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Sample records for addressing diarrhea prevalence

  1. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin

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    Arouna Aminou

    2008-04-01

    Full Text Available Abstract Background In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions in the Middle Belt will remain moderate. Consequently, the Middle Belt might become a major area for immigration but there may be constraining factors as well, particularly with respect to water availability. As a case study, the paper looks into the capacity of the Middle Belt zone of Benin, known as the Oueme River Basin (ORB, to reduce diarrhea prevalence. In Benin it links to the Millennium Development Goals on child mortality and environmental sustainability that are currently farthest from realization. However, diarrhea prevalence is only in part due to lack of availability of drinking water from a safe source. Social factors such as hygienic practices and poor sanitation are also at play. Furthermore, we consider these factors to possess the properties of a local public good that suffers from under provision and requires collective action, as individual actions to prevent illness are bound to fail as long as others free ride. Methods Combining data from the Demographic Health Survey with various spatial data sets for Benin, we apply mixed effect logit regression to arrive at a spatially explicit assessment of geographical and social determinants of diarrhea prevalence. Starting from an analysis of these factors separately at national level, we identify relevant proxies at household level, estimate a function with geo-referenced independent variables and apply it to evaluate the costs and impacts of improving access to good water in the basin. Results First, the study confirms the well established stylized fact on the causes of diarrhea that a household with access to clean water and with good hygienic practices will, irrespective of

  2. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin.

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    Pande, Saket; Keyzer, Michiel A; Arouna, Aminou; Sonneveld, Ben G J S

    2008-04-23

    In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions in the Middle Belt will remain moderate. Consequently, the Middle Belt might become a major area for immigration but there may be constraining factors as well, particularly with respect to water availability. As a case study, the paper looks into the capacity of the Middle Belt zone of Benin, known as the Oueme River Basin (ORB), to reduce diarrhea prevalence. In Benin it links to the Millennium Development Goals on child mortality and environmental sustainability that are currently farthest from realization. However, diarrhea prevalence is only in part due to lack of availability of drinking water from a safe source. Social factors such as hygienic practices and poor sanitation are also at play. Furthermore, we consider these factors to possess the properties of a local public good that suffers from under provision and requires collective action, as individual actions to prevent illness are bound to fail as long as others free ride. Combining data from the Demographic Health Survey with various spatial data sets for Benin, we apply mixed effect logit regression to arrive at a spatially explicit assessment of geographical and social determinants of diarrhea prevalence. Starting from an analysis of these factors separately at national level, we identify relevant proxies at household level, estimate a function with geo-referenced independent variables and apply it to evaluate the costs and impacts of improving access to good water in the basin. First, the study confirms the well established stylized fact on the causes of diarrhea that a household with access to clean water and with good hygienic practices will, irrespective of other conditions, not suffer diarrhea very often. Second

  3. The Prevalence of Norovirus in returning international travelers with diarrhea

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    Löscher Thomas

    2010-05-01

    Full Text Available Abstract Background There is a high incidence of diarrhea in traveling populations. Norovirus (NV infection is a common cause of diarrhea and is associated with 7% of all diarrhea related deaths in the US. However, data on the overall prevalence of NV infection in traveling populations is limited. Furthermore, the prevalence of NV amongst travelers returning to Europe has not been reported. This study determined the prevalence of NV among international travelers returning to Germany from over 50 destinations in and outside Europe. Methods Stool samples of a total of 104 patients with a recent ( Results In our cohort, NV infection was detected in 15.7% of returning travelers with diarrhea. The closer to the date of return symptoms appeared, the higher the incidence of NV, ranging as high as 21.2% within the first four days after return. Conclusions In our cohort, NV infection was shown to be frequent among returning travelers especially in those with diarrhea, with over 1/5 of diarrhea patients tested positive for NV within the first four days after their return to Germany. Due to this prevalence, routine testing for NV infection and hygienic precautions may be warranted in this group. This is especially applicable to patients at an increased risk of spreading the disease, such as healthcare workers, teachers or food-handlers.

  4. Prevalence of diarrhea and enteropathogens in racing sled dogs.

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    McKenzie, E; Riehl, J; Banse, H; Kass, P H; Nelson, S; Marks, S L

    2010-01-01

    Diarrhea is highly prevalent in racing sled dogs, although the underlying causes are poorly understood. Clostridium perfringens enterotoxin (CPE) and Clostridium difficile Toxin A and B are associated with diarrhea in racing sled dogs. One hundred and thirty-five sled dogs. Freshly voided feces were obtained from 55 dogs before racing and from 80 dogs after 400 miles of racing. Samples were visually scored for diarrhea, mucus, blood, and melena. CPE and C. difficile Toxin A and B were detected by ELISA. Samples were cultured for C. perfringens, C. difficile, Campylobacter, Salmonella, and Escherichia coli O157; Giardia and Cryptosporidium spp. were detected via immunofluorescence. Diarrhea occurred in 36% of dogs during racing, and hematochezia, fecal mucus or melena, or all 3 occurred in 57.5% of dogs. Salmonella was isolated from 78.2% of dogs before racing, and from 71.3% of dogs during racing. C. perfringens and C. difficile were isolated from 100 and 58.2% of dogs before racing, and from 95 and 36.3% of dogs during racing. Dogs were more likely to test positive for CPE during than before racing (18.8 versus 5.5%, P = .021); however, no enteropathogens or their respective toxins were significantly associated with hematochezia or diarrhea. Sled dogs participating in long distance racing have a high prevalence of diarrhea and hematochezia that is not associated with common enteropathogens. It is possible that diarrhea and hematochezia represent the effect of prolonged exercise on the gastrointestinal tract.

  5. Diarrhea

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    ... be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come ...

  6. Diarrhea

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    ... to avoid dehydration. Children should be given an oral rehydration solution (ORS). Avoid solid foods until the diarrhea ... Children who have gastroenteritis should be given an oral rehydration solution (ORS) to prevent dehydration. Ease back into ...

  7. Prevalence of Clostridium perfringens enterotoxin A in stool samples of patients with antibiotic-associated diarrhea

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    Granzow, Katharina

    2010-01-01

    The present prospective study revealed a prevalence of Clostridium perfringens enterotoxin A (CPE) of less than 1%. Routine screening of stool samples for CPE does not appear to be justified in patients with antibiotic-associated diarrhea.

  8. Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.

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    Colombara, Danny V; Hernández, Bernardo; McNellan, Claire R; Desai, Sima S; Gagnier, Marielle C; Haakenstad, Annie; Johanns, Casey; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Zyznieuski, Nicholas; Iriarte, Emma; Mokdad, Ali H

    2016-03-01

    Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ(2) tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0-5 months, those 6-23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines. © The American Society of Tropical Medicine and Hygiene.

  9. Maternal agency influences the prevalence of diarrhea and acute respiratory tract infections among young Indonesian children.

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    Agustina, Rina; Shankar, Anita V; Ayuningtyas, Azalea; Achadi, Endang L; Shankar, Anuraj H

    2015-05-01

    To examine the relationship between measures of mother's caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002-2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother' caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1-4) and the prevalence of diarrhea and ARTIs in the youngest child prevalence in children prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.

  10. Prevalence of diarrhea causing protozoan infections and associated ...

    African Journals Online (AJOL)

    Direct saline, formalin-ether concentration, and modified Ziehl-Neelson staining methods were used for stool examination. Eighty six (20.4%) of the stool samples had one or more intestinal protozoan parasites. Prevalence of Entamoeba histolytica/dispar was 15.2% (64/422). Cryptosporidium spp., and Giardia intestinalis ...

  11. [Prevalence of celiac disease in children with chronic diarrhea in China].

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    Wang, Xin-qiong; Liu, Wei; Xu, Jun-jie; Mei, Hong; Peng, Han-ming; Gao, Yuan; Yuan, Lan; Xu, Chun-di

    2010-04-01

    To investigate the prevalence of celiac disease in children with chronic diarrhea in China. Inpatients of the pediatric hospitals in Shanghai, Jinan, Wuhan and Chengdu who were diagnosed as chronic diarrhea were recruited from Jan. 2005 to Dec. 2008. Their clinical history, physical examination and laboratory data were collected. The SPSS version 11.5 statistical package for Microsoft Windows was used for statistical analysis. Data of 199 patients and finally enrolled 118 hospitalized chronic diarrhea inpatients during the observation period were collected and 14 (12%) of the chronic diarrhea patients were suspected as having celiac disease and in one the diagnosis of celiac disease was confirmed. Gluten-free diet (GFD) treatment was effective. M/F: 12/2, the age ranged from 6 months to 12 years; 43% (6/14) had malnutrition, 29% (4/14) had anemia, villous atrophy was found in 4 patients by endoscopy. Duodenal biopsies revealed stage I in 1, stage II in 2, stage IIIa in 7, stage IIIb in 3 and stage IIIc in 1 patient according to the modified Marsh classification. This study was the first time to report the research of celiac disease in children with chronic diarrhea in China. The percentage of suspicious celiac disease patients was 12% (14/118) in children and one was confirmed. CD exists in China. Chinese pediatricians should pay attention to the disease.

  12. Prevalence of Iron Deficiency and Anemia among Young Children with Acute Diarrhea in Bhaktapur, Nepal.

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    Chandyo, Ram K; Ulak, Manjeswori; Adhikari, Ramesh K; Sommerfelt, Halvor; Strand, Tor A

    2015-07-21

    Iron deficiency anemia is still common in children under five years of age and may impair their growth and cognitive development. Diarrhea is the second most common reason for seeking medical care for young children in Nepal. However, neither screening programs nor effective preventive measures for anemia and iron deficiencies are in place among children with diarrhea in many developing countries. The aims of this study were to determine the prevalence of anemia and iron deficiency and explore their associations with clinical, socioeconomic, and anthropometric parameters in Nepalese children. This was a cross-sectional study based on 1232 children, six to 35 months old, with acute diarrhea participating in a zinc supplementation trial. The mean (SD) hemoglobin was 11.2 g/dL (1.2). Anemia was found in 493 children (40%); this estimate increased to 641 (52%) when we adjusted for the altitude of the study area (hemoglobin children had depleted iron stores and 198 (16%) of the children had both depleted iron stores and anemia, indicating iron deficiency anemia. The prevalence of anemia among children presenting with acute diarrhea was high but the degree of severity was mainly mild or moderate. Iron deficiency explained less than half of the total anemia, indicating other nutritional deficiencies inducing anemia might be common in this population.

  13. Prevalence of microsporidia in healthy individuals and immunocompetent patients with acute and chronic diarrhea.

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    Mumcuoglu, Ipek; Cetin, Feyza; Dogruman Al, Funda; Oguz, Ilkiz; Aksu, Neriman

    2016-02-01

    Previously published studies of microsporidial infections have primarily focused on immunodeficient or immunocompromised patients. Data regarding infections caused by this microorganism in immunocompetent subjects are lacking. In the present study, we investigated the prevalence of microsporidia in healthy individuals and immunocompetent patients with acute and chronic diarrhea. The study included stool samples from 74 patients with acute diarrhea, 41 patients with chronic diarrhea, and 88 healthy volunteers. Slides were prepared after concentration with a formalin-ethyl acetate technique and were stained with modified trichrome, calcofluor white, and Uvitex 2B stains. The number of spores observed in each magnification field (×1000) was scored as follows: 1+, 1-10; 2+, 11-20; 3+, > 20. The prevalence of microsporidia was 27.0% in patients with acute diarrhea, 34.1% in patients with chronic diarrhea, and 45.5% in healthy volunteers. The parasite score was 1 + in all positive samples. The rate of microsporidia positivity was higher in solid stools (51.4%), and the rate of positivity increased with advancing age. Unexpectedly, a high prevalence of microsporidia was found in immunocompetent individuals in our region. There was no relationship between positivity for microsporidia and the presence of symptoms, due to higher rates both in solid stools and in healthy subjects. The parasite score was the same in all groups. Our results indicate that there is high exposure to microsporidia in immunocompetent subjects in our region. Natural reservoirs and environmental sources of microsporidia should be determined to design strategies for effective prevention of transmission.

  14. Prevalence of isosporiasis in relation to CD4 cell counts among HIV-infected patients with diarrhea in Odisha, India

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    Indrani Mohanty

    2013-01-01

    Conclusion: I. belli was the predominant parasite with a prevalence of 22% among HIV-positive patients with diarrhea, majority having CD4 cell count <200/μl. This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

  15. Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas

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    Agustina, R.; Sari, T.P.; Satroamidjojo, S.; Bovee-Oudenhoven, I.M.J.; Feskens, E.J.M.; Kok, F.J.

    2013-01-01

    Background: Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian

  16. Prevalence and Genetic Diversity of Enteric Viruses in Children with Diarrhea in Ouagadougou, Burkina Faso.

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    Nafissatou Ouédraogo

    Full Text Available Enteric viruses are a major cause of diarrhea in children, especially those under five years old. Identifying the viral agents is critical to the development of effective preventive measures. This study aimed to determine the prevalence and genetic diversity of common enteric viruses in children under five years old in Burkina Faso. Stool samples from children with (n = 263 and without (n = 50 diarrhea disorders were collected in Ouagadougou, Burkina Faso from November 2011 to September 2012. Rotavirus, norovirus, sapovirus, astrovirus, adenovirus and Aichivirus A were detected using real-time or end-point (RT-PCR. Rotavirus strains were G and P genotyped by multiplex RT-PCR and other viral strains were characterized by sequencing of viral subgenomic segements. At least one viral agent was detected in 85.6% and 72% of the symptomatic and asymptomatic patients, respectively. Rotavirus (63.5%, adenovirus (31.2% and genogroup II norovirus (18.2% were the most prevalent viruses in symptomatic patients, but only rotavirus and genogroup II norovirus were significantly associated with diarrhea (OR: 7.9, 95%CI: 3.7-17; OR: 3.5, 95%CI: 1-11.7, respectively. Sapovirus (10.3%, astrovirus (4.9%, genogroup I norovirus (2.7% and Aichivirus A (0.8% were less prevalent. The predominant genotype of rotavirus was G9P[8] (36.5%, and the predominant norovirus strain was GII.4 variant 2012 (71.4%. Among sapovirus, the genogroup II (87.5% predominated. Astrovirus type 1 (41.7% was the most frequent astrovirus identified. Aichivirus A belonged to the three genotypes (A, B and C. Enteric adenoviruses type 40 and 41 were identified in 10.2% and 5.1% respectively. Several cases of co-infections were detected. The results highlight the high prevalence and the high diversity of enteric viruses in Burkinabe children.

  17. Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India.

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    Joshi, Pooran C; Kaushal, Sonia; Aribam, Bijaya S; Khattri, Prashant; D'Aoust, Olivia; Singh, Mongjam M; Marx, Michael; Guha-Sapir, Debarati

    2011-01-01

    Diarrhea is an important problem among the under-five children in India. The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. A two stage stratified cluster survey was conducted in flood affected (exposed) and non-flood affected areas (unexposed). The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts.

  18. Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India

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    Pooran C. Joshi

    2011-06-01

    Full Text Available Background : Diarrhea is an important problem among the under-five children in India. Objective : The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. Design : A two stage stratified cluster survey was conducted in flood affected (exposed and non-flood affected areas (unexposed. Results : The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. Conclusions : The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts.

  19. Prevalence of Clostridium perfringens toxin in patients suspected of having antibiotic-associated diarrhea.

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    Kim, Young Jin; Kim, Si Hyun; Ahn, Junggu; Cho, Soongmoon; Kim, Dongchun; Kim, Kwanghyun; Lee, Heegun; Son, Hyunwoo; Lee, Hee Joo; Yong, Dongeun; Choi, Jun Yong; Kim, Hye Ran; Shin, Jeong Hwan

    2017-12-01

    Although Clostridium perfringens has been reported as a cause of antibiotic-associated diarrhea (AAD), it is uncommon to detect this pathogen in clinical microbiology laboratories in Korea. The aim of this study was to investigate the prevalence of C. perfringens toxin in patients suspected of having AAD. A total of 135 stool specimens submitted to a clinical microbiology laboratory for C. difficile toxin assay were tested. We tried to detect both C. difficile and C. perfringens toxins using the Seeplex Diarrhea ACE Detection kit (Seegene, Seoul, Korea). We evaluated the prevalence of 10 bacteria and 5 viruses. A total of 40 Clostridium spp. were detected in 34 specimens (29.6%). The C. perfringens toxin was detected in 14 of 135 specimens (10.4%), while C. difficile toxin was detected in 26 specimens (19.3%). Other bacteria and viruses, including 8 Aeromonas spp., were detected in 15 specimens. All tests were negative in 92 of the 135 specimens (68.1%). Clostridium perfringens toxin is relatively common, and we should consider the possibility of its presence in patients suspected of having AAD, especially if C. difficile tests are negative. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Prevalence and genetic diversity of norovirus among patients with acute diarrhea in Guatemala.

