different regions, presented on urban latitude and the rate of ageing in the population. Conclusions: Both high or low temperature could increase the risk of OID, with a lag effect noticed. Prevention program on OID should be focusing on populations living in the high latitude and the elderly population at the low temperature areas.


Assuntos
Temperatura Baixa , Diarreia/epidemiologia , Disenteria/epidemiologia , Temperatura Alta , Idoso , China , Diarreia/diagnóstico , Disenteria/diagnóstico , Humanos , Temperatura Ambiente
16.
BMC Vet Res ; 15(1): 311, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477115

RESUMO

BACKGROUND: Norovirus (NoV) is recognized as a highly contagious enteric pathogen of mammals, and bovine norovirus (BNoV) is associated with calf diarrhoea and has caused great economic losses in the cattle industry. RESULTS: Here, we describe a case of emerging calf diarrhoea on a cattle farm in Henan Province, Central China. BNoV was the only enteric pathogen detected in outbreaks according to tests for enteric viruses, bacteria and parasites. The complete genome of the newly identified strain CH-HNSC-2018 was successfully sequenced and found to be 7342 nucleotides in length. Sequence and phylogenetic analyses revealed that CH-HNSC-2018 belongs to GIII.2 BNoV. Further analysis of the major capsid protein demonstrated that it is separated by specific genetic distances from previous BNoV strains identified in China and has 4 new amino acid (aa) mutations, 134A, 327 T, 380 L and 423A, in the VP1 protein and 11 aa substitutions in the hypervariable P2 subdomain, suggesting that the BNoV strains circulating in China are diverse. CONCLUSIONS: This is the first detection of GIII.2 BNoV in the VP1 region in China. This report should form a basis for further molecular studies on NoV and bovine enteric viruses in China.


Assuntos
Infecções por Caliciviridae/veterinária , Doenças dos Bovinos/virologia , Diarreia/veterinária , Genótipo , Norovirus/isolamento & purificação , Filogenia , Animais , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/virologia , Bovinos , China/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/veterinária , Doenças Transmissíveis Emergentes/virologia , Diarreia/epidemiologia , Diarreia/virologia , Surtos de Doenças/veterinária , Norovirus/genética
17.
BMC Public Health ; 19(1): 1235, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492123

RESUMO

BACKGROUND: Globally childhood diarrhoeal diseases continue to be the second leading cause of death, while in Ethiopia it kills half-million under-five children each year. Sanitation, unsafe water and personal hygiene are responsible for 90% of the occurrence. Thus, this study aimed to assess the prevalence and associated factors of diarrheal diseases among under-five children in Dale District, Sidama Zone, Southern Ethiopia. METHODS: A community-based cross-sectional study was conducted. A face to face interview using a structured questionnaire and observation checklist was used. A total of 546 households with at least one under-five children were selected using simple random sampling techniques. The data entry and cleaning were performed using Epidemiological information software (EPI Info) 3.5.1 and then exported to Statistical Package for Social Science (SPSS) version 16.0 for analysis. Frequencies and proportions were computed as descriptive analysis. Initially using bivariate analysis a crude association between the independent and dependent variables was investigated. Then, those variables with p-value ≤0.25 were included in multivariable analysis to determine the predictor variables for the outcome variables. Finally, further analyses were carried out using multivariable analysis at a significance level of p-value ≤0.05. RESULTS: A total of 537 children under the age of 5 years were included. The 2 weeks prevalence of diarrhea among children under the age of 5 years was 13.6, 95% CI (10.7, 16.5%). Educational level [AOR: 3.97, 95% CI (1.60, 8.916)], age of indexed child [AOR: 12.18, 95% CI (1.78, 83.30)], nutritional status [AOR: 6.41, 95% CI (2.47, 16.77.)], hand washing method [AOR, 3.10, 95% CI (1.10, 8.67)], hand washing after latrine [AOR: 2.73, 95% CI (1.05, 6.56)], refuse disposal method [AOR, 3.23, 95% CI (1.37, 7.60)] and housing floor material [AOR: 3.22, 95% CI (1.16, 8.91] were significantly associated with the occurrence of childhood diarrheal diseases. CONCLUSION: Childhood diarrhea remains the commonest health problem in the study area. The findings have important policy implications for childhood diarrhoeal disease intervention programs. Thus, activities focusing on proper handwashing techniques at all appropriate times, proper refuse disposal, improving nutrition and better childcare also highly recommended.


Assuntos
Diarreia/epidemiologia , Pré-Escolar , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários
18.
Isr Med Assoc J ; 21(8): 538-541, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474016

RESUMO

BACKGROUND: Travelers' diarrhea (TD) is frequently encountered in people traveling from high-income to low-income countries; however, its epidemiology in those traveling between high-income countries is not known. OBJECTIVES: To evaluate the incidence of diarrhea in North American students relocating to Israel. METHODS: A retrospective cohort study involving medical students from the United States and Canada relocating to Israel was conducted. Students who relocated to Israel during 2010-2016 were contacted by email to participate in an anonymous survey. Data included demographic information as well as occurrence, timing, duration, and outcome of diarrhea after relocation. RESULTS: Ninety-seven students participated in the survey. Most (93.7%) students relocated from the United States or Canada. The period-prevalence of diarrhea was 69.1%. The incidence of diarrhea declined from 34.8 cases per 100 student-months during the first month after relocation to 1.3 cases per 100 student-months after 1 year. The duration of diarrhea was up to 1 week in 72.7%. Students who reported diarrhea were younger than students who did not (mean age 24.0 ± 2.2 and 28.4 ± 1.8 years, respectively, P < 0.001). No other demographic parameter was significantly associated with a higher likelihood of diarrhea. CONCLUSIONS: A high proportion of North American medical students relocating to Israel reported diarrhea with clinical and epidemiological features similar to classic TD. Further studies are needed to elucidate the causative agents of TD in Israel.


