- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Socioeconomic characteristics.
- Diarrheal morbidity.
- Relationship between diarrheal diseases and baseline nutritional status of the children.
- Effect of breast-feeding on diarrheal incidence.
- Relationship between blood group and diarrheal diseases.
- Season and diarrheal incidence.
- Enteropathogens isolated from diarrheal stools.
- Entamoeba histolytica-associated diarrhea incidence and association with diarrhea and dysentery.
- Clinical findings of the first E. histolytica-associated diarrhea/dysentery episodes.
- Asymptomatic E. histolytica infection incidence.
- Asymptomatic E. histolytica infection and season.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
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 :705–714.
-
2
World Health Organization, Division of Diarrhoeal and Acute Respiratory Disease Control, 1995. Integrated management of the sick child. Bull World Health Organ 73 :735–740.
-
3
Petri, WA Jr, Haque R., Lyerly D, Vines RR, 2000. Estimating the impact of amebiasis on health. Parasitol Today 16 :320–321.
-
4
Yamashiro T, Nakasone N, Higa N, Iwanaga M, Insisiengmay S, Phounane T, Munnalath K, Sithivong N, Sisavath L, Phanthauamath B, Chomlasak K, Sisulath P, Vongsanith P, 1998. Etiologic study of diarrheal patients in Vientiane, Lao People’s Democratic Republic. J Clin Microbiol 36 :2195–2199.
-
5
Ferreccio C, Prado V, Ojeda A, Cayyazo M, Abrego P, Guers L, Levine MM, 1991. Epidemiologic patterns of acue diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile. Am J Epidemiol 134 :614–627.
-
6
Wanke C, Butler T, Islam M, 1988. Epidemiologic and clinical features of invasive amebiasis in Bangladesh: a case-control comparison with other diarrheal diseases and postmortem findings. Am J Trop Med Hyg 38 :335–341.
-
7
World Health Organization, 1997. World Health Organization (WHO)/Pan American Health Organization/UNESCO report of a consultation of experts on amebiasis. World Health Organ Wkly Epidemiol Rep 72 :97–99.
-
8
Gathiram V, Jackson TFGH, 1987. A longitudinal study of asymptomatic carriers of pathogenic zymodemes of Entamoeba histolytica. S Afr Med J 72 :669–672.
-
9
Haque R, Ali IKM, Petri WA Jr, 1999. Prevalence and immune response of E. histolytica infection in preschool children in Bangladesh. Am J Trop Med Hyg 60 :1031–1034.
-
10
Gathiram V, Jackson TFHG, 1985. Frequency distribution of Entamoeba histolytica in a rural South African population. Lancet 1 :719–721.
-
11
Haque R, Faruque ASG, Hahn P, Lyerly DM, Petri WA Jr, 1997. Entamoeba histolytica and Entamoeba dispar infection in children in Bangladesh. J Infect Dis 175 :734–736.
-
12
Haque R, Ali IKM, Sack RB, Farr BM, Ramakrishnan, Petri WA Jr, 2001. Amebiasis and mucosal IgA antibody against the Entamoeba histolytica adherence lectin in Bangladeshi children. J Infect Dis 183 :1787–1793.
-
13
Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM, 1979. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr 32 :607–629.
-
14
World Health Organization, 1990. A Manual for the Treatment of Diarrhea For Use by Physicians and Other Senior Health Workers. Geneva: World Health Organization, CDD/SER/ 80.2 Rev. 2.
-
15
Ruuska T, Vesikari T, 1990. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrheal episodes. Scand J Infect Dis 22 :259–267.
-
16
Lennett EH, Balows A, Hausler WJ Jr, Shadmoy HJ, eds., 1985. Manual of Clinical Microbiology. Fourth edition. Washington. DC: American Society for Microbiology.
-
17
Levine MM, Prado V, Robins-Browne R, Lior H, Kaper JB, Moseley SL, Gicquelais K, Nataro JP, Vial P, Tall B, 1988. Use of DNA probes and Hep-2 cell adherence assay to detect diarrheagenic Escherichia coli.J Infect Dis 158 :224–228.