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    Estévez, Alejandra; Arvelo, Wences; Hall, Aron J; López, María R; López, Beatriz; Reyes, Lissette; Moir, Juan Carlos; Gregoricus, Nicole; Vinjé, Jan; Parashar, Umesh D; Lindblade, Kim A

    2013-07-01

    Noroviruses (NoVs) are a leading cause of acute gastroenteritis outbreaks and sporadic cases of diarrhea in industrialized countries. To study the prevalence and genetic diversity of NoVs in Guatemala, stool specimens were collected from hospitalized and ambulatory patients presenting with diarrhea (≥3 loose or liquid stools in a 24-hr period) who were enrolled in a prospective surveillance system in the Departments of Santa Rosa (October 2007 to August 2010) and Quetzaltenango (August 2009 to August 2010), Guatemala. Specimens were tested for rotavirus, enteric bacteria, and parasites by routine methods and for genogroups I and II NoV by real-time reverse transcription-PCR. A total of 2,403 stool specimens were collected from hospitalized (n = 528) and ambulatory patients (n = 1,875). Overall, 341 (14%) samples tested positive for NoVs including 114 (22%) hospitalized and 227 (12%) ambulatory patients. NoVs disease peaked during the winter (November-January) months. Among the 341 NoVs-positive patients, 32 (9%) were also positive for rotavirus, 32 (9%) for bacteria, and 9 (3%) for protozoa. Nucleotide sequences were obtained from 84 samples collected from hospitalized children aged Guatemala. The findings highlight the need to implement laboratory diagnostics for NoVs to improve appropriate clinical management of diarrheal diseases and guide vaccine development. Copyright © 2013 Wiley Periodicals, Inc.

  1. Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas.

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    Agustina, Rina; Sari, Tirta P; Satroamidjojo, Soemilah; Bovee-Oudenhoven, Ingeborg M J; Feskens, Edith J M; Kok, Frans J

    2013-10-19

    Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. A cross-sectional study was conducted among 274 randomly selected children aged 12-59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child's defecation pattern. Food-hygiene practices including mother's and child's hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child's bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea.

  2. Prevalence of Clostridium spp. and Clostridium difficile in children with acute diarrhea in São Paulo city, Brazil

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    Claudia EA Ferreira

    2003-06-01

    Full Text Available Species of Clostridium are widely distributed in the environment, inhabiting both human and animal gastrointestinal tracts. Clostridium difficile is an important pathogen associated with outbreaks of pseudomembranous colitis and other intestinal disorders, such as diarrhea. In this study, the prevalence of Clostridium spp. and C. difficile, from hospitalized children with acute diarrhea, was examined. These children were admitted to 3 different hospitals for over 12 months. Eighteen (20% and 19 (21% stool specimens from children with (90 and without (91 diarrhea respectively, were positive to clostridia. Only 10 C. difficile strains were detected in 5.5% of the stool samples of children with diarrhea. None healthy children (without diarrhea harbored C. difficile. From these 10 C. difficile, 9 were considered as toxigenic and genotyped as tcdA+/tcdB+ or tcdA-/tcdB+, and 1 strain as nontoxigenic (tcdA-/tdcB-. They were detected by the citotoxicity on VERO cells and by the multiplex-polymerase chain reaction. Thirty clinical fecal extracts produced minor alterations on VERO cells. The presence of C. difficile as a probable agent of acute diarrhea is suggested in several countries, but in this study, the presence of these organisms was not significant. More studies will be necessary to evaluate the role of clostridia or C. difficile in diarrhoeal processes in children.

  3. Prevalence and Molecular Characterization of Campylobacter spp. Isolated from Patients with Diarrhea in Shunyi, Beijing

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    Ying Li

    2018-01-01

    Full Text Available Bacterial pathogens have been confirmed as the major cause of acute diarrhea among outpatients in China. In this study, 370 stool samples from the patients aged from 15 to 87 years old with diarrhea were collected over 12 months (from May 2016 to April 2017 in two hospitals in Shunyi, Beijing. Bacterial isolation was performed for the common enteric pathogens: Campylobacter, Salmonella, Shigella, Diarrheagenic Escherichia coli, and Vibrio parahaemolyticus for 370 samples. The filtration method was used for the Campylobacter isolation in this study. The prevalence and molecular characterization of the Campylobacter were investigated. The isolation ratio for Campylobacter, Salmonella, Shigella, Diarrheagenic E. coli, and V. parahaemolyticus was 7.0% (26/370, 6.2% (23/370, 0.3% (1/370, 7.3% (27/370, and 10.3% (38/370, respectively. Based on the isolation result, Campylobacter positive cases presented in almost every month of the whole year and the isolation ratio was the highest among the tested pathogens during October to March. There was no significant difference between genders of Campylobacter positive cases. More Campylobacter positive cases presented dehydration compared with those who were positive for Salmonella. Twenty-six Campylobacter isolates were obtained in this study and 24 of these were Campylobacter jejuni. The antibiotic susceptibility tests indicated that 83.3% (20/24 of the isolates exhibited resistance to three or more types of antibiotic. Twenty STs were identified for the 26 Campylobacter isolates and four novel STs were identified in this study. No clonal cluster was found among these isolates. This is the first study for Campylobacter isolated using the filtration method in China which indicated the Campylobacter infection might be seriously under-ascertained in the diarrheal patients in China.

  4. Prevalence and Antimicrobial Resistance of Campylobacterjejuni and Campylobacter coli from Adult Hospitalized Patients with Diarrhea in Thailand.

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    Pham, Ngan Thi Kim; Ushijima, Hiroshi; Trinh, Quang Duy; Khamrin, Pattara; Komine-Aizawa, Shihoko; Okitsu, Shoko; Maneekarn, Niwat; Hayakawa, Satoshi

    2015-01-01

    Infection with Campylobacter jejuni and C. coli are recognized as the major cause of bacterial gastroenteritis in humans. A total of 310 fecal samples collected from Thai adult patients with diarrhea in 2008 were screened for the presence of Campylobacter by PCR. Resistance to fluoroquinolone and macrolides of the detected Campylobacter strains were analyzed by studying the mutations in the gyrA and 23S rRNA genes, respectively. Campylobacter species were detected in 4/310 (1.3%) of diarrheal patients, and C. jejuni was found in 3 of the 4 cases (75%). Fluoroquinolone resistance was noted in 2 cases (50%); however, no resistance to macrolides was observed. Campylobacter was detected in a low prevalence in adult Thai patients hospitalized with diarrhea, and the resistance to fluoroquinolones is still a matter of concern in case antibiotic therapy is required.

  5. A molecular study on the prevalence and virulence potential of Aeromonas spp. recovered from patients suffering from diarrhea in Israel.

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    Yigal Senderovich

    Full Text Available BACKGROUND: Species of the genus Aeromonas are native inhabitants of aquatic environments and have recently been considered emerging human pathogens. Although the gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered, their role as etiologic agents of bacterial diarrhea is still disputed. Aeromonas-associated diarrhea is a phenomenon occurring worldwide; however, the exact prevalence of Aeromonas infections on a global scale is unknown. METHODOLOGY/PRINCIPAL FINDINGS: The prevalence and virulence potential of Aeromonas in patients suffering from diarrhea in Israel was studied using molecular methods. 1,033 diarrheal stools were sampled between April and September 2010 and Aeromonas species were identified in 17 (∼2% patients by sequencing the rpoD gene. Aeromonas species identity and abundance was: A. caviae (65%, A. veronii (29% and Aeromonas taiwanensis (6%. This is the first clinical record of A. taiwanensis as a diarrheal causative since its recent discovery from a wound infection in a patient in Taiwan. Most of the patients (77% from which Aeromonas species were isolated were negative for any other pathogens. The patients ranged from 1 to 92 years in age. Aeromonas isolates were found to possess different virulence-associated genes: ahpB (88%, pla/lip/lipH3/apl-1 (71%, act/hlyA/aerA (35%, alt (18%, ast (6%, fla (65%, lafA (41%, TTSS ascV (12%, TTSS ascF-ascG (12%, TTSS-dependent ADP-ribosylating toxins aexU (41% and aexT (6% in various combinations. Most of the identified strains were resistant to beta-lactam antibiotics but susceptible to third-generation cephalosporin antibiotics. CONCLUSIONS: Aeromonas may be a causative agent of diarrhea in patients in Israel and therefore should be included in routine bacteriological screenings.

  6. Toddler's Diarrhea

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    ... Toddler’s Diarrhea? Toddler’s diarrhea is also known as chronic nonspecific diarrhea of childhood, and it affects children from 6 months to 5 years of age. Children with toddler’s diarrhea will have 3- ...

  7. Prevalence and determinants of acute diarrhea among children younger than five years old in Jabithennan District, Northwest Ethiopia, 2014.

    Science.gov (United States)

    Anteneh, Zelalem Alamrew; Andargie, Kassawmar; Tarekegn, Molalign

    2017-01-19

    Despite the global decline in death rates of children younger than five years old, the risk of a child dying before turning five years of age remains highest in the WHO African Region. The problem of child death in Ethiopia is worse, with an Ethiopian child being 30 times more likely to die by his/her fifth birthday than a child in Western Europe. Therefore, the aim of this study was to assess the prevalence and factors associated with diarrhea among children younger than five years old. A community-based, cross-sectional study was conducted with mothers who had children younger than five years old from April to June 2014. A multistage sampling procedure was used to select eligible women. The data were coded, entered, cleaned and analyzed with the SPSS software package, version 16. he data of 775 mothers were included in the analysis, and 21.5% of the children had diarrhea in the two weeks before the survey. The main factors affecting the occurrence of diarrhea were residence (Odds ratio (AOR) = 11.29, 95% Confidence interval (CI): 3.49-36.52), sex (AOR = 2.52, 95% CI:1.28-4.93), methods of complementary feeding (AOR = 50.88, 95% CI: 23.85- 108.54), types of water storage equipment (AOR = 19.50, 95% CI: 8.11-46.90), and cleansing materials used to wash hands (AOR = 5.53, 95% CI: 2.19-13.99). Approximately one-fifth of the children included in the study reported diarrheal disease. Residence, sex of the child, type of water storage container, methods of complementary feeding, and cleansing materials to wash the hands were the most important variables that affected the occurrence of diarrhea in children. Therefore, families, the government and nongovernmental organizations working in the area must cooperate in interventions and prevention to minimize the risk of disease.

  8. Chronic Diarrhea

    Science.gov (United States)

    ... can infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... may represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  9. Prevalence of Cryptosporidium spp. and other intestinal parasites in children with diarrhea

    Directory of Open Access Journals (Sweden)

    Mutalip Çiçek

    2011-03-01

    Full Text Available This study was planned to determine the role of Cryptosporidium sp. and other intestinal parasites in the diarrheal diseases in children with 0-15 years old Van district.Materials and methods: In this study, stool samples of 450 children were examined for parasites. In the study, nativ-lugol, formaldehyde-ethyl acetate sedimentation methods and trichrome staining methods were used to detect parasites in stool samples. Additionally, sedimentation methods and modified acid fast staining method were used to detect the Cryptosporidium oocysts.Results: Parasites were found in 154 (34.2% among 450 children’s with diarrhea. In this study; the ratios of parasites were as follow: Giardia intestinalis 13.5%, Blastocystis hominis 10%, Entamoeba coli 3.78%, Cryptosporidium spp. 2.2%, Hymenolepis nana 1.33 %ve Ascaris lumbricoides 1.11%.Entamoeba histolytica/Entamoeba dispar 0.89%, Chilomastix mesnili 1.78%, Iodamoeba butschlii 0.89%, Entamoeba hartmanni 0.89%, Trichomonas hominis 0.67%, Enteromonas hominis 0.67%,Conclusion: In the investigate, it was found that Giardia intestinalis and Blastocystis hominis were most prominent agents in children with diarrhea in our vicinity and Cryptosporidium spp also was an important agent which should be investigated carefully in especially risk group in routine laboratory studies.

  10. Prevalence and determinants of acute diarrhea among children younger than five years old in Jabithennan District, Northwest Ethiopia, 2014

    Directory of Open Access Journals (Sweden)

    Zelalem Alamrew Anteneh

    2017-01-01

    Full Text Available Abstract Background Despite the global decline in death rates of children younger than five years old, the risk of a child dying before turning five years of age remains highest in the WHO African Region. The problem of child death in Ethiopia is worse, with an Ethiopian child being 30 times more likely to die by his/her fifth birthday than a child in Western Europe. Therefore, the aim of this study was to assess the prevalence and factors associated with diarrhea among children younger than five years old. Methods A community-based, cross-sectional study was conducted with mothers who had children younger than five years old from April to June 2014. A multistage sampling procedure was used to select eligible women. The data were coded, entered, cleaned and analyzed with the SPSS software package, version 16. Results he data of 775 mothers were included in the analysis, and 21.5% of the children had diarrhea in the two weeks before the survey. The main factors affecting the occurrence of diarrhea were residence (Odds ratio (AOR = 11.29, 95% Confidence interval (CI: 3.49-36.52, sex (AOR = 2.52, 95% CI:1.28-4.93, methods of complementary feeding (AOR = 50.88, 95% CI: 23.85- 108.54, types of water storage equipment (AOR = 19.50, 95% CI: 8.11-46.90, and cleansing materials used to wash hands (AOR = 5.53, 95% CI: 2.19-13.99. Conclusion Approximately one-fifth of the children included in the study reported diarrheal disease. Residence, sex of the child, type of water storage container, methods of complementary feeding, and cleansing materials to wash the hands were the most important variables that affected the occurrence of diarrhea in children. Therefore, families, the government and nongovernmental organizations working in the area must cooperate in interventions and prevention to minimize the risk of disease.

  11. Prevalence of Clostridium perfringens, Clostridium perfringens enterotoxin and dysbiosis in fecal samples of dogs with diarrhea.

    Science.gov (United States)

    Minamoto, Yasushi; Dhanani, Naila; Markel, Melissa E; Steiner, Jörg M; Suchodolski, Jan S

    2014-12-05

    Clostridium perfringens has been suspected as an enteropathogen in dogs. However, its exact role in gastrointestinal (GI) disorders in dogs remains unknown. Recent studies suggest the importance of an altered intestinal microbiota in the activation of virulence factors of enteropathogens. The aim of this study was to evaluate the relationship between diarrhea, dysbiosis, and the presence of C. perfringens and its enterotoxin (CPE). Fecal samples were collected prospectively from 95 healthy control dogs and 104 dogs with GI disease and assessed for bacterial abundances and the presence of CPE using quantitative PCR and ELISA, respectively. C. perfringens was detected in all dogs. Potentially enterotoxigenic C. perfringens were detected in 33.7% (32/95) of healthy control dogs and 48.1% (50/104) diseased dogs, respectively. CPE was detected by ELISA in 1.0% (1/95) of control dogs and 16.3% (17/104) of diseased dogs. Abundances of Fusobacteria, Ruminococcaceae, Blautia, and Faecalibacterium were significantly decreased in diseased dogs, while abundances of Bifidobacterium, Lactobacillus, and Escherichia coli were significantly increased compared to control dogs. The microbial dysbiosis was independent of the presence of the enterotoxigenic C. perfringens or CPE. In conclusion, the presence of CPE as well as fecal dysbiosis was associated with GI disease. However, the presence of C. perfringens was not indicative of GI disease in all cases of diarrhea, and the observed increased abundance of enterotoxigenic C. perfringens may be part of intestinal dysbiosis occurring in GI disease. The significance of an intestinal dysbiosis in dogs with GI disease deserves further attention. Published by Elsevier B.V.