Assuntos
Diarreia/epidemiologia , Inquéritos Epidemiológicos/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Doença Relacionada a Viagens , Doença Aguda , Adulto , Canadá/etnologia , Estudos de Coortes , Diarreia/etnologia , Feminino , Humanos , Incidência , Israel/epidemiologia , Masculino , Projetos Piloto , Estudos Retrospectivos , Viagem , Estados Unidos/etnologia , Adulto Jovem
19.
PLoS Negl Trop Dis ; 13(8): e0007211, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31415558

RESUMO

BACKGROUND: Pediatric diarrhea can be caused by a wide variety of pathogens, from bacteria to viruses to protozoa. Pathogen prevalence is often described as seasonal, peaking annually and associated with specific weather conditions. Although many studies have described the seasonality of diarrheal disease, these studies have occurred predominantly in temperate regions. In tropical and resource-constrained settings, where nearly all diarrhea-associated mortality occurs, the seasonality of many diarrheal pathogens has not been well characterized. As a retrospective study, we analyze the seasonal prevalence of diarrheal pathogens among children with moderate-to-severe diarrhea (MSD) over three years from the seven sites of the Global Enteric Multicenter Study (GEMS), a case-control study. Using data from this expansive study on diarrheal disease, we characterize the seasonality of different pathogens, their association with site-specific weather patterns, and consistency across study sites. METHODOLOGY/PRINCIPAL FINDINGS: Using traditional methodologies from signal processing, we found that certain pathogens peaked at the same time every year, but not at all sites. We also found associations between pathogen prevalence and weather or "seasons," which are defined by applying modern machine-learning methodologies to site-specific weather data. In general, rotavirus was most prevalent during the drier "winter" months and out of phase with bacterial pathogens, which peaked during hotter and rainier times of year corresponding to "monsoon," "rainy," or "summer" seasons. CONCLUSIONS/SIGNIFICANCE: Identifying the seasonally-dependent prevalence for diarrheal pathogens helps characterize the local epidemiology and inform the clinical diagnosis of symptomatic children. Our multi-site, multi-continent study indicates a complex epidemiology of pathogens that does not reveal an easy generalization that is consistent across all sites. Instead, our study indicates the necessity of local data to characterizing the epidemiology of diarrheal disease. Recognition of the local associations between weather conditions and pathogen prevalence suggests transmission pathways and could inform control strategies in these settings.


Assuntos
Diarreia Infantil/epidemiologia , Diarreia/epidemiologia , Saúde Global , Estudos Multicêntricos como Assunto/métodos , África/epidemiologia , Ásia/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Países em Desenvolvimento , Diarreia/microbiologia , Diarreia/parasitologia , Diarreia/virologia , Diarreia Infantil/microbiologia , Diarreia Infantil/parasitologia , Diarreia Infantil/virologia , Projetos de Pesquisa Epidemiológica , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Estações do Ano , Clima Tropical
20.
Ethiop J Health Sci ; 29(4): 513-524, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447525

RESUMO

Background: Diarrhea remains the leading cause of morbidity and mortality among under 5 children in low- and middle-income countries. In Tanzania, diarrhea remains one of the major public health problems. This study aimed to investigate spatial variations and the factors correlated with diarrhea in under five children. Methods: This is a secondary data analysis using data from the population-based cross section Tanzanian Demographic and Health Survey 2015-16 data. Spatial analysis was done using the Bernoulli model from SaTScan™ software, and a generalized linear mixed model was used to identify the factors associated with childhood diarrhea. Results: The overall reported prevalence of childhood diarrhea for the under five children in Tanzania was 12.1% (95%CI 11.3%-12.9%). The SaTScan spatial statics analysis revealed that diarrhea in children was not random. The odds of diarrhea were 7.35 times higher (AOR= 7.35; 95%CI: 5.29, 10.22) among children in the 6-11 months age group compared to children within the 48-59 months of age. As mother's age increased, the risk of diarrhea for the under five children decreased whereas the highest risk of diarrhea was observed in the two rich income brackets richer (AOR=1.70, 95%CI=1.30, 2.22), and richest (AOR= 1.05, 95%CI=1, 1.09). The odds of diarrhea were 1.25 times higher (AOR=1.25, 95%CI=1.06, 1.46) among children with unsafe stool disposal compared to those with safe disposal. Conclusion: The socio-demographic factors associated with diarrhea among children were mother's age in years, current age of the child, wealth index and child stool disposal.


Assuntos
Diarreia/epidemiologia , Adolescente , Adulto , Fatores Etários , Pré-Escolar , Estudos Transversais , Diarreia/etiologia , Diarreia Infantil/epidemiologia , Diarreia Infantil/etiologia , Escolaridade , Feminino , Geografia , Humanos , Lactente , Idade Materna , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Tanzânia/epidemiologia , Adulto Jovem
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