Volume 83, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The objective was to assess the association of enteric pathogens in diarrheal disease in a remote rural area in Thailand. Stool specimens were collected from 236 children aged 3 months to 5 years with acute diarrhea (cases) and from 236 asymptomatic controls. Standard microbiologic methods, and enzyme immunoassay for viral pathogens, , and , were used to identify enteric pathogens with susceptibility testing by disk diffusion. , , , and enterotoxigenic were commonly isolated from cases and controls (22% versus 25%, 10% versus 11%, 6% versus 9%, and 10% versus 6%, respectively). Only , rotavirus, and adenovirus were identified significantly more frequently in cases than controls (9% versus 0%, 18% versus 3%, and 16% versus 2%, respectively), whereas was detected less often in cases than controls. Most pre-school children were infested with enteric pathogens; laboratory-based studies are important to understand the epidemiology of enteric pathogens in remote areas among marginal populations.


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  1. Boschi-Pinto C, Velebit L, Shibuya K, , 2008. Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ 86: 710717.[Crossref]
  2. Snyder JD, Merson MH, , 1982. The magnitude of the global problem of acute diarrhoeal disease: a review of active surveillance data. Bull World Health Organ 60: 605613.
  3. Bern C, Martines J, de Zoysa I, Glass RI, , 1992. The magnitude of the global problem of diarrhoeal disease: a ten-year update. Bull World Health Organ 70: 705714.
  4. Kosek M, Bern C, Guerrant RL, , 2003. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organ 81: 197204.
  5. Vandamme P, Nachamkin I, Blaser MJ, , 2000. Taxonomy of the family Campylobacteraceae. , eds. Campylobacter, 2nd ed. Washington, DC: ASM Press, 326.
  6. Sommerfelt H, Kalland KH, Raj P, Moseley SL, Bhan MK, Bjorvatn B, , 1988. Cloned polynucleotide and synthetic oligonucleotide probes used in colony hybridization are equally efficient in the identification of enterotoxigenic Escherichia coli . J Clin Microbiol 26: 22752278.
  7. Echeverria P, Seriwatana J, Sethabutr O, Chatkaeomorakot A, Macaro AJL, Conway de Macario E, , 1990. Detection of diarrheagenic Escherichia coli using nucleotide probes. , eds. Gene Probes for Bacteria. San Diego, CA: Academic Press Inc., 95141.[Crossref]
  8. Nataro JP, Baldini MM, Kaper JB, Black RE, Bravo N, Levine MM, , 1985. Detection of an adherence factor of enteropathogenic Escherichia coli with a DNA probe. J Infect Dis 152: 560565.[Crossref]
  9. Giron JA, Ho AS, Schoolnik GK, , 1991. An inducible bundle-forming pilus of enteropathogenic Escherichia coli . Science 254: 710713.[Crossref]
  10. Schorling JB, Wanke CA, Schorling SK, McAuliffe JF, de Souza MA, Guerrant RL, , 1990. A prospective study of persistent diarrhea among children in an urban Brazilian slum. Patterns of occurrence and etiologic agents. Am J Epidemiol 132: 144156.[Crossref]
  11. Huilan S, Zhen LG, Mathan MM, Mathew MM, Olarte J, Espejo R, Khin Maung U, Ghafoor MA, Khan MA, Sami Z, , 1991. Etiology of acute diarrhoea among children in developing countries: a multicentre study in five countries. Bull World Health Organ 69: 549555.
  12. Hien BT, Trang do T, Scheutz F, Cam PD, Molbak K, Dalsgaard A, , 2007. Diarrhoeagenic Escherichia coli and other causes of childhood diarrhoea: a case-control study in children living in a wastewater-use area in Hanoi, Vietnam. J Med Microbiol 56: 10861096.[Crossref]
  13. Guerrant RL, Kirchhoff LV, Shields DS, Nations MK, Leslie J, de Sousa MA, Araujo JG, Correia LL, Sauer KT, McClelland KE, , 1983. Prospective study of diarrheal illnesses in northeastern Brazil: patterns of disease, nutritional impact, etiologies, and risk factors. J Infect Dis 148: 986997.[Crossref]
  14. Echeverria P, Taylor DN, Lexsomboon U, Bhaibulaya M, Blacklow NR, Tamura K, Sakazaki R, , 1989. Case-control study of endemic diarrheal disease in Thai children. J Infect Dis 159: 543548.[Crossref]
  15. Black RE, Lopez de Romana G, Brown KH, Bravo N, Bazalar OG, Kanashiro HC, , 1989. Incidence and etiology of infantile diarrhea and major routes of transmission in Huascar, Peru. Am J Epidemiol 129: 785799.[Crossref]
  16. Albert MJ, Faruque AS, Faruque SM, Sack RB, Mahalanabis D, , 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbiol 37: 34583464.
  17. Levine MM, Kaper JB, Black RE, Clements ML, , 1983. New knowledge on pathogenesis of bacterial enteric infections as applied to vaccine development. Microbiol Rev 47: 510550.
  18. Cravioto A, Reyes RE, Trujillo F, Uribe F, Navarro A, De La Roca JM, Hernandez JM, Perez G, Vazquez V, , 1990. Risk of diarrhea during the first year of life associated with initial and subsequent colonization by specific enteropathogens. Am J Epidemiol 131: 886904.[Crossref]
  19. Black RE, Brown KH, Becker S, Alim AR, Huq I, , 1982. Longitudinal studies of infectious diseases and physical growth of children in rural Bangladesh. II. Incidence of diarrhea and association with known pathogens. Am J Epidemiol 115: 315324.[Crossref]
  20. Gilman RH, Marquis GS, Miranda E, Vestegui M, Martinez H, , 1988. Rapid reinfection by Giardia lamblia after treatment in a hyperendemic Third World community. Lancet 1: 343345.[Crossref]
  21. Black RE, Nelson K, Williams CM, Graham N, , 2000. Diarrheal disease. , eds. Infectious Disease Epidemiology: Theory and Practice. Gaithersburg, MD: Aspen Publishers Inc., 497517.
  22. Vu Nguyen T, Le Van P, Le Huy C, Nguyen Gia K, Weintraub A, , 2006. Etiology and epidemiology of diarrhea in children in Hanoi, Vietnam. Int J Infect Dis 10: 298308.[Crossref]
  23. World Health Organization, 2005. The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. Available at: http://whqlibdoc.who.int/publications/2005/9241593180.pdf. Accessed August 1, 2010.
  24. Serichantalergs O, Dalsgaard A, Bodhidatta L, Krasaesub S, Pitarangsi C, Srijan A, Mason CJ, , 2007. Emerging fluoroquinolone and macrolide resistance of Campylobacter jejuni and Campylobacter coli isolates and their serotypes in Thai children from 1991 to 2000. Epidemiol Infect 135: 12991306.[Crossref]
  25. Isenbarger DW, Hoge CW, Srijan A, Pitarangsi C, Vithayasai N, Bodhidatta L, Hickey KW, Cam PD, , 2002. Comparative antibiotic resistance of diarrheal pathogens from Vietnam and Thailand, 1996–1999. Emerg Infect Dis 8: 175180.[Crossref]
  26. Hoge CW, Gambel JM, Srijan A, Pitarangsi C, Echeverria P, , 1998. Trends in antibiotic resistance among diarrheal pathogens isolated in Thailand over 15 years. Clin Infect Dis 26: 341345.[Crossref]

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  • Received : 29 Jun 2010
  • Accepted : 11 Aug 2010

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