  12. Prevalence of Campylobacter spp. relative to other enteric pathogens in grow-finish pigs with diarrhea.

    Science.gov (United States)

    Burrough, Eric; Terhorst, Samantha; Sahin, Orhan; Zhang, Qijing

    2013-08-01

    Salmonella spp., Lawsonia intracellularis, and Brachyspira spp. are pathogens commonly associated with diarrhea in growing and finishing pigs. Brachyspira spp. infection has recently reemerged as a significant concern due to an increase in the incidence of swine dysentery; however, the mechanisms underlying this increase in dysentery remain largely unknown. Pigs are also well-recognized as potential carriers of Campylobacter spp., particularly Campylobacter coli, yet enteric disease in swine associated with infection by these bacteria is considered uncommon and diagnosis has historically been based upon exclusion of other causes. Accordingly, Campylobacter culture is often excluded in routine diagnostic testing of cases of porcine enterocolitis and the incidence of infection is therefore largely unknown. In this study, feces from 155 cases of clinical diarrhea in grow-finish pigs submitted to the Iowa State University Veterinary Diagnostic Laboratory were cultured for Campylobacter spp. in addition to other testing as indicated for routine diagnostic investigation. Campylobacter culture was positive from 82.6% (128/155) of samples with C. coli accounting for 75% of isolates and Campylobacter jejuni for the remaining 25%. In 14.8% (23/155) of cases a Campylobacter spp. was the sole infectious agent detected; however, there was no association with any particular Campylobacter spp. Interestingly, for those cases with a laboratory diagnosis of Brachyspira-associated disease, 100% (15/15) were also culture positive for Campylobacter spp. suggesting a possible interrelationship between these bacteria in the pig gut. No association was noted between Campylobacter culture results and infection with either Salmonella spp. or L. intracellularis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Prevalence of enteropathogenic viruses and molecular characterization of group A rotavirus among children with diarrhea in Dar es Salaam Tanzania

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    Maselle Samwel Y

    2007-12-01

    Full Text Available Abstract Background Different groups of viruses have been shown to be responsible for acute diarrhea among children during their first few years of life. Epidemiological knowledge of viral agents is critical for the development of effective preventive measures, including vaccines. Methods In this study we determined the prevalence of the four major enteropathogenic viruses – rotavirus, norovirus, adenovirus and astrovirus – was determined in 270 stool samples collected from children aged 0 – 60 months who were admitted with diarrhea in four hospitals in Dar es Salaam, Tanzania, using commercially available ELISA kits. In addition, the molecular epidemiology of group A rotavirus was investigated using reverse transcriptase multiplex polymerase chain reaction (RT-PCR. Results At least one viral agent was detected in 87/270 (32.2% of the children. The prevalence of rotavirus, norovirus, adenovirus and astrovirus was 18.1%, 13.7%, 2.6% and 0.4%, respectively. In most cases (62.1% of viruses were detected in children aged 7–12 months. The G and P types (VP7 and VP4 genotypes respectively were further investigated in 49 rotavirus ELISA positive samples. G9 was the predominant G type (81.6%, followed by G1 (10.2% and G3 (0.2%. P[8] was the predominant P type (83.7%, followed by P[6] (0.4% and P[4] (0.2%. The following G and P types were not detected in this study population; G2, G4, G8 G10, P[9], P[10] and P[11]. The dominating G/P combination was G9P[8], accounting for 39 (90.7% of the 43 fully characterized strains. Three (6.1% of the 49 rotavirus strains could not be typed. Conclusion Nearly one third of children with diarrhea admitted to hospitals in Dar es Salaam had one of the four viral agents. The predominance of rotavirus serotype G9 may have implication for rotavirus vaccination in Tanzania.

  14. Prevalence of diarrheagenic Escherichia coli in children with diarrhea in Salvador, Bahia, Brazil

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    Marcia Regina Franzolin

    2005-07-01

    Full Text Available We report the frequency of the different diarrheagenic Escherichia coli (DEC categories isolated from children with acute endemic diarrhea in Salvador, Bahia. The E. coli isolates were investigated by colony blot hibridization whit the following genes probes: eae, EAF, bfpA, Stx1, Stx2, ST-Ih, ST-Ip, LT-I, LT-II, INV, and EAEC, as virulence markers to distinguish typical and atypical EPEC, EHEC/STEC, ETEC, EIEC, and EAEC. Seven of the eight categories of DEC were detected. The most frequently isolated was atypical EPEC (10.1% followed by ETEC (7.5%, and EAEC (4.2%. EHEC, STEC, EIEC, and typical EPEC were each detected once. The strains of ETEC, EAEC, and atypical EPEC belonged to a wide variety of serotypes. The serotypes of the others categories were O26:H11 (EHEC, O21:H21 (STEC, O142:H34 (typical EPEC, and O?H55 (EIEC. We also present the clinical manifestations and other pathogenic species observed in children with DEC. This is the first report of EHEC and STEC in Salvador, and one of the first in Brazil.

  15. Study of prevalence rate of Campylobacter jejuni enteritis in children affected with diarrhea in Khorramabad

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    katayon Bakhtiyar

    2012-06-01

    Conclusion: According to the findings of the present investigation, the prevalence rate of Campylobacter enteritis in children less than 12 in Khorramabad in 2007 was 5.92 % which is same as the findings of similar studies in Zahedan (6%, Tehran (5%, Sari (4.8% and Shiraz (5%.

  16. Prevalence and clinical manifestations of rotavirus diarrhea in children of rural area of Thailand

    OpenAIRE

    Sanguansak Rerksuppaphol; Lakkana Rerksuppaphol

    2011-01-01

    Introduction/ Background: Rotavirus diarrhoea is a leading cause of child death. It is a major concern in emerging nations. Many studies and analysis were executed for genetic assessment of rotavirus, however, very few studies from Thailand focused on clinical manifestation.Aim: To estimate the prevalence and clinical manifestations of rotavirus diarrhoea among children of Ongkaluck district, Nakorn Nayok rural area of Thailand.Method: Children aged ≤ 7 with acute diarrhoea as presenting symp...

  17. Prevalence of Yersinia enterocolitica Bioserotype 3/O:3 among Children with Diarrhea, China, 2010–2015

    Science.gov (United States)

    Duan, Ran; Liang, Junrong; Zhang, Jing; Chen, Yuhuang; Tong, Jing; Guo, Bangcheng; Hu, Wanfu; Wang, Mingliu; Zhao, Jiayong; Liu, Chang; Hao, Huijing

    2017-01-01

    Yersinia enterocolitica is thought to not significantly contribute to diarrheal disease in China, but evidence substantiating this claim is limited. We determined the prevalence of Y. enterocolitica infection and strain types present among children enterocolitica infection and should be used as an indication for microbiological diagnostic testing, rather than for the diagnosis of bacillary dysentery. In contrast with Y. enterocolitica isolates from adults, which were primarily biotype 1A, isolates from children were primarily bioserotype 3/O:3. Most pathogenic isolates from children shared pulsed-field gel electrophoresis patterns with isolates from pigs and dogs, suggesting a possible link between isolates from animals and infections in children. Our findings underscore the need for improved diagnostics for this underestimated pathogen. PMID:28820132

  18. Addresses

    Data.gov (United States)

    Town of Chapel Hill, North Carolina — Point features representing locations of all street addresses in Orange County, NC including Chapel Hill, NC. Data maintained by Orange County, the Town of Chapel...

  19. Diarrhea in Critically Ill Patients: The Role of Enteral Feeding.

    Science.gov (United States)

    de Brito-Ashurst, Ione; Preiser, Jean-Charles

    2016-09-01

    This tutorial presents a systematic approach to the management of diarrhea in the critical care setting. Diarrhea is a common and prevalent problem in critically ill patients. Despite the high prevalence, its management is far from simple. Professionals are confronted with a myriad of definitions based on frequency, consistency, and volume. The causes are complex and multifactorial, yet enteral tube feeding formula is believed to be the perpetrator. Potential causes for diarrhea are discussed, and 3 case reports provide context to examine the treatment from a nutrition perspective. Each scenario is comprehensively addressed discussing potential causes and providing specific clinical strategies contributing to improved bowel function in this patient group. The approach used for diarrhea management is based on a complete understanding of enteral tube formula, their composition, and their impact in the presence of gut dysfunction. Choosing the right feeding formula may positively influence bowel function and contribute to improved nutrition. © 2016 American Society for Parenteral and Enteral Nutrition.

  20. Prevalence of Escherichia coli virulence genes in patients with diarrhea and a subpopulation of healthy volunteers in Madrid, Spain

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    Adriana eCabal

    2016-05-01

    Full Text Available Etiological diagnosis of diarrheal diseases may be complicated by their multi-factorial nature. In addition, Escherichia coli strains present in the gut can occasionally harbor VGs without causing disease, which complicates the assessment of their clinical significance in particular.The aim of this study was to detect and quantify nine VGs (stx1, stx2, eae, aggR, ehxA, invA, est and elt typically present in five E. coli enteric pathotypes (EHEC, ETEC, EPEC, EAEC and EIEC in fecal samples collected from 49 patients with acute diarrhea and 32 healthy controls from Madrid, Spain. In addition, the presence of four serotype-related genes (wzxO104 and fliCH4, rbfO157 and fliCH7 was also determined. Presence of target genes was assessed using a quantitative real-time PCR assay previously developed, and the association of presence and burden of VGs with clinical disease and/or other risk factors was explored. Prevalence of ehxA (typically associated with STEC and EPEC, invA (EIEC and the rbfO157+fliCH7 (STEC and/or STEC/EAEC combination were significantly (p<0.02 higher in the diarrheic group, while the wzxO104+fliCH4 combination was significantly (p=0.014 more prevalent in the control group. On the other hand, eae was detected in more than 90% of the individuals in both patient and control populations, and it was not associated with bfpA, suggesting the absence of typical EPEC. No significant differences in the quantitative values were detected for any VG among study groups, but the difference in the load of aggR (EAEC and invA in the patients with respect to the controls was close to the significance, suggesting a potential role of these VGs in the clinical signs observed when they are present at high levels.

  1. Sanitation facilities, hygienic conditions, and prevalence of acute diarrhea among under-five children in slums of Addis Ababa, Ethiopia: Baseline survey of a longitudinal study.

    Science.gov (United States)

    Adane, Metadel; Mengistie, Bezatu; Kloos, Helmut; Medhin, Girmay; Mulat, Worku

    2017-01-01

    In developing countries, children under the age of five years who live in slums are highly vulnerable to diarrhea. However, there is a paucity of information on the relationship between sanitation facilities and hygienic conditions to acute diarrhea among under-five children in slum areas of Addis Ababa, Ethiopia. Therefore, this study examines the sanitation facilities and hygienic conditions in the slums of Addis Ababa and identifies the main factors significantly associated with acute diarrhea among children aged 0-50 months in those slums. A community-based cross-sectional household survey was carried out between September and November 2014, that then served as the baseline survey of a longitudinal study. For this survey, 697 children aged 0-50 months were recruited from two slum districts in Addis Ababa. A pre-tested structured questionnaire and an observational checklist were used for data collection. Multivariable logistic regression analysis was used to identify sanitation facilities and hygiene-related factors that were significantly associated with acute diarrhea by controlling potential confounding effects of selected socio-demographic factors. Adjusted odds ratio (AOR) with corresponding 95% confidence interval (CI) was used to quantify the strength of association. The prevalence of acute diarrhea among children aged 0-50 months in the study area was 11.9% and 94.6% of the sanitation facilities were unimproved. Sharing of a sanitation facility by six or more households (AOR = 4.7; 95% CI: 2.4-9.4), proximity of sanitation facilities within 15 meters of homes (AOR = 6.6; 95% CI: 2.5-17.0), presence of feces (AOR = 3.9; 95% CI: 1.5-10.3) and flies (AOR = 2.5; 95% CI: 1.3-5.0) on the floor of and/or around sanitation facilities, and presence of uncollected garbage inside house compounds (AOR = 3.2; 95% CI: 1.2-8.4) were significantly associated with acute diarrhea. This study reveals the slum environment to be high risk for diarrhea due to close proximity

  2. School Nurses' Perceived Prevalence and Competence to Address Student Mental Health Problems

    Science.gov (United States)

    Stephan, Sharon H.; Connors, Elizabeth H.

    2013-01-01

    Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their…

  3. Prevalence and risk factors for shedding of thermophilic Campylobacter in calves with and without diarrhea in Austrian dairy herds.

    Science.gov (United States)

    Klein, D; Alispahic, M; Sofka, D; Iwersen, M; Drillich, M; Hilbert, F

    2013-02-01

    The objectives of this study were to evaluate the presence of thermophilic Campylobacter in feces of calves with and without diarrhea on dairy farms and to survey farm characteristics and management practices to define risk factors for the presence of Campylobacter. Fifty dairy farms were chosen based on the presence of calf diarrhea, and 50 farms in which calves were free from diarrhea served as a standard of comparison. In total, fecal samples were taken from 382 calves. Farm data and management practices were surveyed using a questionnaire on farm. Campylobacter were isolated from fecal samples and colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis. Campylobacter spp., mainly Campylobacter jejuni (93% of isolated species), were detected on 33% of the farms and in 14.9% of the calves. Detection of Campylobacter did not differ between farms or between calves with and without diarrhea, although we found a tendency for calves suffering from diarrhea to shed Campylobacter more often. Calves may act as a reservoir of Campylobacter and may therefore lead to infections of other animals and humans. To define control strategies to reduce Campylobacter in calves, we identified on-farm risk factors. The presence of poultry on the farm, the time of cow-calf separation following birth, the use of an individual bucket for each calf, the feeding of waste milk, and the duration of individual housing were variables significantly associated with the appearance or absence of Campylobacter. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  4. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin

    NARCIS (Netherlands)

    Pande, S.; Keyzer, M.A.; Arouna, A.; Sonneveld, B.G.J.S.

    2008-01-01

    Background: In West Africa, the Northern Sahelian zone and the coastal areas are densely populated but the Middle Belt in between is in general sparsely settled. Predictions of climate change foresee more frequent drought in the north and more frequent flooding in the coastal areas, while conditions

  5. [Chronic diarrhea].

    Science.gov (United States)

    Stelzer, Teresa; Heuss, Ludwig Theodor

    2014-09-01

    Defined by lasting more than four weeks - is a common but often challenging clinical scenario. It is important to be aware that diarrhoea means different things to different patients. The evaluation of chronic diarrhoea depends on taking an excellent history and careful physical examination as well as planning investigations thoughtfully. Functional diarrhea ist the most common cause of chronic diarrhea in the developed countries and motility disorders are more common than inflammatory, osmotic or secretory causes. In some cases categorizing patients by their stool characteristics can be helpful in directing further evaluation.

  6. Acute diarrhea.

    Science.gov (United States)

    Tobillo, E T; Schwartz, S M

    1998-10-01

    Diarrhea can result from damage to the intestinal lining caused by viruses or bacteria, malabsorption, inflammatory processes, bile salt and pancreatic enzyme deficiency, abnormal motility, or the presence of osmotically active solutes in the gut. While it is important to elicit information to determine the possible cause of diarrhea, be sure to check circulatory status first. Some patients may need rehydration therapy more urgently than they need a diagnosis. The main goals of treatment are to prevent dehydration and correct electrolyte imbalance, to provide supportive and symptomatic therapy, and to treat underlying disease. In most cases, a specific diagnosis is not necessary to guide initial treatment.

  7. Clinical approach and management of chronic diarrhea.

    Science.gov (United States)

    Abdullah, Murdani; Firmansyah, M Adi

    2013-04-01

    Chronic diarrhea is defined as the passage of loose stools that last for more than 4 weeks. Although generally it is estimated that the prevalence of chronic diarrhea only ranges 3-5% of population, but it poses some specific equally essential challenges compared to acute diarrhea because there are many differential diagnosis that should be considered as the cause of chronic diarrhea. One of them includes colorectal cancer and the small intestinal bacterial overgrowth, known as SIBO. In general, chronic diarrhea can be categorized into watery, malabsorption, and inflammatory diarrhea. A proper history taking, physical examination and laboratory investigation is therefore necessary for clinician in managing chronic diarrhea. Overall, the management of chronic diarrhea includes two types, i.e. supportive and pharmacological management both for infectious and non-infectious etiologies. Pharmacological treatment can also be classified into two kinds of treatment including symptomatic and causal treatment, which can be achieved through empirical therapy.

  8. Traveler's Diarrhea

    Science.gov (United States)

    ... lettuce or other leafy raw vegetables (such as spinach).Do not eat raw or rare (slightly cooked) meat or fish.Do not eat food from people who sell it on the street.Boiling water will kill the germs that cause diarrhea, making ...

  9. [Campylobacter spp.: prevalence and pheno-genotypic characterization of isolates recovered from patients suffering from diarrhea and their pets in La Pampa Province, Argentina].

    Science.gov (United States)

    Tamborini, Ana L; Casabona, Luis M; Viñas, María R; Asato, Valeria; Hoffer, Alicia; Farace, María I; Lucero, María C; Corso, Alejandra; Pichel, Mariana

    2012-01-01

    The prevalence of Campylobacter spp. was investigated in 327 patients suffering from diarrhea and in 36 animals (dogs, cats and chickens) owned by the patients that presented infection by Campylobacter in Santa Rosa, La Pampa, Argentina. Campylobacter spp. was isolated in 50/327 patients and in 12/36 animals, being Campylobacter jejuni the most common species. Resistance to ciprofloxacin (65 %) and tetracycline (32 %) was found among 35 isolates of human origin studied. Seven genetic subtypes were observed among 13 C. jejuni isolates by pulsed field gel electrophoresis. Two subtypes grouped isolates belonging to patients and their respective dogs whereas another subtype grouped one isolate of human origin and two isolates from the patient's chickens. The results of this investigation highlight the need to strengthen surveillance of Campylobacter spp. not only in poultry, which is recognized as the main reservoir, but also in pets, which were shown to be asymptomatic carriers of the pathogen.