-
18
Albert JM, Faruque ASG, Faruque SM, Sack RB, Mahalanabis D, 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbiol 37 :3458–3464.
-
19
Miller RV, ed., 1977. Technical Manual. Seventh edition. Washington, DC: American Association of Blood Banks.
-
20
Baqui AH, Black RE, Sack RB, Chowdhury HR, Yunus M, Siddique AK, 1993. Malnutrition, cell-mediated immune deficiency, and diarrhea: a community-based longitudinal study in rural Bangladeshi children. Am J Epidemiol 17 :355–365.
-
21
Baqui AH, Black RE, Sack RB, Yunus MD, Siddique AK, Chowdhury HR, 1992. Epidemiological and clinical characteristics of acute and persistent diarrhoea in rural Bangladeshi children. Acta Paediatr 381 (suppl):15–21.
-
22
Guerrant RL, Kirchhoff, Shields DS, Nations MK, Leslie J, de Sousa A, Araujo JG, Correia LL, Sauer KT, McClelland KE, Trowbridge FL, Hughes JM, 1983. Prospective study of diarrheal illness in northeastern Brazil: patterns of diseases, nutritional impact, etiologies, and risk factors. J Infect Dis 148 :986–997.
-
23
Santosham M, Sack RB, Reid R, Black R, Croll J, Yolken R, Aurelian L, Wolff M, Chan E, Garrett S, Froehlich J, 1995. Diarrhoeal diseases in the White Mountain Apaches: epidemiologic studies. J Diarrhoeal Dis Res 13 :18–28.
-
24
Baqui AH, Sack RB, Black RE, Haider K, Hossain A, Abdul Alim ARM, Yunus M, Chowdhury HR, Siddique AK, 1992. Enteropathogens associated with acute and persistent diarrhea in Bangladeshi children < 5 years of age. J Infect Dis 166 :792–796.
-
25
Huilan S, Zhen Lu G, Mathan MM, Mathew MM, Olarte J, Espejo R, Maung K, Ghafoor MA, Khan MA, Sami Z, Sutton RG, 1991. Etiology of acute diarrhea among children in developing countries: a multicentric study in five countries. Bull World Health Organ 69 :549–555.
-
26
Frederik PL, van Loon, Clemens JD, Sack DA, Rao MR, Ahmed F, Chowdhury S, Harris JR, Ali M, Chakraborty J, Khan MR, Neogy PK, Svennerholm AM, Holmgren J, 1991. ABO blood groups and the risk of diarrhea to enterotoxigenic Escherichia coli.J Infect Dis 163 :1243–1246.
-
27
Glass RI, Holmgren J, Haley CE, Khan MR, Marisvennerholm A, Stoli BJ, Hossain KMB, Black RE, Yunus M, Barua D, 1985. Predisposition for cholera of individuals with O blood group. Am J Epidemiol 121 :791–796.
-
28
Janda JM, Abbott SL, 1998. Evolving concepts regarding the genus Aeromonas: an expanding panorama of species, diseases presentation, and unanswered questions. Clin Infect Dis 27 :332–344.
-
29
Teka T, Faruque ASG, Hossain MI, Fuchs GJ, 1999. Aeromonas-associated diarrhoea in Bangladeshi children: clinical and epidemiological characteristics. Ann Trop Paediatr 19 :15–20.
-
30
Bhattacharya MK, Teka T, Faruque ASG, Fuchs GJ, 1997. Cryptosporidium infection in children in urban Bangladesh. J Trop Pediatr 43 :282–285.
-
31
Zaki A.M, Herbert L, Pont Du, Alamy MAEA, Arafat RR, Amin K, Awad MM, Bassiouni L, Imam IZ, Malih GSE, Marsafie AE, Mohieldin MS, Naguib T, Rakha MA, Sidaros M, Wasef N, Wright CE, Wyatt RG, 1986. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg 35 :1013–1022.
