The Detection of Enteropathogens in Acute Diarrhea in a Family Cohort Population in Rural Egypt

Ahmed M. ZakiCentral Health Laboratory

Search for other papers by Ahmed M. Zaki in
Current site
Google Scholar
PubMed
Close
,
Herbert L. DuPontThe University of Texas Health Science Center at Houston, Texas

Search for other papers by Herbert L. DuPont in
Current site
Google Scholar
PubMed
Close
,
Mohamed A. el AlamyEpidemiology Study Center-Bilbeis

Search for other papers by Mohamed A. el Alamy in
Current site
Google Scholar
PubMed
Close
,
Raouf R. ArafatEpidemiology Study Center-Bilbeis

Search for other papers by Raouf R. Arafat in
Current site
Google Scholar
PubMed
Close
,
Kareema AminSerum and Vaccine Institute, Ministry of Health, Cairo, Egypt

Search for other papers by Kareema Amin in
Current site
Google Scholar
PubMed
Close
,
Mustafa M. AwadCentral Health Laboratory

Search for other papers by Mustafa M. Awad in
Current site
Google Scholar
PubMed
Close
,
Lila BassiouniSerum and Vaccine Institute, Ministry of Health, Cairo, Egypt

Search for other papers by Lila Bassiouni in
Current site
Google Scholar
PubMed
Close
,
Imam Z. ImamSerum and Vaccine Institute, Ministry of Health, Cairo, Egypt

Search for other papers by Imam Z. Imam in
Current site
Google Scholar
PubMed
Close
,
Girgis S. el MalihCentral Health Laboratory

Search for other papers by Girgis S. el Malih in
Current site
Google Scholar
PubMed
Close
,
Aisha el MarsafieCentral Health Laboratory

Search for other papers by Aisha el Marsafie in
Current site
Google Scholar
PubMed
Close
,
Mohammad S. MohieldinCentral Health Laboratory

Search for other papers by Mohammad S. Mohieldin in
Current site
Google Scholar
PubMed
Close
,
Tary NaguibSerum and Vaccine Institute, Ministry of Health, Cairo, Egypt

Search for other papers by Tary Naguib in
Current site
Google Scholar
PubMed
Close
,
Magda A. RakhaCentral Health Laboratory

Search for other papers by Magda A. Rakha in
Current site
Google Scholar
PubMed
Close
,
Michael SidarosCentral Health Laboratory

Search for other papers by Michael Sidaros in
Current site
Google Scholar
PubMed
Close
,
Nadia WasefCentral Health Laboratory

Search for other papers by Nadia Wasef in
Current site
Google Scholar
PubMed
Close
,
Charles E. WrightThe University of Texas Health Science Center at Houston, Texas

Search for other papers by Charles E. Wright in
Current site
Google Scholar
PubMed
Close
, and
Richard G. WyattNational Institutes of Health, Bethesda, Maryland

Search for other papers by Richard G. Wyatt in
Current site
Google Scholar
PubMed
Close
Restricted access

In 8 villages of rural northeastern Egypt, a 2-year study of the etiologic agents associated with episodes of diarrhea was carried out. Stool specimens (3,243) from 3,513 episodes of diarrhea were processed for enteropathogens. The most commonly identified agents in the group with diarrhea were Giardia lamblia (44%), heat stable enterotoxin (ST)-producing enterotoxigenic Escherichia coli (ETEC) (15%), heat labile toxin (LT)- producing ETEC (12%), enteropathogenic E. coli (EPEC) (4%), rotavirus (3%), Shigella (2%) and Salmonella (1%). Isolation rates were increased in cases compared to controls for all agents except G. lamblia and EPEC strains. Rotavirus, Salmonella and ST-producing ETEC were more frequently isolated during cooler months and Shigella and LT-ETEC occurred more commonly in warmer months. Campylobacter, EPEC, Giardia and E. histolytica did not show a discernable seasonal pattern. Rotavirus was primarily associated with diarrhea in infants only. Forty-four percent of children experienced at least 1 bout of rotavirus diarrhea by the age of 3 years. Vomiting was reported in 65% of cases of rotavirus infection. Dehydration was reported in >40% of those with rotavirus-, Salmonella-, Campylobacter-, LT-ETEC- and EPEC-associated illness and in those without an identifiable agent. While rotavirus was implicated in 3% of cases overall, when vomiting or vomiting plus dehydration occurred, rotavirus was identified with a rate of 10% and 12%, respectively. Dysentery was common only in Shigella cases, occurring in 24%. A decrease in occurrence of rotavirus, Campylobacter and possibly EPEC illness was seen in the infants <6 months of age who were breast-fed when compared to those who were not.

Author Notes

Deceased.

Save