  10. Prevalência baixa de adenovírus em crianças com diarreia em Belo Horizonte-MG Low prevalence of adenoviruses in children with acute diarrhea in Belo Horizonte-MG

    Directory of Open Access Journals (Sweden)

    Ricardo Jenner Duarte

    2012-08-01

    Full Text Available INTRODUÇÃO: Diversos microrganismos são reconhecidos como agentes de diarreia aguda, entre eles, os adenovírus, cuja associação com a doença apresenta variações geográficas e é pouco conhecida no Brasil. OBJETIVOS: Investigar a presença de adenovírus em fezes de crianças com diarreia aguda e sem diarreia, em Belo Horizonte-MG, e estudar os fatores epidemiológicos associados à adenovirose intestinal. MATERIAL E MÉTODOS: O teste imunocromatográfico qualitativo (kit VIKIA® Rota-Adeno, bioMérieux foi utilizado para pesquisa de antígenos de adenovírus em amostras fecais obtidas de 268 crianças com diarreia aguda e 124 sem diarreia, em 2005 e 2006, no Hospital Infantil João Paulo II, Belo Horizonte-MG. Dados laboratoriais, clínicos e epidemiológicos foram registrados em banco de dados (SPSS Statistical package, IBM. RESULTADOS: Adenovírus foi detectado nas fezes de 16 crianças (4,1%: 12 (4,5% com diarreia e quatro (3,2% sem diarreia. A virose foi mais comum em meninas e a distribuição etária da infecção foi homogênea. Entre as 16 crianças com infecção pelo vírus, 11 (68,8% tinham até 12 meses de idade. Entretanto, diferença significativa não foi observada para os parâmetros analisados. Distribuição sazonal da infecção por adenovírus não foi detectada. CONCLUSÃO: Nossos dados demonstram que a prevalência da adenovirose é baixa na população pediátrica no nosso meio.INTRODUCTION: Several microorganisms, among them enteric adenovirus, are widely recognized as etiological agents of acute diarrhea. The association between adenovirus and the disease varies among geographical regions and is poorly known in Brazil. OBJECTIVES: To investigate the presence of adenovirus in stool samples from children with and without diarrhea in Belo Horizonte-MG. To study factors associated with enteric adenovirus infection. MATERIAL AND METHOD: A qualitative immunochromatographic assay (kit VIKIA® Rota-Adeno, bio

  11. Diarrhea at the Hajj and Umrah.

    Science.gov (United States)

    Gautret, Philippe; Benkouiten, Samir; Sridhar, Shruti; Al-Tawfiq, Jaffar A; Memish, Ziad A

    2015-01-01

    This systematic review aims to summarize the incidence and etiology of diarrheal illness among pilgrims attending the Hajj and Umrah. Gastroenteritis and diarrhea have been potential threats during previous Hajj pilgrimages. The last cases of Hajj related cholera were reported in 1989. Currently, respiratory tract infections account for the majority of health problems during the Hajj. This shift in epidemiology reflects the improvement of sanitary conditions in Saudi Arabia in general, and at religious sites in particular. Nevertheless, gastrointestinal diseases, food-poisoning outbreaks, and diarrhea continue to occur among pilgrims. Available studies about diarrhea among Hajj pilgrims indicate a mean prevalence of 2% with the highest prevalence of 23% among a group of French pilgrims in 2013. There is an obvious lack of information about the etiology of diarrheal disease at the Hajj. Further studies addressing this issue in hospitalized patients as well as prospective cohort studies would be of interest. During the Hajj, hand washing is regularly carried out by pilgrims under a ritual purification, often called ablution. We recommend implementation of effective hand hygiene practices focusing on the regular use of alcohol-based hand rubs, as they require less time than traditional hand washing, act more rapidly, and contribute to sustained improvement in compliance associated with decreased infection rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Prevalence of lactose intolerance in patients with diarrhea-predominant irritable bowel syndrome: data from a tertiary center in southern China.

    Science.gov (United States)

    Xiong, Lishou; Wang, Yilin; Gong, Xiaorong; Chen, Minhu

    2017-11-21

    Symptoms associated with lactose intolerance (LI) and diarrhea-predominant irritable bowel syndrome (IBS-D) are almost the same. These disease entities are difficult to differentiate clinically. In practice, differential diagnosis depends on self-reported patient milk intolerance. However, there is limited data on the prevalence of LI in China. The aim of this study was to investigate the prevalence of LI in IBS-D patients and asymptomatic healthy controls. Lactose malabsorption (LM) was diagnosed by a lactose hydrogen breath test (HBT) and was defined by peak breath H 2 excretion over the baseline level of ≥ 20 ppm. LI-related symptoms were monitored for 8 h following lactose administration. LI was defined in LM patients with positive symptoms during the observation time. Patients with IBS-D were additionally asked if they were intolerant to milk. A total of 109 eligible IBS-D patients (Rome III criteria) and 50 healthy controls were enrolled in this study. Except for hydrogen non-producers, the prevalence of LM did not differ between IBS-D patients and the control group (85%, 82/96 vs 72%, 34/47; P = 0.061). There was, however, a higher LI prevalence in IBS patients than in healthy subjects (45%, 43/96 vs 17%, 8/47; P = 0.002). Sensitivity, specificity, and positive and negative predictive values of self-reported milk intolerance for detecting LI were 58, 58, 53, and 63%, respectively. Prevalence of LI is significantly higher in IBS-D patients than in healthy subjects. Self-reported milk intolerance is a poor diagnostic predictor of LI.

  13. The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Seungman Cha

    2015-09-01

    Full Text Available Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014. A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74–0.97 for Krachi West, 0.96 (0.87–1.05 for Krachi East, and 0.91 (0.83–0.98 for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71–0.96 for Krachi West, 0.95 (0.86–1.04 for Krachi East, and 0.89 (0.82–0.97 for both districts. This study provides a basis for a better approach to water quality interventions.

  14. Dietary management of diarrhea.

    Science.gov (United States)

    Brown, K H; Bentley, M E

    1989-01-01

    The Dietary Management of Diarrhea project in Callejon de Huaylas, Peru is an interdisciplinary effort to reduce or eliminate the nutritional complications of diarrhea in children. A recent government nutrition and health survey showed chronic childhood malnutrition to be a common problem beginning around the time of weaning. Ethnographic studies were then used to provide: 1) specific information on beliefs about diarrhea and child feeding patterns during diarrhea; 2) information to design the questionnaire for the sample survey; and 3) cultural and social information for the educational intervention phase of the program. The sample survey administered to approximately 2500 families with children under 3. Results show diarrhea to be extremely common, with point prevalence rates reaching 20% for children 6-23 months. Breastfeeding was initiated almost universally and continued for a median of about 21 months. However, other liquids were often added unnecessarily to the infant's diet. Solid foods were being received by a majority of infants by 5 months, and by almost all by 9 months. There was no change in foods offered to children with diarrhea. Based on the research, the following activities were proposed for the pilot intervention: 1) development of an improved weaning food of enhanced energy and nutrient density that could be used for the treatment of diarrhea, 2) dissemination of information about these recipes using radio and face-to-face demonstrations in community programs and rural marketplaces, and 3) training health professionals to promote the weaning food. The recipe (eventually named sanquito) was developed with mother from the community, tested within the community for acceptability and clinically with hospitalized children. It was then heavily promoted both to the general public and to health professionals. At the completion of the educational intervention (March-August 1988) it was evaluated by 1) interviews with health professionals about whether

  15. Side Effects: Diarrhea

    Science.gov (United States)

    Diarrhea, a side effect of cancer treatment, may cause symptoms such as loose, watery stools. Diarrhea can lead to dehydration and malnutrition in cancer patients. Learn about ways to treat and manage diarrhea during cancer treatment.

  16. Addressing epidemiological and public health analytic challenges in outcome and impact research: a commentary on 'Prechewing Infant Food, Consumption of Sweets and Dairy and Not Breastfeeding are Associated with Increased Diarrhea Risk of Ten Month Old Infants'.

    Science.gov (United States)

    Habicht, Jean-Pierre; Pelto, Gretel H

    2016-07-01

    Based on a paper by Conkle et al 2016, in which the authors use a descriptive epidemiological design to examine the relationship of premastication and other dietary behavioral variables to childhood diarrhea in the US, we address larger issues of "plausible causality" and the challenges involved in moving from epidemiological studies to public health policy. Drawing on examples from breastfeeding research and water, sanitation and hygiene (WASH) research, we discuss the following propositions: 1. Effective outcome analyses require simultaneous investigation of different, even contradictory, pathways; 2. Outcome versus impact assessments require different analytic procedures including context analysis; 3. Impact analysis requires understanding the trade-offs between detrimental and beneficial outcomes in relation to potential interventions; 4. No estimates exist for the likely detrimental and beneficial impacts of banning premastication, much less for their trade-offs. © 2016 John Wiley & Sons Ltd.

  17. Human rotavirus genotypes causing acute watery diarrhea among ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major cause of childhood morbidity and mortality in the developing countries. Rotavirus is a major cause of acute watery diarrhea. Aim: This study aims at characterizing the prevalent rotavirus G-genotypes among under.five children presenting with acute watery diarrhea in Benin City, Nigeria.

  18. Prevalence and characteristics of extended-spectrum β-lactamase genes in Escherichia coli isolated from piglets with post-weaning diarrhea in Heilongjiang province, China.

    Science.gov (United States)

    Xu, Guofeng; An, Wei; Wang, Hongdong; Zhang, Xiuying

    2015-01-01

    The purpose of this study was to investigate the prevalence of extended spectrum β-lactamase (ESBL) genes in Escherichia coli isolated from post-weaning diarrhea (PWD) piglets in Heilongjiang province, China. Of 458 E. coli isolated from 589 fecal samples from PWD piglets, a total of 198 isolates were confirmed as ESBL producers by the double-disk synergy test (DDST). Polymerase chain reaction (PCR) and sequencing were performed to identify genes for ESBL, plasmid-mediated quinolone resistance (PMQR), and integrons. Of the 198 isolates, bla CTX-M and bla TEM were detected in 191 and 149 isolates, respectively. Sequencing revealed that 10 bla CTX-M subtypes were detected, and bla CTX-M-14 was the most prevalent, followed by bla CTX-M-55 and bla CTX-M-65. Of the 149 TEM-positive strains, four were bla TEM-52 and the rest were bla TEM-1. Among the 198 ESBL-positive isolates, 173 isolates were found to harbor at least one PMQR gene, with oqxAB, qnrS, qnrB, qepA, and aac(6')-Ib-cr being detected alone or in combination in 125, 114, 26, 24, and 45 strains, respectively. One hundred and fifty-five ESBL-positive isolates were also positive for class I integron (int1), and eight different gene cassette arrays were confirmed in 110 isolates by restriction fragment length polymorphism (RFLP) and DNA sequencing analyses, with predominance of dfrA17-aadA5, dfrA12-orfF-aadA2, and dfrA1-aadA1 arrays. To the best of our knowledge, this is the first report of the bla TEM-52 gene in pig E. coli isolates in China and this is also the first description of the coexistence of the qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB genes in one E. coli strain.

  19. Prevalence and characteristics of extended-spectrum beta-lactamase genes in Escherichia coli isolated from piglets with post-weaning diarrhea in Heilongjiang province, China

    Directory of Open Access Journals (Sweden)

    Xiuying eZhang

    2015-10-01

    Full Text Available The purpose of this study was to investigate the prevalence of extended spectrum β-lactamase (ESBL genes in Escherichia coli isolated from post-weaning diarrhea (PWD piglets in Heilongjiang province, China. Of 458 E. coli isolated from 589 fecal samples from PWD piglets, a total of 198 isolates were confirmed as ESBL producers by the double-disk synergy test (DDST. Polymerase chain reaction (PCR and sequencing were performed to identify genes for ESBL, PMQR, and integrons. Of the 198 isolates, blaCTX-M and blaTEM were detected in 191 and 149 isolates, respectively. Sequencing revealed that ten blaCTX-M subtypes were detected, and blaCTX-M-14 was the most prevalent, followed by blaCTX-M-55 and blaCTX-M-65. Of the 149 TEM-positive strains, four were blaTEM-52 and the rest were blaTEM-1. Among the 198 ESBL-positive isolates, 173 isolates were found to harbor at least one PMQR genes, with oqxAB, qnrS, qnrB, qepA, and aac(6′-Ib-cr being detected alone or in combination in 125, 114, 26, 24, and 45 strains, respectively. 155 ESBL-positive isolates were also positive for class I integron (int1, and eight different gene cassette arrays were confirmed in 110 isolates by restriction fragment length polymorphism (RFLP and DNA sequencing analyses, with predominance of dfrA17-aadA5, dfrA12-orfF-aadA2, and dfrA1-aadA1 arrays. To the best of our knowledge, this is the first report of the blaTEM-52 gene in pig E. coli isolates in China and this is also the first description of the coexistence of the qnrB, qnrS, aac(6′-Ib-cr, qepA, and oqxAB genes in one E. coli strain.

  20. Bovine viral diarrhea virus in free-ranging wild ruminants in Switzerland: low prevalence of infection despite regular interactions with domestic livestock

    Science.gov (United States)

    2012-01-01

    Background In the frame of an eradication program for bovine viral diarrhea (BVD) in Swiss livestock, the question was raised whether free-ranging wildlife could threaten the success of this sanitary measure. Therefore, we conducted serological and virological investigations on BVD virus (BVDV) infections in the four indigenous wild ruminant species (roe deer, red deer, Alpine chamois and Alpine ibex) from 2009 to 2011, and gathered information on interactions between wild and domestic ruminants in an alpine environment by questionnaire survey. Results Thirty-two sera out of 1’877 (1.7%, 95% confidence interval [CI] 1.2-2.4) were seropositive for BVDV, and a BVDV1 sub genotype h virus was found in a seropositive chamois (0.05%, 95% CI 0.001-0.3). The seropositive animals originated from sub-alpine or alpine regions and significantly more seropositive red deer, chamois and ibex than roe deer were found. There were no statistically significant differences between sampling units, age classes, genders, and sampling years. The obtained prevalences were significantly lower than those documented in livestock, and most positive wild ruminants were found in proximity of domestic outbreaks. Additionally, BVDV seroprevalence in ibex was significantly lower than previously reported from Switzerland. The survey on interspecific interactions revealed that interactions expected to allow BVDV transmission, from physical contacts to non-simultaneous use of the same areas, regularly occur on pastures among all investigated ruminant species. Interactions involving cervids were more often observed with cattle than with small ruminants, chamois were observed with all three domestic species, and ibex interacted mostly with small ruminants. Interactions related to the use of anthropogenic food sources were frequently observed, especially between red deer and cattle in wintertime. Conclusions To our knowledge, this is the first report of BVDV RNA isolated from an Alpine chamois

  1. Bovine viral diarrhea virus in free-ranging wild ruminants in Switzerland: low prevalence of infection despite regular interactions with domestic livestock

    Directory of Open Access Journals (Sweden)

    Casaubon Julien

    2012-10-01

    Full Text Available Abstract Background In the frame of an eradication program for bovine viral diarrhea (BVD in Swiss livestock, the question was raised whether free-ranging wildlife could threaten the success of this sanitary measure. Therefore, we conducted serological and virological investigations on BVD virus (BVDV infections in the four indigenous wild ruminant species (roe deer, red deer, Alpine chamois and Alpine ibex from 2009 to 2011, and gathered information on interactions between wild and domestic ruminants in an alpine environment by questionnaire survey. Results Thirty-two sera out of 1’877 (1.7%, 95% confidence interval [CI] 1.2-2.4 were seropositive for BVDV, and a BVDV1 sub genotype h virus was found in a seropositive chamois (0.05%, 95% CI 0.001-0.3. The seropositive animals originated from sub-alpine or alpine regions and significantly more seropositive red deer, chamois and ibex than roe deer were found. There were no statistically significant differences between sampling units, age classes, genders, and sampling years. The obtained prevalences were significantly lower than those documented in livestock, and most positive wild ruminants were found in proximity of domestic outbreaks. Additionally, BVDV seroprevalence in ibex was significantly lower than previously reported from Switzerland. The survey on interspecific interactions revealed that interactions expected to allow BVDV transmission, from physical contacts to non-simultaneous use of the same areas, regularly occur on pastures among all investigated ruminant species. Interactions involving cervids were more often observed with cattle than with small ruminants, chamois were observed with all three domestic species, and ibex interacted mostly with small ruminants. Interactions related to the use of anthropogenic food sources were frequently observed, especially between red deer and cattle in wintertime. Conclusions To our knowledge, this is the first report of BVDV RNA isolated from an

  2. Cow’s milk allergy in patients with diarrhea

    OpenAIRE

    Nanis S Marzuki; Arwin AP Akib; I Boediman

    2016-01-01

    Background Cow’s milk allergy (CMA) might be one of the causes of diarrhea in children. Previous prospective studies found the prevalence of CMA in children aged 0-3 years between 1.1-5.2%, but data about the prevalence of CMA in children with diarrhea was very limited. Objective This study intended to estimate the prevalence of CMA in children with diarrhea. Methods Children aged 0-3 years, who came with diarrhea and consumed milk formula were selected for further eva...