-
32
Abd-Alla MD, Ravdin JI, 2002. Diagnosis of amoebic colitis by antigen captures ELISA patients presenting with acute diarrhoea in Cairo, Egypt. Trop Med Int Health 7 :365–370.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1686 | 1538 | 23 |
| Full Text Views | 443 | 8 | 0 |
| PDF Downloads | 219 | 13 | 0 |
EPIDEMIOLOGIC AND CLINICAL CHARACTERISTICS OF ACUTE DIARRHEA WITH EMPHASIS ON ENTAMOEBA HISTOLYTICA INFECTIONS IN PRESCHOOL CHILDREN IN AN URBAN SLUM OF DHAKA, BANGLADESH
RASHIDUL HAQUE
RASHIDUL HAQUE
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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DINESH MONDAL
DINESH MONDAL
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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BETH D. KIRKPATRICK
BETH D. KIRKPATRICK
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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SELIM AKTHER
SELIM AKTHER
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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BARRY M. FARR
BARRY M. FARR
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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R. BRADLEY SACK
R. BRADLEY SACK
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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WILLIAM A. PETRI JR.
WILLIAM A. PETRI JR.
Centre for Health and Population Research, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh; Department of Medicine, Unit of Infectious Disease, University of Vermont College of Medicine, Burlington, Vermont; Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville, Virginia; Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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The epidemiology, clinical features, nutritional status, and causative agents of diarrhea were studied in 289 Bangladeshi children (147 boys and 142 girls) 2–5 years old. The use of improved diagnostic tests for amebiasis enabled for the first time analysis of the contribution of Entamoeba histolytica to total diarrheal illness in this community setting. The average incidence rate of diarrhea was 1.8/child-year, and the average number of diarrheal days was 3.7 days/child-year over an average observation period of 2.8 years/child. Seventy-five percent of the diarrheal episodes were ≤ 2 days in duration. Persistent diarrhea was relatively uncommon (0.2% of the children) and chronic diarrhea was observed in only one episode. Compared with malnourished and/or stunted children, better-nourished children experienced significantly fewer diarrheal episodes. The diarrheal incidence rate for children with blood group A was significantly less that that of the children with blood groups O and AB. The most frequent bacterial enteropathogens isolated from diarrheal stool specimens were enterotoxigenic Escherichia coli (9%) and Aeromonas species (9%), followed by Plesimonas shigelloides (4%) and Shigella flexneri (3.8%). Rotavirus was the most common viral agent isolated from diarrheal stool samples (5%). Giardia lamblia, Cryptosporidium parvum, and E. histolytica were identified in 11%, 8.4%, and 8%, respectively, of the diarrheal stool specimens. Dysentery was observed in 7.7% of all diarrheal episodes. The most common pathogens isolated from dysenteric stool were S. flexneri (11.6%), Aeromonas sp. (10%), E. histolytica (8.7%), Campylobacter jejunii (5.8%), P. shigelloides (4.3%), and A. caviae (4.3%). The overall incidence rate of E. histolytica-associated diarrhea was 0.08/child-year. Visible blood and hemoccult test-detected blood loss was found in 7% and 25%, respectively, of cases of E. histolytica-associated diarrhea. Children who had recovered from a diarrheal episode with E. histolytica, but not E. dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.
Author Notes
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Socioeconomic characteristics.
- Diarrheal morbidity.
- Relationship between diarrheal diseases and baseline nutritional status of the children.
- Effect of breast-feeding on diarrheal incidence.
- Relationship between blood group and diarrheal diseases.
- Season and diarrheal incidence.
- Enteropathogens isolated from diarrheal stools.
- Entamoeba histolytica-associated diarrhea incidence and association with diarrhea and dysentery.
- Clinical findings of the first E. histolytica-associated diarrhea/dysentery episodes.
- Asymptomatic E. histolytica infection incidence.