  3. Chronic Diarrhea in Children

    Science.gov (United States)

    ... Digestive System & How it Works Zollinger-Ellison Syndrome Chronic Diarrhea in Children View or Print All Sections Definition & Facts Chronic diarrhea is passing loose, watery stools three or more ...

  4. Gastrointestinal Infections and Diarrhea

    Science.gov (United States)

    ... or lakes can lead to an infection and chronic diarrhea. Infants in childcare settings can become infected with ... than 2 weeks, however, are a sign of chronic diarrhea. Call your doctor if you think that you ...

  5. Postpartum depression in an Indian community: more prevalent less addressed issue

    OpenAIRE

    Aruna Nigam; Anupam Prakash; Neha Maheshwari

    2016-01-01

    Background: Postpartum depression is major health concern which not only has effect on maternal mortality and morbidity but also have effect on the cognitive and behavioral development of the child. Aims of the study was to study the prevalence of postpartum depression and its correlates. Methods: 100 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Diagnosis of depression was made using the Edinburgh Postnatal Depression...

  6. By the book: ADHD prevalence in medical students varies with analogous methods of addressing DSM items.

    Science.gov (United States)

    Mattos, Paulo; Nazar, Bruno P; Tannock, Rosemary

    2018-02-15

    The marked increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students gives rise to questions about how best to diagnose in this setting. The aim of the present study was to calculate ADHD prevalence in a large non-clinical sample of medical students using a stepwise design and to determine whether ADHD diagnosis varies if interviewees use additional probing procedures to obtain examples of positive DSM items. A total of 726 students were screened with the Adult Self-Report Scale (ASRS) and invited for an interview with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) adapted for adults. The ASRS was positive for 247 students (37%), although only 83 (7.9%) received an ADHD diagnosis. ASRS sensitivity and specificity rates were 0.97 and 0.40, respectively. Probing procedures were used with a subgroup of 226 students, which decreased the number of ADHD diagnoses to 12 (4.5%). Probing for an individual's real-life examples during the K-SADS interview almost halved ADHD prevalence rate based on the ASRS and K-SADS, which rendered the rate consistent with that typically reported for young adults. In reclassified cases, although examples of inattention did not match the corresponding DSM item, they often referred to another DSM inattention item.

  7. Probiotics for prevention and treatment of diarrhea.

    Science.gov (United States)

    Guandalini, Stefano

    2011-11-01

    Probiotics have been extensively studied over the past several years in the prevention and, to a larger extent, in the treatment of diarrheal diseases, especially in pediatric populations. Diarrhea is a symptom, and not a disease. This review will not address chronic disorders associated with diarrhea, or Clostridium difficile-induced diarrhea. Rather it will focus on published clinical trials performed on acute-onset, likely infectious diarrhea occurring in the settings of day-care centers, in the community, acquired in the hospital, antibiotic-associated diarrhea, and treatment of acute infectious diarrhea. For prevention of diarrhea acquired in day-care centers, 9 randomized and placebo-controlled trials have been published, conducted in different parts of the world. Probiotics tested were Lactobacillus GG, Bifidobacterium lactis (alone or in combination with Streptococcus thermophilus, and Lactobacillus reuteri, Lactobacillus rhamnosus (not GG), and Lactobacillus acidophilus, in various trials either alone or in comparison with each other. The evidence of their efficacy in these settings is only modest for the prevention of diarrhea, although somewhat better for prevention of upper respiratory infections. In the community, new trails conducted in underprivileged areas of India, again with modest efficacy. Previous trials that examined the potential role of probiotics in preventing the spreading of diarrhea in hospitalized children had yielded conflicting results. More recently, a large trial in Poland showed, however, rather good evidence of efficacy for Lactobacillus GG. The prevention of antibiotic-associated diarrhea has been the subject of many investigations, both in children and in adults. Most commonly used probiotics were Lactobacillus GG, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium ssp, Streptococcus ssp, and the yeast Saccharomyces boulardii. In general, most of these trials do show clear evidence of efficacy, with the 2 most

  8. Prevention and Care Programs Addressing the Growing Prevalence of Diabetes in China.

    Science.gov (United States)

    Yin, Junmei; Kong, Alice P S; Chan, Juliana C N

    2016-12-01

    According to a 2010 national survey, 11 % of adults in China have diabetes, affecting 109.6 million individuals. The high prevalence of diabetes has been attributed to the aging of the population, the rapid adoption of energy-dense foods, and a reduction in physical activity. Collectively, these secular changes have created an obesogenic environment that can unmask diabetes in subjects with a genetic predisposition. The growing prevalence of maternal obesity, gestational diabetes, childhood obesity, and early-onset disease can lead to premature morbidity and mortality. Rising to meet these public health challenges, researchers in China have conducted randomized studies to demonstrate the benefits of lifestyle modification in preventing diabetes (the Da Qing Study), as well as that of team-based integrated care, using multiple strategies including peer support and information technology, in order to reduce hospitalizations, cardiovascular-renal complications, and premature deaths. With growing evidence supporting the benefits of these diabetes prevention and management programs, the next challenge is to use policies and systems to scale up the implementation of these programs through raising awareness, building capacity, and providing resources to reduce the human and socioeconomic burden of diabetes.

  9. Testing for Chronic Diarrhea.

    Science.gov (United States)

    Raman, M

    Chronic diarrhea is a frequently encountered symptom in clinical practice. The etiologies for chronic diarrhea are diverse and broad with varying clinical implications. A useful method of categorizing chronic diarrhea to guide a diagnostic work-up is a pathophysiology-based framework. Chronic diarrhea may be categorized as malabsorptive, secretory, osmotic, and inflammatory or motility related. Frequently, overlap between categories may exist for any given diarrhea etiology and diagnostic testing must occur with an understanding of the differential diagnosis. Investigations to achieve a diagnosis for chronic diarrhea range from screening blood and stool tests to more directed testing such as diagnostic imaging, and endoscopic and histological evaluation. The pathophysiology-based framework proposed in this chapter will allow the clinician to select screening tests followed by targeted tests to minimize cost and complications to the patient, while providing a highly effective method to achieve an accurate diagnosis. © 2017 Elsevier Inc. All rights reserved.

  10. Surveillance of Rotavirus Diarrhea in Hasan Sadikin Hospital Bandung

    OpenAIRE

    Dwi Prasetyo; Iesje Martiza; Yati Soenarto

    2010-01-01

    The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance stud...

  11. Does Dientamoeba fragilis cause diarrhea? A systematic review.

    Science.gov (United States)

    Wong, Zing-Wae; Faulder, Kate; Robinson, Joan L

    2018-02-05

    It remains controversial whether Dientamoeba fragilis is a commensal parasite or a pathogen. The objective of this systematic review was to establish the strength of the evidence that Dientamoeba fragilis would cause diarrhea. A search was performed for studies that reported either the association between D. fragilis detection in stools and diarrhea or diarrhea outcomes with D. fragilis therapy or challenge. Data from seven studies of specific populations reported that 22% had D. fragilis in stools of which only 23% had diarrhea. Eleven studies of stool samples submitted to laboratories reported that 4.3% of individuals had D. fragilis of which 54% had diarrhea. Twelve studies reported that D. fragilis was detected from 1.6% of individuals with diarrhea and 9.6% of diarrheal stools. Five studies analyzed the prevalence of D. fragilis in individuals with and without diarrhea; the two with a statistically significant difference between groups had discordant results. The only cohort study with an appropriate control group reported diarrhea in a higher proportion of children with D. fragilis than in controls. No D. fragilis treatment studies included diarrhea as an outcome. There were only two challenge studies involving one person each. In conclusion, the evidence that D. fragilis would cause diarrhea or that treatment would hasten diarrhea resolution is inconclusive.

  12. Etiology of Acute Diarrhea in Tunisian Children with Emphasis on Diarrheagenic Escherichia coli: Prevalence and Identification of E. coli Virulence Markers.

    Science.gov (United States)

    Ben Salem-Ben Nejma, Imen; Hassine Zaafrane, Mouna; Hassine, Fredj; Sdiri-Loulizi, Khira; Ben Said, Moncef; Aouni, Mahjoub; Mzoughi, Ridha

    2014-07-01

    Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age. Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens. In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7%) and 95 diarrheagenic Escherichia coli strains (76.6%): 29 enteroaggregative E.coli (EAEC) (23.4%), 15 enteroinvasive E.coli (EIEC) (12.1%), 17 enteropathogenic E.coli (EPEC) (13.7%), 26 enterotoxigenic E.coli (ETEC) (21%) and 2 enterohemoragic E.coli (EHEC) (1.6%). However, in the control group, 23 pathogenic E.coli strains were isolated (42.6%): 8 EAEC (14.8%), 12 EIEC (22.2%) and 3 EPEC (5.5%). Among diarrheagenic E.coli (DEC), only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P Entamoeba coli and cryptosporidium Oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively. These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.

  13. Drug-induced diarrhea

    Science.gov (United States)

    ... Zantac), and nizatidine (Axid) Medicines that suppress the immune system (such as mycophenolate) Nonsteroidal anti-iflammatory drugs (NSAIDs) ... care provider about taking supplements containing healthy bacteria (probiotics). Some of these products may reduce the risk of diarrhea. Keep taking these ... References Schiller LR, Sellin JH. Diarrhea. In: ...

  14. Overview of the causes of chronic diarrhea in children

    Science.gov (United States)

    The major causes and the prevalence of chronic diarrhea differ between developed and developing countries. In the developing world, chronic diarrhea is typically associated with serial enteric infections and malnutrition; it is manifested by a chronic enteropathy, with impaired mucosal healing, and ...

  15. Diarrhea and Swimming

    Science.gov (United States)

    ... Externa) "Swimmer's Ear" (Otitis Externa) Prevention Head Lice MRSA Pinworm & Swimming Other Recreational Water-related Issues Pools & ... Professionals Aquatics Staff Travelers En Español Publications, Data, & Statistics Disease & Outbreak Tracking Prevention Commentaries Diarrhea & Vomiting Skin, ...

  16. [Chronic diarrhea in the diabetic. A review of the literature].

    Science.gov (United States)

    Frías Ordoñez, Juan Sebastián; Otero Regino, William

    2016-01-01

    The association of diarrhea with diabetes mellitus has been known for more than 70 years. In diabetic patients its prevalence is around 20%.Its clinical manifestations are diverse, and represents a diagnostic and therapeutic challenge.There are certain diagnoses of higher prevalence in diabetic patients than in the general population.The different related etiologies can be adequately diagnosed through the clinical history and complementary diagnostic tests.The medications used by the diabetic patient to manage their disease often cause chronic diarrhea, so the pharmacological background should be studied at the time of the study of diarrhea.Diabetic patients can present other associated pathological conditions, such as celiac disease or microscopic colitis, which only discomfort is diarrhea.Exocrine pancreatic function may be decreased in the diabetic patient, frequently leading to exocrine pancreatic insufficiency. Dietary factors, such as sugar-free sweeteners and other agents, can cause diarrhea in the diabetic patient.The presence of conditions such as autonomic neuropathy and peripheral neuropathy secondary to diabetes mellitus may explain disorders such as anorectal dysfunction and faecal incontinence. Finally, diabetic enteropathy alone or with associated bacterial overgrowth can cause diarrhea.Achieving adequate glycemic control is the pillar of the treatment of diarrhea in the diabetic, after which there are additional measures that are applied according to the specific context of the patient.This article reviews the causes of higher diarrhea incidence in the diabetic patient and the pathophysiological mechanisms involved.

  17. Entamoeba moshkovskii is associated with diarrhea in infants and causes diarrhea and colitis in mice.

    Science.gov (United States)

    Shimokawa, Chikako; Kabir, Mamun; Taniuchi, Mami; Mondal, Dinesh; Kobayashi, Seiki; Ali, Ibne Karim M; Sobuz, Shihab U; Senba, Masachika; Houpt, Eric; Haque, Rashidul; Petri, William A; Hamano, Shinjiro

    2012-09-01

    Entamoeba moshkovskii is prevalent in developing countries and morphologically indistinguishable from pathogenic Entamoeba histolytica and nonpathogenic Entamoeba dispar. It is not known if E. moshkovskii is pathogenic. Mice were intracecally challenged with the trophozoites of each Entamoeba spp. to test the ability to cause diarrhea, and infants in Bangladesh were prospectively observed to see if newly acquired E. moshkovskii infection was associated with diarrhea. E. moshkovskii and E. histolytica caused diarrhea and weight loss in susceptible mice. E. dispar infected none of the mouse strains tested. In Mirpur, Dhaka, Bangladesh, E. moshkovskii, E. histolytica, and E. dispar were identified in 42 (2.95%), 66 (4.63%), and 5 (0.35%), respectively, of 1426 diarrheal episodes in 385 children followed prospectively from birth to one year of age. Diarrhea occurred temporally with acquisition of a new E. moshkovskii infection: in the 2 months preceding E. moshkvskii-associated diarrhea, 86% (36 of 42) of monthly surveillance stool samples were negative for E. moshkovskii. E. moshkovskii was found to be pathogenic in mice. In children, the acquisition of E. moshkovskii infection was associated with diarrhea. These data are consistent with E. moshkovskii causing disease, indicating that it is important to reexamine its pathogenicity.

  18. Syndromic (phenotypic diarrhea in early infancy

    Directory of Open Access Journals (Sweden)

    Bodemer Christine

    2008-02-01

    Full Text Available Abstract Syndromic diarrhea (SD, also known as phenotypic diarrhea (PD or tricho-hepato-enteric syndrome (THE, is a congenital enteropathy presenting with early-onset of severe diarrhea requiring parenteral nutrition (PN. To date, no epidemiological data are available. The estimated prevalence is approximately 1/300,000–400,000 live births in Western Europe. Ethnic origin does not appear to be associated with SD. Infants are born small for gestational age and present with facial dysmorphism including prominent forehead and cheeks, broad nasal root and hypertelorism. Hairs are woolly, easily removed and poorly pigmented. Severe and persistent diarrhea starts within the first 6 months of life (≤ 1 month in most cases and is accompanied by severe malabsorption leading to early and relentless protein energy malnutrition with failure to thrive. Liver disease affects about half of patients with extensive fibrosis or cirrhosis. There is currently no specific biochemical profile, though a functional T-cell immune deficiency with defective antibody production was reported. Microscopic analysis of the hair show twisted hair (pili torti, aniso- and poilkilotrichosis, and trichorrhexis nodosa. Histopathological analysis of small intestine biopsy shows non-specific villous atrophy with low or no mononuclear cell infiltration of the lamina propria, and no specific histological abnormalities involving the epithelium. The etiology remains unknown. The frequent association of the disorder with parental consanguinity and/or affected siblings suggests a genetic origin with an autosomal recessive mode of transmission. Early management consists of total PN. Some infants have a rather milder phenotype with partial PN dependency or require only enteral feeding. Prognosis of this syndrome is poor, but most patients now survive, and about half of the patients may be weaned from PN at adolescence, but experience failure to thrive and final short stature. Disease name

  19. Breastfeeding and the risk for diarrhea morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Victora Cesar

    2011-04-01

    Full Text Available Abstract Background Lack of exclusive breastfeeding among infants 0-5 months of age and no breastfeeding among children 6-23 months of age are associated with increased diarrhea morbidity and mortality in developing countries. We estimate the protective effects conferred by varying levels of breastfeeding exposure against diarrhea incidence, diarrhea prevalence, diarrhea mortality, all-cause mortality, and hospitalization for diarrhea illness. Methods We systematically reviewed all literature published from 1980 to 2009 assessing levels of suboptimal breastfeeding as a risk factor for selected diarrhea morbidity and mortality outcomes. We conducted random effects meta-analyses to generate pooled relative risks by outcome and age category. Results We found a large body of evidence for the protective effects of breastfeeding against diarrhea incidence, prevalence, hospitalizations, diarrhea mortality, and all-cause mortality. The results of random effects meta-analyses of eighteen included studies indicated varying degrees of protection across levels of breastfeeding exposure with the greatest protection conferred by exclusive breastfeeding among infants 0-5 months of age and by any breastfeeding among infants and young children 6-23 months of age. Specifically, not breastfeeding resulted in an excess risk of diarrhea mortality in comparison to exclusive breastfeeding among infants 0-5 months of age (RR: 10.52 and to any breastfeeding among children aged 6-23 months (RR: 2.18. Conclusions Our findings support the current WHO recommendation for exclusive breastfeeding during the first 6 months of life as a key child survival intervention. Our findings also highlight the importance of breastfeeding to protect against diarrhea-specific morbidity and mortality throughout the first 2 years of life.

  20. Predictors of under-five childhood diarrhea: Mecha District, West ...

    African Journals Online (AJOL)

    Results: The prevalence of diarrhea among mothers and under-five children was 8.2% and 18.0%, respectively. Maternal education (AOR=5.6, 95% CI: 1.5 - 19.4), maternal history of recent diarrhea (AOR, 5.5; 95% CI, 2.9 - 9.8), availability of latrine facility (AOR, 1.9; 95% CI, 1.1-3.4), duration of breast feeding (AOR=2.7, ...

  1. Insect Consumption to Address Undernutrition, a National Survey on the Prevalence of Insect Consumption among Adults and Vendors in Laos.

    Science.gov (United States)

    Barennes, Hubert; Phimmasane, Maniphet; Rajaonarivo, Christian

    2015-01-01

    Insect consumption (entomophagy) is a potentially high nutritious and healthy source of food with high fat, protein, vitamin, fiber and micronutrient content. At least 2 billion people globally eat insects (over 1900 edible species) though this habit is regarded negatively by others. There is a limited amount of data on the perception and consumption of insects. We conducted a national cross-sectional survey in the Lao People's Democratic Republic (Laos) to assess the prevalence and characteristics of insect consumption among adult lay people and insect vendors. We conducted a multi stage randomized national survey in 1303 households in 96 villages in 16 Lao provinces. Three insect vendors or collectors per village were also included. A standardized pretested questionnaire addressed the following issues: socioeconomic characteristics, type of insects consumed and frequency of consumption, reasons and trends in consumption as well as reports on side effects, over the last 10 years. A total of 1059 adults (Sex ratio F/M: 1.2, 30 ethnic groups), and 256 vendors were enrolled. A total of 1025 (96.8%) lay people were currently insect consumers, 135 (13.0%) daily or weekly consumers, and 322 (31.1%) consumed several times per month. For the majority (575, 55.6%) the consumption was infrequent (less than a few times per year) and only 22 (2%) had never eaten insects. Consumption started in childhood. Insect availability was seasonal (670, 63.2%) and respondents would have eaten more insects, if they had been more available (919, 86.7%). Hmong and Leu ethnic groups had significantly lower consumption levels than the general population. Eggs of weaver ants, short-tailed crickets, crickets, grasshoppers, and cicadas were the top 5 insects consumed. Consumption had decreased in the last decade, mostly due to less availability (869; 84.0%) and change of life (29; 5.5%). Of 1059, 80 (7.5%) reported allergy problems and 106 (10.0%) reported some use in traditional medicine. A

  2. Insect Consumption to Address Undernutrition, a National Survey on the Prevalence of Insect Consumption among Adults and Vendors in Laos.

    Directory of Open Access Journals (Sweden)

    Hubert Barennes

    Full Text Available Insect consumption (entomophagy is a potentially high nutritious and healthy source of food with high fat, protein, vitamin, fiber and micronutrient content. At least 2 billion people globally eat insects (over 1900 edible species though this habit is regarded negatively by others. There is a limited amount of data on the perception and consumption of insects. We conducted a national cross-sectional survey in the Lao People's Democratic Republic (Laos to assess the prevalence and characteristics of insect consumption among adult lay people and insect vendors.We conducted a multi stage randomized national survey in 1303 households in 96 villages in 16 Lao provinces. Three insect vendors or collectors per village were also included. A standardized pretested questionnaire addressed the following issues: socioeconomic characteristics, type of insects consumed and frequency of consumption, reasons and trends in consumption as well as reports on side effects, over the last 10 years.A total of 1059 adults (Sex ratio F/M: 1.2, 30 ethnic groups, and 256 vendors were enrolled. A total of 1025 (96.8% lay people were currently insect consumers, 135 (13.0% daily or weekly consumers, and 322 (31.1% consumed several times per month. For the majority (575, 55.6% the consumption was infrequent (less than a few times per year and only 22 (2% had never eaten insects. Consumption started in childhood. Insect availability was seasonal (670, 63.2% and respondents would have eaten more insects, if they had been more available (919, 86.7%. Hmong and Leu ethnic groups had significantly lower consumption levels than the general population. Eggs of weaver ants, short-tailed crickets, crickets, grasshoppers, and cicadas were the top 5 insects consumed. Consumption had decreased in the last decade, mostly due to less availability (869; 84.0% and change of life (29; 5.5%. Of 1059, 80 (7.5% reported allergy problems and 106 (10.0% reported some use in traditional medicine. A

  3. Insect Consumption to Address Undernutrition, a National Survey on the Prevalence of Insect Consumption among Adults and Vendors in Laos

    Science.gov (United States)

    Barennes, Hubert; Phimmasane, Maniphet; Rajaonarivo, Christian

    2015-01-01

    Background Insect consumption (entomophagy) is a potentially high nutritious and healthy source of food with high fat, protein, vitamin, fiber and micronutrient content. At least 2 billion people globally eat insects (over 1900 edible species) though this habit is regarded negatively by others. There is a limited amount of data on the perception and consumption of insects. We conducted a national cross-sectional survey in the Lao People’s Democratic Republic (Laos) to assess the prevalence and characteristics of insect consumption among adult lay people and insect vendors. Methods We conducted a multi stage randomized national survey in 1303 households in 96 villages in 16 Lao provinces. Three insect vendors or collectors per village were also included. A standardized pretested questionnaire addressed the following issues: socioeconomic characteristics, type of insects consumed and frequency of consumption, reasons and trends in consumption as well as reports on side effects, over the last 10 years. Results A total of 1059 adults (Sex ratio F/M: 1.2, 30 ethnic groups), and 256 vendors were enrolled. A total of 1025 (96.8%) lay people were currently insect consumers, 135 (13.0%) daily or weekly consumers, and 322 (31.1%) consumed several times per month. For the majority (575, 55.6%) the consumption was infrequent (less than a few times per year) and only 22 (2%) had never eaten insects. Consumption started in childhood. Insect availability was seasonal (670, 63.2%) and respondents would have eaten more insects, if they had been more available (919, 86.7%). Hmong and Leu ethnic groups had significantly lower consumption levels than the general population. Eggs of weaver ants, short-tailed crickets, crickets, grasshoppers, and cicadas were the top 5 insects consumed. Consumption had decreased in the last decade, mostly due to less availability (869; 84.0%) and change of life (29; 5.5%). Of 1059, 80 (7.5%) reported allergy problems and 106 (10.0%) reported some use

  4. Pharmacologic Agents for Chronic Diarrhea

    Science.gov (United States)

    2015-01-01

    Chronic diarrhea is usually associated with a number of non-infectious causes. When definitive treatment is unavailable, symptomatic drug therapy is indicated. Pharmacologic agents for chronic diarrhea include loperamide, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists, diosmectite, cholestyramine, probiotics, antispasmodics, rifaximin, and anti-inflammatory agents. Loperamide, a synthetic opiate agonist, decreases peristaltic activity and inhibits secretion, resulting in the reduction of fluid and electrolyte loss and an increase in stool consistency. Cholestyramine is a bile acid sequestrant that is generally considered as the first-line treatment for bile acid diarrhea. 5-HT3 receptor antagonists have significant benefits in patients with irritable bowel syndrome (IBS) with diarrhea. Ramosetron improves stool consistency as well as global IBS symptoms. Probiotics may have a role in the prevention of antibiotic-associated diarrhea. However, data on the role of probiotics in the treatment of chronic diarrhea are lacking. Diosmectite, an absorbent, can be used for the treatment of chronic functional diarrhea, radiation-induced diarrhea, and chemotherapy-induced diarrhea. Antispasmodics including alverine citrate, mebeverine, otilonium bromide, and pinaverium bromide are used for relieving diarrheal symptoms and abdominal pain. Rifaximin can be effective for chronic diarrhea associated with IBS and small intestinal bacterial overgrowth. Budesonide is effective in both lymphocytic colitis and collagenous colitis. The efficacy of mesalazine in microscopic colitis is weak or remains uncertain. Considering their mechanisms of action, these agents should be prescribed properly. PMID:26576135

  5. HIV/AIDS-associated opportunistic protozoal diarrhea.

    Science.gov (United States)

    Agholi, Mahmoud; Hatam, Gholam Reza; Motazedian, Mohammad Hossein

    2013-01-01

    Human immunodeficiency virus (HIV) infection has altered both the epidemiology and outcome of enteric opportunistic parasitic infections. This study was done to determine the prevalence and species/genotypes of intestinal coccidian and microsporidial infections among HIV/AIDS patients with diarrhea and/or a history of diarrhea alternately with an asymptomatic interval, and their association with CD4 T cell count. This cross-sectional study was done from May 2010 to May 2011 in Shiraz University of Medical Sciences, South of Iran. A blood sample was obtained from HIV-positive patients for a CD4 T cell count upon enrollment. Sociodemographic data and a history of diarrhea were collected by interviewing 356 consecutive participants (273 males and 83 females). Whenever possible more than a fecal sample was collected from all the participants and examined for parasites using direct, physiological saline solution ethyl acetate, an acid-fast trichrome stain, nested polymerase chain reaction, and sequencing techniques for the detection, confirmation, and genotyping of Cryptosporidium spp., Cyclospora cayetanensis, Isospora belli, and intestinal microsporidia (Enterocytozoon bieneusi). The most common opportunistic and nonopportunistic pathogens were Cryptosporidium spp. (C. parvum and C. andersoni), E. bieneusi, Giardia lamblia, Sarcocystis spp., and Blastocystis homonis affecting 34, 8, 23, 1, and 14 patients, respectively. C. cayetanensis, I. belli, Enterobius vermicularis, and Hymenolepis nana were observed in few patients. A CD4 count <200 cells/μl was significantly associated with the presence of opportunistic parasites and diarrhea (p<0.05). Opportunistic intestinal parasites should be suspected in any HIV/AIDS patient with chronic diarrhea. Tropical epidemic nonopportunistic enteric parasitic infections among such patients should not be neglected in Iran.

  6. Microscopic colitis in children with chronic diarrhea.

    Science.gov (United States)

    Singh, Prashant; Das, Prasenjit; Jain, A K; Mathan, Minnie; Mathur, Meera; Bhat, Abdus Sami; Varma, Sharat; Chaturvedi, Mona K; Gupta, Siddhartha Datta; Bhatnagar, Shinjini

    2013-08-01

    The aim of the present study was to study microscopic colitis (MC) in children with special reference to its role in chronic diarrhea and changes in mucosal biopsies. A total of 100 consecutive children ages 3 to 12 years, with nonbloody diarrhea (passage of ≥3 loose stools per day) of >12 weeks' duration were screened and 26 were enrolled in the study in which no specific etiology could be found and colonoscopy did not reveal any mucosal abnormality. Colonic biopsies were evaluated for the presence of lymphocytic colitis or collagenous colitis and those with the characteristic changes were defined to have MC (group A). Colonic biopsies from patients with MC were compared with biopsies from patients with chronic diarrhea but no evidence of MC (group B). One hundred children ages 3 to 12 years with bleeding per rectum were screened and colonic biopsies from 45 patients (group C) who had colonic mucosal changes but no vascular or polyp lesion were compared with patients with MC. Of the 26 patients with chronic diarrhea, MC was found in 5 (3 lymphocytic colitis and 2 collagenous colitis). Significantly higher polymorphonuclear infiltration was seen in group A as compared with group B (13.8 [5.4-20.6] vs 7.2 [0-19.6]; P = 0.03) or group C (13.8 [5.4-20.6] vs 4 [0-13.4]; P = 0.007). Intraepithelial lymphocytes (12 [4-32] vs 4 [0-24]; P = 0.008) and basement membrane thickening (3.5 [2.9-10.6] vs 2.5 [1.6-5.86]; P = 0.008) were also significantly higher in group A as compared with group C. MC was found to be present in children with nonbloody chronic diarrhea in children. Further multicentric studies may provide adequate data on its prevalence.

  7. Severity of Rotavirus Diarrhea in Children: One Year Experience in a Children Hospital of Bangladesh

    OpenAIRE

    Soofia Khatoon; Maleeha Hussain; Aminur Rahman; ARM Luthful Kabir; Selim Ahmed; Abdul Hannan1

    2009-01-01

    Objective:This study was conducted to determine the hospital prevalence, clinical severity and treatment outcome of rotavirus versus non-rotavirus diarrhea in children attending a secondary level children hospital of Bangladesh. Methods: Total 601 children aged from 1 month to 5 years with watery diarrhea were enrolled and their stool samples were analyzed by ELISA for rotavirus antigen. Findings: Total 601 children aged from 1 month to 5 years with watery diarrhea were enrolled and their sto...

  8. Acute diarrhea in children

    Directory of Open Access Journals (Sweden)

    Radlović Nedeljko

    2015-01-01

    Full Text Available Acute diarrhea (AD is the most frequent gastroenterological disorder, and the main cause of dehydration in childhood. It is manifested by a sudden occurrence of three or more watery or loose stools per day lasting for seven to 10 days, 14 days at most. It mainly occurs in children until five years of age and particularly in neonates in the second half-year and children until the age of three years. Its primary causes are gastrointestinal infections, viral and bacterial, and more rarely alimentary intoxications and other factors. As dehydration and negative nutritive balance are the main complications of AD, it is clear that the compensation of lost body fluids and adequate diet form the basis of the child’s treatment. Other therapeutic measures, except antipyretics in high febrility, antiparasitic drugs for intestinal lambliasis, anti-amebiasis and probiotics are rarely necessary. This primarily regards uncritical use of antibiotics and intestinal antiseptics in the therapy of bacterial diarrhea. The use of antiemetics, antidiarrhetics and spasmolytics is unnecessary and potentially risky, so that it is not recommended for children with AD.

  9. Diarrhea associated with typhoid fever

    NARCIS (Netherlands)

    Roy, S. K.; Speelman, P.; Butler, T.; Nath, S.; Rahman, H.; Stoll, B. J.

    1985-01-01

    To study the pathogenesis of diarrhea occurring with typhoid fever, we selected 42 patients with diarrhea and blood cultures positive for Salmonella typhi or Salmonella paratyphi A, but without diarrheal copathogens, for measurement of stool output and examination of fecal composition. The mean

  10. Nonantibiotic therapy for travelers' diarrhea.

    Science.gov (United States)

    Ericsson, C D; DuPont, H L; Johnson, P C

    1986-01-01

    Several trials have shown that nonantibiotic drugs are efficacious in the treatment of travelers' diarrhea. When compared with placebo (P less than .025), bismuth subsalicylate (Pepto-Bismol) taken orally at a dosage of as low as 30 ml every half hour for eight doses was shown to be effective in reducing the frequently of episodes of diarrhea. Preliminary results indicated that loperamide (two 2-mg capsules followed by one capsule after each loose bowel movement) was more effective (P less than .025) than bismuth subsalicylate in relieving diarrhea. Likewise, preliminary results showed that BW942c, an unlicensed endorphin-like pentapeptide, offered more relief of diarrhea in the first 12 hr of therapy than did trimethoprim-sulfamethoxazole (P = .02) or placebo (P = .0007). Use of a nonantibiotic drug for empiric treatment of travelers' diarrhea appears to be a reasonable approach, especially for patients with mild to moderate disease and with no evidence of high fever or dysentery.

  11. [The treatment of acute diarrhea].

    Science.gov (United States)

    Leemans, L

    2013-09-01

    Racecadotril has sufficient proven efficacy in the treatment of acute diarrhea in children. Treatment outcomes in adults are less convincing. The place of gelatin tannate is unclear. Some sources point to potential hepatotoxicity and diminished iron absorption, with a concomitant risk of anemia, at least in case of excessive or prolonged use. Loperamide still has a prominent place in the treatment of acute and chronic diarrhea. Attention should be payed to correct dosing and some well-known contra-indications. Probiotics are indicated in children, as well as in the prevention of antibiotics-induced diarrhea. There is no evidence to support their use in the treatment of acute diarrhea in adults. Up till now publications disagree on the efficacy in the prevention of travelers' diarrhea. Astringents and absorbents are no longer supported in guidelines. Oral rehydration systems have a part to play in pediatric treatment.

  12. How to do in persistent diarrhea of children?: concepts and treatments of chronic diarrhea.

    Science.gov (United States)

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-12-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the vicious cycle of chronic diarrhea and is one of the main one thing among treatments. We should know the exact concept of chronic diarrhea and provide appropriate treatments according to etiologies of chronic diarrhea.

  13. Diarrhea Caused by Rotavirus in Children Less than 5 Years of Age in Hanoi, Vietnam

    OpenAIRE

    Nguyen, Trung Vu; Le, Phung Van; Le Huy, Chinh; Weintraub, Andrej

    2004-01-01

    Group A rotaviruses are the major cause of diarrhea in young children worldwide. From March 2001 to April 2002, 836 children less than 5 years of age were investigated in Hanoi, Vietnam. This included 587 children with diarrhea and 249 age-matched controls. Group A rotavirus was identified in 46.7% of the children with diarrhea and 3.6% of the controls, which was a significant difference. Within the diarrhea group, the highest prevalence was seen in children from 13 to 24 months of age, and t...

  14. Diarrhea after bariatric procedures: Diagnosis and therapy.

    Science.gov (United States)

    Borbély, Yves M; Osterwalder, Alice; Kröll, Dino; Nett, Philipp C; Inglin, Roman A

    2017-07-14

    Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

  15. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  16. pic gene of enteroaggregative Escherichia coli and its association with diarrhea in Peruvian children.