- Asymptomatic E. histolytica infection and season.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
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 :705–714.
-
2
World Health Organization, Division of Diarrhoeal and Acute Respiratory Disease Control, 1995. Integrated management of the sick child. Bull World Health Organ 73 :735–740.
-
3
Petri, WA Jr, Haque R., Lyerly D, Vines RR, 2000. Estimating the impact of amebiasis on health. Parasitol Today 16 :320–321.
-
4
Yamashiro T, Nakasone N, Higa N, Iwanaga M, Insisiengmay S, Phounane T, Munnalath K, Sithivong N, Sisavath L, Phanthauamath B, Chomlasak K, Sisulath P, Vongsanith P, 1998. Etiologic study of diarrheal patients in Vientiane, Lao People’s Democratic Republic. J Clin Microbiol 36 :2195–2199.
-
5
Ferreccio C, Prado V, Ojeda A, Cayyazo M, Abrego P, Guers L, Levine MM, 1991. Epidemiologic patterns of acue diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile. Am J Epidemiol 134 :614–627.
-
6
Wanke C, Butler T, Islam M, 1988. Epidemiologic and clinical features of invasive amebiasis in Bangladesh: a case-control comparison with other diarrheal diseases and postmortem findings. Am J Trop Med Hyg 38 :335–341.
-
7
World Health Organization, 1997. World Health Organization (WHO)/Pan American Health Organization/UNESCO report of a consultation of experts on amebiasis. World Health Organ Wkly Epidemiol Rep 72 :97–99.
-
8
Gathiram V, Jackson TFGH, 1987. A longitudinal study of asymptomatic carriers of pathogenic zymodemes of Entamoeba histolytica. S Afr Med J 72 :669–672.
-
9
Haque R, Ali IKM, Petri WA Jr, 1999. Prevalence and immune response of E. histolytica infection in preschool children in Bangladesh. Am J Trop Med Hyg 60 :1031–1034.
-
10
Gathiram V, Jackson TFHG, 1985. Frequency distribution of Entamoeba histolytica in a rural South African population. Lancet 1 :719–721.
-
11
Haque R, Faruque ASG, Hahn P, Lyerly DM, Petri WA Jr, 1997. Entamoeba histolytica and Entamoeba dispar infection in children in Bangladesh. J Infect Dis 175 :734–736.
-
12
Haque R, Ali IKM, Sack RB, Farr BM, Ramakrishnan, Petri WA Jr, 2001. Amebiasis and mucosal IgA antibody against the Entamoeba histolytica adherence lectin in Bangladeshi children. J Infect Dis 183 :1787–1793.
-
13
Hamill PVV, Drizd TA, Johnson CL, Reed RB, Roche AF, Moore WM, 1979. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr 32 :607–629.
-
14
World Health Organization, 1990. A Manual for the Treatment of Diarrhea For Use by Physicians and Other Senior Health Workers. Geneva: World Health Organization, CDD/SER/ 80.2 Rev. 2.
-
15
Ruuska T, Vesikari T, 1990. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrheal episodes. Scand J Infect Dis 22 :259–267.
-
16
Lennett EH, Balows A, Hausler WJ Jr, Shadmoy HJ, eds., 1985. Manual of Clinical Microbiology. Fourth edition. Washington. DC: American Society for Microbiology.
-
17
Levine MM, Prado V, Robins-Browne R, Lior H, Kaper JB, Moseley SL, Gicquelais K, Nataro JP, Vial P, Tall B, 1988. Use of DNA probes and Hep-2 cell adherence assay to detect diarrheagenic Escherichia coli.J Infect Dis 158 :224–228.
-
18
Albert JM, Faruque ASG, Faruque SM, Sack RB, Mahalanabis D, 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbiol 37 :3458–3464.
-
19
Miller RV, ed., 1977. Technical Manual. Seventh edition. Washington, DC: American Association of Blood Banks.