    Science.gov (United States)

    Durand, David; Contreras, Carmen A; Mosquito, Susan; Ruíz, Joaquim; Cleary, Thomas G; Ochoa, Theresa J

    2016-08-01

    Enteroaggregative Escherichia coli (EAEC) causes acute and persistent diarrhea among children, HIV-infected patients, and travelers to developing countries. We have searched for 18 genes-encoding virulence factors associated with aggregative adherence, dispersion, biofilm, toxins, serine protease autotransporters of Enterobacteriaceae (SPATEs) and siderophores, analyzed in 172 well-characterized EAEC strains (aggR(+)) isolated from stool samples of 97 children with diarrhea and 75 healthy controls from a passive surveillance diarrhea cohort study in Peru. Eighty-one different genetic profiles were identified, 37 were found only associated with diarrhea and 25 with control samples. The most frequent genetic profile was aggC(+)aatA(+)aap(+)shf(+)fyuA(+), present in 19 strains, including diarrhea and controls. The profile set1A(+)set1B(+)pic(+) was associated with diarrhea (P pic was associated with diarrhea (P < 0.05) and with prolonged diarrhea (diarrhea ≥ 7 days) (P < 0.05). In summary, this is the first report on the prevalence of a large set of EAEC virulence genes and its association with diarrhea in Peruvian children. More studies are needed to elucidate the exact role of each virulence factor. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Update on chronic diarrhea: a run-through for the clinician.

    Science.gov (United States)

    Sandhu, Davinder K; Surawicz, Christina

    2012-10-01

    Chronic diarrhea is a common patient complaint, with an estimated prevalence of 5 %. Diarrhea is defined as >200 g/day of stool with decreased consistency, and chronic diarrhea is defined as lasting more than 4 weeks. The purpose of this review is to guide the clinician's diagnostic evaluation and management of chronic diarrhea, rather than providing a textbook comprehensive review of the subject, focusing on the patient in developed countries and excluding the immune suppressed patient. While the investigation and treatment of chronic diarrhea can be challenging due to its myriad causes, when the clinician employs a practical approach, dividing chronic diarrhea into bloody, fatty, and watery causes, it simplifies and streamlines the work-up and management plan and leads to improved patient outcomes.

  18. Isospora belli associated recurrent diarrhea in a child with AIDS

    OpenAIRE

    Nateghi Rostami, M.; Nikmanesh, B.; Haghi-Ashtiani, M. T.; Monajemzadeh, M; M Douraghi; Ghalavand, Z.; Kashi, L

    2013-01-01

    Persistent diarrhea is a major manifestation of Acquired Immunodeficiency Syndrome (AIDS) which might be more complicated in Human Immunodeficiency Virus (HIV) infected children especially those from developing countries. There are numerous reports showing the emergence of intestinal opportunistic coccidian parasites, mostly Cryptosporidium parvum and Isospora belli in HIV-infected individuals. The prevalence of isosporiasis is probably underestimated in developing countries because routinely...

  19. Epidemiology of rotavirus diarrhea in children under 5 years in ...

    African Journals Online (AJOL)

    We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods: Stool samples ...

  20. Environmental determinants of diarrhea among under-five children ...

    African Journals Online (AJOL)

    wondwossen birke

    BACKGROUND: Though the relationship between environmental risk factors and the occurrence of diarrhea in children have been documented elsewhere, there are limited studies in Ethiopia in general and in Nekemte. Town in particular. The present study assessed the prevalence and environmental determinants/factors ...

  1. Control of Bovine Viral Diarrhea Virus in Ruminants

    Science.gov (United States)

    This document is a consensus statement, produced at the request of the American College of Veterinary Internal Medicine that reflects the opinion of an expert panel regarding the prevalence and host range, clinical manifestations, and the potential for ultimate eradication of bovine viral diarrhea v...

  2. Pathogenesis of Infectious Diarrhea

    Directory of Open Access Journals (Sweden)

    John Stephen

    2001-01-01

    Full Text Available A brief overview of some of the main features involved in normal physiological bi-directional absorption and secretion of fluid in the gut is given, including the nature and cellular location of key enzymes, ion pumps, symports, antiports and diffusion channels; the microanatomy of intestinal villous vasculature and the dynamics of villus blood flow, which together generate hypertonic zones in villus tip regions; and the production, differentiation, escalator movement (from crypt to villus tip and subsequent shedding of intestinal epithelial cells. (Neural and hormonal mechanisms that regulate normal mucosal ion transport are not discussed. The manner in which Vibrio cholerae, several pathotypes of Escherichia coli, several Salmonella serotypes, rotavirus, Campylobacter species, Shigella dysenteriae, Yersinia species and Clostridium difficile perturb these mechanisms and cause diarrhea, is discussed. Throughout the article, the main emphasis is on experimental studies designed to elucidate biological mechanisms and (where relevant the microbial determinants responsible for diarrheal disease. Allusions are also made to the involvement of host responses such as the inflammatory response, the production and release of potent cytokines and accelerated homeostatic responses (such as increased rates of crypt cell division seen in some infections, and the role that they play in pathophysiological fluid secretion.

  3. When your child has diarrhea

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000693.htm When your child has diarrhea To use the sharing features on ... gut has while absorbing regular foods. Things Your Child Should Avoid Eating or Drinking Children should avoid ...

  4. ACUTE INFECTIOUS DIARRHEA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T.V. Kulichenko

    2009-01-01

    Full Text Available The article highlights the key principles for detection and differentiation of the acute infectious diarrhea in children. The modern guidelines for treatment of the acute gastroenteritis and gastroenterocolitis are based on the rational application of the antibacterial medications and minimization drugs administration. There are therapeutic approaches recommended by WHO and ESPGHAN.Key words: acute gastroenteritis, gastroenterocolitis, diarrhea, acute enteric infections, detection, treatment, oral rehydration, nifuroxazide, children.

  5. Chronic Diarrhea: Diagnosis and Management.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Sellin, Joseph H

    2017-02-01

    Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff. Symptom clusters and settings can be used to assess the likelihood of particular causes of diarrhea. Irritable bowel syndrome can be distinguished from some other causes of chronic diarrhea by the presence of pain that peaks before defecation, is relieved by defecation, and is associated with changes in stool form or frequency (Rome criteria). Patients with chronic diarrhea usually need some evaluation, but history and physical examination may be sufficient to direct therapy in some. For example, diet, medications, and surgery or radiation therapy can be important causes of chronic diarrhea that can be suspected on the basis of history alone. Testing is indicated when alarm features are present, when there is no obvious cause evident, or the differential diagnosis needs further delineation. Testing of blood and stool, endoscopy, imaging studies, histology, and physiological testing all have roles to play but are not all needed in every patient. Categorizing patients after limited testing may allow more directed testing and more rapid diagnosis. Empiric antidiarrheal therapy can be used to mitigate symptoms in most patients for whom a specific treatment is not available. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Congenital chloride diarrhea: late presentation

    OpenAIRE

    Al Bishi, Laila; Mustafa,

    2011-01-01

    Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to...

  7. Diarrhea management in children under five in sub-Saharan Africa: does the source of care matter? A Countdown analysis

    Directory of Open Access Journals (Sweden)

    Liliana Carvajal-Vélez

    2016-08-01

    Full Text Available Abstract Background Diarrhea remains a high burden disease, responsible for nine percent of deaths in children under five globally. We analyzed diarrhea management practices in young children and their association with the source of care. Methods We used Demographic and Health Survey data from 12 countries in sub-Saharan Africa with high burdens of childhood diarrhea. We classified the quality of diarrhea management practices as good, fair, or poor based on mothers’ reports for children with diarrhea, using WHO/UNICEF recommendations for appropriate treatment. We described the prevalence of diarrhea management by type and assessed the association between good management and source of care, adjusting for potential confounders. Results Prevalence of good diarrhea management is low in 11 of the 12 analyzed surveys, varying from 17 % in Cote d’Ivoire to 38 % in Niger. The exception is Sierra Leone, where prevalence of good practice is 67 %. Prevalence of good management was low even among children taken to health facilities [median 52 %, range: 34–64 %]. Diarrhea careseeking from health facilities or community providers was associated with higher odds of good management than care from traditional/informal sources or no care. Careseeking from facilities did not result systematically in a higher likelihood of good diarrhea management than care from community providers. The odds of good diarrhea management were similar for community versus facility providers in six countries, higher in community than facility providers in two countries, and higher in facility than in community providers in four countries. Conclusion Many children’s lives can be saved with correct management of childhood diarrhea. Too many children are not receiving adequate care for diarrhea in high-burden sub-Saharan African countries, even among those seen in health facilities. Redoubling efforts to increase careseeking and improve quality of care for childhood diarrhea

  8. Human rotavirus genotypes causing acute watery diarrhea among ...

    African Journals Online (AJOL)

    2014-06-17

    Jun 17, 2014 ... transplacental antibodies and breast milk, which contain lactadherin.[11‑13] Repeated rotavirus ... the asymptomatic infection in older children and adults. Two licensed rotavirus vaccines have shown ... as age, sex, home address, onset of diarrhea, and sources of drinking water were obtained through a.

  9. Cryptosporidiosis in patients with diarrhea and chronic liver diseases.

    Science.gov (United States)

    Mousa, Nasser; Abdel-Razik, Ahmed; El-Nahas, Hala; El-Shazly, Atef; Abdelaziz, Mohammad; Nabih, Marwa; Hamed, Magdy; Eissa, Mohammad; Effat, Narmin; Eldars, Walled

    2014-12-15

    The aim of this study was to evaluate the epidemiology and clinical significance of Cryptosporidium in patients with diarrhea and chronic liver diseases. The study included 150 patients with chronic liver diseases and diarrhea, and 50 subjects with diarrhea as a control group. Stool samples were screened for the presence of Cryptosporidium by microscopic examination after modified Ziehl-Neelsen staining and detection of Cryptosporidium coproantigen by enzyme-linked immunosorbent assay (ELISA). The prevalence of Cryptosporidium infection in patients with chronic liver diseases was 30% (45/150) versus 14% (7/50) in controls. Cryptosporidium infection increased with the progression of chronic liver diseases from Child-Pugh class A to Child-Pugh class C (p 9 (pdiarrhea associated with Cryptosporidium infection developed hepatic encephalopathy, and only diarrhea was identified as a precipitating factor for hepatic encephalopathy. Cryptosporidium is one of the important causes of diarrhea in patients with chronic liver diseases. The infection significantly increased with the progression of chronic liver diseases. In patients with advanced chronic liver diseases, Cryptosporidium infection may be a precipitating factor of hepatic encephalopathy.

  10. Surveillance of Rotavirus Diarrhea in Hasan Sadikin Hospital Bandung

    Directory of Open Access Journals (Sweden)

    Dwi Prasetyo

    2010-12-01

    Full Text Available The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance study and had stool specimens tested for the presence of rotavirus using enzyme immunoassay (EIA. The strains of rotavirus were determined using reverse transcriptase-polymerase chain reaction (RT-PCR. Rotavirus were detected in 47.8% analyzed samples (87/184, G and P-genotype of rotavirus were G[1] (37.5% and P[6] (53.5%. Most subjects were males (56%, 6–11 months of age (35%. Most common clinical manifestations besides diarrhea were dehydration (72.7% and vomiting (50%. Subjects with positive rotavirus more common had dehydration (72% vs 28% and vomiting (61% vs 39%. In conclusion, vomiting and dehydration are the prominent clinical manifestations of diarrhea with positive rotavirus infection. G1 and P6 are the most common genotype of rotavirus.

  11. Prevalence

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Darwish

    2014-07-01

    Conclusion: Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region.

  12. Congenital chloride diarrhea: late presentation

    Directory of Open Access Journals (Sweden)

    Al Bishi L

    2011-04-01

    Full Text Available Laila Al Bishi1, Mustafa Al Toonisi2Pediatric Department, North West Armed Forces Hospital, Tabuk, Kingdom of Saudi ArabiaAbstract: We report the case of a male infant who presented with diarrhea at 6 months of age. He was failing to thrive, and biochemical investigation revealed hypokalemic hypochloremic metabolic alkalosis. Diagnosis of congenital chloride diarrhea was suspected and confirmed by the stool chloride result. He was started on high-dose sodium chloride and potassium chloride to control the electrolyte imbalance. The disease was difficult to control for a year after diagnosis. Late presentation is associated with severe chronic electrolyte disturbances and high-dose replacement therapy.Keywords: congenital chloride diarrhea, hypokalemic hypochloremic metabolic alkalosis, high stool chloride

  13. Occurrence of Tropheryma whipplei during diarrhea in Hajj pilgrims: a PCR analysis of paired rectal swabs.

    Science.gov (United States)

    Gautret, Philippe; Benkouiten, Samir; Parola, Philippe; Brouqui, Philippe; Memish, Ziad; Raoult, Didier

    2014-01-01

    Tropheryma whipplei was recently associated with gastroenteritis in children. We hypothesize that T. whipplei may be a contributing microbe in traveller's diarrhea. The presence of T. whipplei was investigated by PCR on rectal swab samples of Hajj pilgrims before and after travelling to the Kingdom of Saudi Arabia (KSA). Additionally a rectal swab was performed at the time of diarrhea for some pilgrims. A total of 129 pilgrims underwent rectal swab samples before departure and on return. All pilgrims were negative for T. whipplei before travel. One pilgrim (0.8%) was positive on return but did not reported diarrhea. A total of 30 pilgrims (23.3%) experienced diarrhea during the stay in the KSA. Nine pilgrims with diarrhea underwent the additional rectal swab during their diarrhea episode, two of them were positive for T. whipplei. This work suggests that T. whipplei may be associated with adult traveller's diarrhea, by finding T. whipplei DNA individuals negative before and after the episode of diarrhea. Further study addressing this issue in larger cohorts of Hajj pilgrims with systematic sampling at the time of diarrheal episode may help to understand the potential role of T. whipplei in traveller's diarrhea. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Microbiological Contamination of Drinking Water Associated with Subsequent Child Diarrhea.

    Science.gov (United States)

    Luby, Stephen P; Halder, Amal K; Huda, Tarique Md; Unicomb, Leanne; Islam, M Sirajul; Arnold, Benjamin F; Johnston, Richard B

    2015-11-01

    We used a prospective, longitudinal cohort enrolled as part of a program evaluation to assess the relationship between drinking water microbiological quality and child diarrhea. We included 50 villages across rural Bangladesh. Within each village field-workers enrolled a systematic random sample of 10 households with a child under the age of 3 years. Community monitors visited households monthly and recorded whether children under the age of 5 years had diarrhea in the preceding 2 days. Every 3 months, a research assistant visited the household and requested a water sample from the source or container used to provide drinking water to the child. Laboratory technicians measured the concentration of Escherichia coli in the water samples using membrane filtration. Of drinking water samples, 59% (2,273/3,833) were contaminated with E. coli. Of 12,192 monthly follow-up visits over 2 years, mothers reported that their child had diarrhea in the preceding 2 days in 1,156 (9.5%) visits. In a multivariable general linear model, the log10 of E. coli contamination of the preceding drinking water sample was associated with an increased prevalence of child diarrhea (prevalence ratio = 1.14, 95% CI = 1.05, 1.23). These data provide further evidence of the health benefits of improved microbiological quality of drinking water. © The American Society of Tropical Medicine and Hygiene.

  15. Solar disinfection improves drinking water quality to prevent diarrhea in under-five children in sikkim, India.

    Science.gov (United States)

    Rai, Bb; Pal, Ranabir; Kar, Sumit; Tsering, Dechen C

    2010-09-01

    Solar radiations improve the microbiological quality of water and offer a method for disinfection of drinking water that requires few resources and no expertise and may reduce the prevalence of diarrhea among under-five children. To find out the reduction in the prevalence of diarrhea in the under-five children after consumption of potable water treated with solar disinfection method. This was a population-based interventional prospective study in the urban slum area of Mazegoan, Jorethang, south Sikkim, during the period 1(st) May 2007 to 30(th) November 2007 on 136 children in the under-five age group in 102 households selected by random sampling. Main outcome measure was the assessment of the reduction of the prevalence of diarrhea among under-five children after consumption of potable water treated with solar disinfection method practiced by the caregivers in the intervention group keeping water in polyethylene terephthalate (PET) bottles as directed by the investigators. The data were collected by the interview method using a pre-tested questionnaire prepared on the basis of socio-demographics and prevalence of diarrhea. The data were subjected to percentages and chi-square tests, which were used to find the significance. After four weeks of intervention among the study group, the diarrhea prevalence was 7.69% among solar disinfection (SODIS) users, while 31.82% prevalence was observed among non-users in that period; the reduction in prevalence of diarrhea was 75.83%. After eight weeks of intervention, the prevalence of diarrhea was 7.58% among SODIS users and 31.43% among non-users; the reduction in diarrhea was 75.88% in the study group. The findings were found to be statistically significant. In our study, we observed that the prevalence of diarrhea decreased significantly after solar disinfection of water was practiced by the caregivers keeping potable water in PET bottles in the intervention group.