-
20
Baqui AH, Black RE, Sack RB, Chowdhury HR, Yunus M, Siddique AK, 1993. Malnutrition, cell-mediated immune deficiency, and diarrhea: a community-based longitudinal study in rural Bangladeshi children. Am J Epidemiol 17 :355–365.
-
21
Baqui AH, Black RE, Sack RB, Yunus MD, Siddique AK, Chowdhury HR, 1992. Epidemiological and clinical characteristics of acute and persistent diarrhoea in rural Bangladeshi children. Acta Paediatr 381 (suppl):15–21.
-
22
Guerrant RL, Kirchhoff, Shields DS, Nations MK, Leslie J, de Sousa A, Araujo JG, Correia LL, Sauer KT, McClelland KE, Trowbridge FL, Hughes JM, 1983. Prospective study of diarrheal illness in northeastern Brazil: patterns of diseases, nutritional impact, etiologies, and risk factors. J Infect Dis 148 :986–997.
-
23
Santosham M, Sack RB, Reid R, Black R, Croll J, Yolken R, Aurelian L, Wolff M, Chan E, Garrett S, Froehlich J, 1995. Diarrhoeal diseases in the White Mountain Apaches: epidemiologic studies. J Diarrhoeal Dis Res 13 :18–28.
-
24
Baqui AH, Sack RB, Black RE, Haider K, Hossain A, Abdul Alim ARM, Yunus M, Chowdhury HR, Siddique AK, 1992. Enteropathogens associated with acute and persistent diarrhea in Bangladeshi children < 5 years of age. J Infect Dis 166 :792–796.
-
25
Huilan S, Zhen Lu G, Mathan MM, Mathew MM, Olarte J, Espejo R, Maung K, Ghafoor MA, Khan MA, Sami Z, Sutton RG, 1991. Etiology of acute diarrhea among children in developing countries: a multicentric study in five countries. Bull World Health Organ 69 :549–555.
-
26
Frederik PL, van Loon, Clemens JD, Sack DA, Rao MR, Ahmed F, Chowdhury S, Harris JR, Ali M, Chakraborty J, Khan MR, Neogy PK, Svennerholm AM, Holmgren J, 1991. ABO blood groups and the risk of diarrhea to enterotoxigenic Escherichia coli.J Infect Dis 163 :1243–1246.
-
27
Glass RI, Holmgren J, Haley CE, Khan MR, Marisvennerholm A, Stoli BJ, Hossain KMB, Black RE, Yunus M, Barua D, 1985. Predisposition for cholera of individuals with O blood group. Am J Epidemiol 121 :791–796.
-
28
Janda JM, Abbott SL, 1998. Evolving concepts regarding the genus Aeromonas: an expanding panorama of species, diseases presentation, and unanswered questions. Clin Infect Dis 27 :332–344.
-
29
Teka T, Faruque ASG, Hossain MI, Fuchs GJ, 1999. Aeromonas-associated diarrhoea in Bangladeshi children: clinical and epidemiological characteristics. Ann Trop Paediatr 19 :15–20.
-
30
Bhattacharya MK, Teka T, Faruque ASG, Fuchs GJ, 1997. Cryptosporidium infection in children in urban Bangladesh. J Trop Pediatr 43 :282–285.
-
31
Zaki A.M, Herbert L, Pont Du, Alamy MAEA, Arafat RR, Amin K, Awad MM, Bassiouni L, Imam IZ, Malih GSE, Marsafie AE, Mohieldin MS, Naguib T, Rakha MA, Sidaros M, Wasef N, Wright CE, Wyatt RG, 1986. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg 35 :1013–1022.
-
32
Abd-Alla MD, Ravdin JI, 2002. Diagnosis of amoebic colitis by antigen captures ELISA patients presenting with acute diarrhoea in Cairo, Egypt. Trop Med Int Health 7 :365–370.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1686 | 1538 | 23 |
| Full Text Views | 443 | 8 | 0 |
| PDF Downloads | 219 | 13 | 0 |