  16. Malaria parasitemia and childhood diarrhea in a peri-urban area of Guinea-Bissau

    DEFF Research Database (Denmark)

    Sodemann, Morten; Jakobsen, M S; Mølbak, Kare

    1999-01-01

    between diarrhea and parasite rate, parasite density, or clinical malaria. However, anti-malarials were easily available and frequently used, which was reflected by a 0.7% prevalence of children with a parasite density > 100/200 leukocytes. Thus, the findings do not preclude that diarrhea may be a sign......To examine the association between diarrhea in early childhood and malaria parasitemia, we conducted a nested case-control study in Guinea-Bissau of 297 children with diarrhea and a similar number of children without diarrhea matched for age, season, and residential area. There were no associations...... of clinical malaria or high-parasite density in endemic areas with lower use of antimalarials....

  17. Syndromic diarrhea/Tricho-hepato-enteric syndrome

    Science.gov (United States)

    2013-01-01

    Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE) is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE) sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la transmission

  18. Syndromic diarrhea/Tricho-hepato-enteric syndrome

    Directory of Open Access Journals (Sweden)

    Fabre Alexandre

    2013-01-01

    Full Text Available Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la

  19. Chronic Diarrhea: A Concern After Gallbladder Removal?

    Science.gov (United States)

    Chronic diarrhea: A concern after gallbladder removal? I had my gallbladder removed six months ago, and I'm ... Barkun A, et al. Bile acid malabsorption in chronic diarrhea: Pathophysiology and treatment. Canadian Journal of Gastroenterology. 2013; ...

  20. Diseases in Chronic Non-infective Diarrhea

    OpenAIRE

    Simadibrata, Marcellus; Rani, Aziz; Daldiyono, Daldiyono; Syam, Ari Fahrial; Tytgat, GNJ; Yuwono, Vera; Lesmana, L A; Ariawan, Iwan

    2004-01-01

    Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and smal...

  1. Bile acid malabsorption in chronic diarrhea: pathophysiology and treatment.

    Science.gov (United States)

    Barkun, Alan N; Love, Jonathan; Gould, Michael; Pluta, Henryk; Steinhart, Hillary

    2013-11-01

    Bile acid malabsorption (BAM) is a common but frequently under-recognized cause of chronic diarrhea, with an estimated prevalence of 4% to 5%. The published literature for the period 1965 to 2012 was examined for articles regarding the pathophysiology and treatment of BAM to provide an overview of the management of BAM in gastroenterology practice. BAM is classified as type 1 (secondary to ileal dysfunction), type 2 (idiopathic) or type 3 (secondary to gastrointestinal disorders not associated with ileal dysfunction). The estimated prevalence of BAM is >90% in patients with resected Crohn disease (CD) and 11% to 52% of unresected CD patients (type 1); 33% in diarrhea-predominant irritable bowel syndrome (type 2); and is a frequent finding postcholecystectomy or postvagotomy (type 3). Investigations include BAM fecal bile acid assay, 23-seleno-25-homo-tauro-cholic acid (SeHCAT) testing and high-performance liquid chromatography of serum 7-α-OH-4-cholesten-3-one (C4), to determine the level of bile acid synthesis. A less time-consuming and expensive alternative in practice is an empirical trial of the bile acid sequestering agent cholestyramine. An estimated 70% to 96% of chronic diarrhea patients with BAM respond to short-course cholestyramine. Adverse effects include constipation, nausea, borborygmi, flatulence, bloating and abdominal pain. Other bile acid sequestering agents, such as colestipol and colesevelam, are currently being investigated for the treatment of BAM-associated diarrhea. BAM is a common cause of chronic diarrhea presenting in gastroenterology practice. In accordance with current guidelines, an empirical trial of a bile acid sequestering agent is warranted as part of the clinical workup to rule out BAM.

  2. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  3. Epidemiology of rotavirus diarrhea in children under 5 years in Northern Cameroon

    OpenAIRE

    Ndze, Valentine Ngum; Akum, Achidi Eric; Kamga, Gonsu Hortense; Enjema, Lyonga Emilia; Esona, Mathew Dioh; Banyai, Krisztian; Therese, Obama Abena Marie

    2012-01-01

    Background Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Methods Stool samples were colle...

  4. MANIFESTATION OF AIDS WITH DIARRHEA

    Directory of Open Access Journals (Sweden)

    Rahmat Zainuddin

    2014-09-01

    Full Text Available Infectious diseases HIV/AIDS is a global health problem. According to WHO (2000 reported that 58 million people in the world are infected with HIV, within the 22 million people died from AIDS or 7000 people die every day. HIV Infection caused decrease and disorder of humoral and cellular immunity. Intestinal mucosal normally shows a physiologic inflamation that account for intestinal mucosal integrity. Diarhhea in HIV infection due to immune deficiency can caused by pathogen and non pathogen. Acute and chronic diarrhea usually found in HIV infection patient, the latter is more frequent. HIV enteropathy cause chronic diarrhea without pathogen infection because intestinal mucous damage by HIV direct infection. Treatment is characterized as causative supportive and symptomatic treatment causal, supportive and Symptomatic. Immunonutrient is very important within management patient HIV/AIDS.

  5. A Systematic Review and Meta-analysis of the Association Between Giardia lamblia and Endemic Pediatric Diarrhea in Developing Countries

    Science.gov (United States)

    Muhsen, Khitam; Levine, Myron M.

    2012-01-01

    We performed a systematic literature review and meta-analysis examining the association between diarrhea in young children in nonindustrialized settings and Giardia lamblia infection. Eligible were case/control and longitudinal studies that defined the outcome as acute or persistent (>14 days) diarrhea, adjusted for confounders and lasting for at least 1 year. Data on G. lamblia detection (mainly in stools) from diarrhea patients and controls without diarrhea were abstracted. Random effects model meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Twelve nonindustrialized-setting acute pediatric diarrhea studies met the meta-analysis inclusion criteria. Random-effects model meta-analysis of combined results (9774 acute diarrhea cases and 8766 controls) yielded a pooled OR of 0.60 (95% CI, .38–.94; P = .03), indicating that G. lamblia was not associated with acute diarrhea. However, limited data suggest that initial Giardia infections in early infancy may be positively associated with diarrhea. Meta-analysis of 5 persistent diarrhea studies showed a pooled OR of 3.18 (95% CI, 1.50–6.76; P Giardia with that syndrome. The well-powered Global Enteric Multicenter Study (GEMS) is prospectively addressing the association between G. lamblia infection and diarrhea in children in developing countries. PMID:23169940

  6. Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing, China.

    Science.gov (United States)

    Ma, Chunna; Wu, Shuangsheng; Yang, Peng; Li, Haiyue; Tang, Song; Wang, Quanyi

    2014-05-13

    To date, a large proportion of people still suffer from diarrhea diseases. In addition to the burden of diarrhea, there are substantial social and economic costs caused by the high incidence of diarrheal diseases. Therefore, the purpose of this study was to explore the self-reported prevalence of diarrhea and associated risk factors of diarrhea among adults in Beijing, China. A multistage, stratified study based on cross-sectional data was performed using randomized and systematic sampling, recruiting 12,936 adults over 18 years of age in Beijing. All adults were requested to complete a questionnaire, including information such as demographic characteristics, incidence of diarrhea, and behaviors related to the diarrhea. The self-reported prevalence of diarrhea was 17.5% during the last year prior to the survey. Six behavioral factors were significantly associated with diarrhea in our study including: (1) washing hands before meals and after defecation (Adjusted Odds Ratio (AOR) 0.707, 95% CI 0.597 ~ 0.837), (2) washing hands with soap and running water (AOR 0.872, 95% CI 0.786 ~ 0.967), (3) consuming raw seafood (AOR 1.285, 95% CI 1.138 ~ 1.450), (4) using the same chopping block and knife when processing raw and cooked food (AOR 1.375, 95% CI 1.225 ~ 1.542), (5) using the same chopsticks to handle raw and cooked food (AOR1.149, 95% CI 1.041 ~ 1.268), and (6) regularly participating in physical exercise (AOR 0.719, 95% CI 0.651 ~ 0.793). Good health habits, good eating habits, and regular exercise can prevent the episodes of diarrhea, and thus decrease the potential for disease occurrence.

  7. The prevalence of Cryptosporidium parvum and its relationship to ...

    African Journals Online (AJOL)

    It is therefore concluded that C. parvum is more prevalent in HIV negative children than in HIV positive children with diarrhea; and during onset of diarrhea, HIV positive children develop mild malnutrition as diarrhea duration progressed from normal nutrition to malnutrition. However in HIV negative children, nutrition status ...

  8. Clinical Treatment of Nondysentery Travelers’ Diarrhea During Deployment

    Science.gov (United States)

    2010-03-01

    diarrhea, and other diar- rhea issues will be addressed in future articles. If the above recommendations are adhered to, afflicted personnel will have a...from poorly focused empiricism to fluid therapy and modem pharmacotherapy. Aliment Pharmacol Ther 2007; 25: 759-69. 38. Tribble DR, Baqar S, Pang LW...2005; 170: 492-5. 51. Wingate D, Phillips SF, Lewis SJ, et al: Guidelines for adults on self- medication for the treatment of acute diarThoea. Aliment

  9. Water system unreliability and diarrhea incidence among children in Guatemala.

    Science.gov (United States)

    Trudeau, Jennifer; Aksan, Anna-Maria; Vásquez, William F

    2017-11-16

    This article examines the effect of water system unreliability on diarrhea incidence among children aged 0-5 in Guatemala. We use secondary data from a nationally representative sample of 7579 children to estimate the effects of uninterrupted and interrupted water services on diarrhea incidence. The national scope of this study imposes some methodological challenges due to unobserved geographical heterogeneity. To address this issue, we estimate mixed-effects logit models that control for unobserved heterogeneity by estimating random effects of selected covariates that can vary across geographical areas (i.e. water system reliability). Compared to children without access to piped water, children with uninterrupted water services have a lower probability of diarrhea incidence by approximately 33 percentage points. Conversely, there is no differential effect between children without access and those with at least one day of service interruptions in the previous month. Results also confirm negative effects of age, female gender, spanish language, and garbage disposal on diarrhea incidence. Public health benefits of piped water are realized through uninterrupted provision of service, not merely access. Policy implications are discussed.

  10. Childhood Diarrhea Determinants in Sub-Saharan Africa: A Cross Sectional Study of Tiko-Cameroon

    Directory of Open Access Journals (Sweden)

    Ayuk Betrand Tambe

    2015-09-01

    Full Text Available Introduction: Diarrhea remains the second leading cause of death among children under five years globally. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea. It kills more young children than Acquired Immunodeficiency Syndrome (AIDS, malaria and measles combined. World Health Organization has accordingly underlined the need for epidemiological surveys of infantile diarrhea in all geographical areas. The main research objectives were to estimate the prevalence of diarrhea and identify factors associated with diarrheal diseases in Tiko city in Cameroon. Method: The present study was a cross-sectional community household survey which was conducted in Tiko town from 1st to 31st of August 2012. With the use of a questionnaire, a total of 602 households that had at least one child under five years of age were interviewed. Mothers/caregivers were questioned on the morbidity of diarrhea and the logistic regression model was employed to examine the determinants of childhood diarrhea. Both univariable and multivariable data analysis was performed using SPSS version 16.0. Results: The results of this study showed that the prevalence of diarrhea was 23.8% and children under 24 months were highly affected. We found children using the main toilet and other types of toilet facilities such as bushes, diaper, and streams (OR: 0.194; p < 0.001, 95% CI and usage of narrow-mouth container for storage of drinking water (OR: 0.492; p < 0.001, 95% CI less likely to suffer from diarrhea. In contrast, higher rates of diarrhea prevalence were seen in children from households with two or more siblings (OR: 1.222; p < 0.001, 95% CI and whose mothers/caregivers never had the knowledge of safe sources of drinking water (OR: 1.849; p < 0.01, 95% CI. Conclusion: Childhood diarrhea is a public health problem in Tiko city. Hence, interventions aimed at reducing the prevalence should take into consideration the integration of family planning

  11. Diarrhea Recurrence in Patients with Clostridium difficile-Associated Diarrhea: Role of Concurrent Antibiotics

    Directory of Open Access Journals (Sweden)

    MJ Alfa

    1999-01-01

    Full Text Available OBJECTIVE: To monitor prospectively patients with Clostridium difficile-associated diarrhea (CAD in a six hundred bed tertiary care hospital to determine which factors influenced the recurrence of the diarrhea.

  12. Diarrhea

    Science.gov (United States)

    ... Intestinal Pseudo-obstruction Irritable Bowel Syndrome (IBS) Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Irritable Bowel Syndrome (IBS) in Children Lactose Intolerance Ménétrier’s Disease Microscopic Colitis Ostomy Surgery of the ...

  13. Diarrhea

    Science.gov (United States)

    ... that do not have peels. DO NOT eat raw shellfish or undercooked meat. DO NOT consume dairy products. ... to ask your health care provider - adult Diet - clear liquid Diet - full liquid When you have ...

  14. [Proliferation of anaerobic flora in the small intestine of infants with acute and protracted diarrhea].

    Science.gov (United States)

    da Cruz, A S; Fagundes Neto, U

    1995-01-01

    Bacterial proliferation in the small intestine can induce the protraction of diarrhea due to malabsorption of the nutrients. We performed the culture of the small intestine juice for the aerobic and anaerobic flora in 40 infants with persistent and acute diarrhea. Bacterial proliferation was observed in 32 (80%) patients, being 30 (75%) due to the aerobic microflora and 17 (43%) due to the anaerobic microflora. There was no statistical difference in the bacterial growth between acute and persistent diarrhea. The aerobic bacteria most frequently isolated was E. coli in 23 patients, and Bacteroides sp was the most prevalent anaerobic bacteria, isolated in 9 cases. The transitory flora was significantly more abundant in patients with persistent diarrhea.

  15. Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea

    Directory of Open Access Journals (Sweden)

    Abdulwahab MA Telmesani

    2010-01-01

    Full Text Available Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.

  16. Oral rehydration salts, zinc supplement and rota virus vaccine in the management of childhood acute diarrhea.

    Science.gov (United States)

    Telmesani, Abdulwahab Ma

    2010-05-01

    Acute diarrhea remains a major cause of morbidity and mortality in children. Since the introduction of oral rehydration salts (ORS) mortality has dropped to less than 50% worldwide. Low osmolarity ORS improved the outcome and reduced the hospitalization further. Zinc difficiency has been found to be associated with severe episodes of acute diarrhea. Zinc supplement in developing countries did reduce the incidence and prevalence of diarrhea. In addition, Zinc supplement significantly reduced the severity of diarrhea and duration of the episode. In the Americas and Europe, Rota virus vaccine was 90% effective in preventing severe episodes of severe rotavirus gastroenteritis. This review concludes that low osmolarilty ORS, zinc supplementation and rotavirus vaccine are major factors in reducing the morbidity, mortality and hospitalization resulting from to acute gastroenteritis in childhood.

  17. Water Filter Provision and Home-Based Filter Reinforcement Reduce Diarrhea in Kenyan HIV-Infected Adults and Their Household Members

    OpenAIRE

    Patricia B Pavlinac; Naulikha, Jaqueline M.; Chaba, Linda; Kimani, Naomi; Sangaré, Laura R.; Yuhas, Krista; Singa, Benson O.; John-Stewart, Grace; Walson, Judd L.

    2014-01-01

    Among human immunodeficiency virus (HIV) -infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared...

  18. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial.

    Science.gov (United States)

    Guandalini, S; Pensabene, L; Zikri, M A; Dias, J A; Casali, L G; Hoekstra, H; Kolacek, S; Massar, K; Micetic-Turk, D; Papadopoulou, A; de Sousa, J S; Sandhu, B; Szajewska, H; Weizman, Z

    2000-01-01

    The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in non-rotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute-onset diarrhea of all causes. Children 1 month to 3 years of age with acute-onset diarrhea were enrolled in a double-blind, placebo-controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 10(10) CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped. One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight-height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in- versus outpatients. Duration of diarrhea after enrollment was 71.9 +/- 35.8 hours in group A versus 58.3 +/- 27.6 hours in group B (mean +/- SD; P = 0.03). In rotavirus-positive children, diarrhea lasted 76.6 +/- 41.6 hours in group A versus 56.2 +/- 16.9 hours in groups B (P children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.

  19. DETECTION, RIBOTYPING AND ANTIMICROBIAL RESISTANCE PROPERTIES OF CLOSTRIDIUM DIFFICILE STRAINS ISOLATED FROM THE CASES OF DIARRHEA

    OpenAIRE

    Kouzegaran, Samaneh; Ganjifard, Mahmood; Tanha, Amir Saber

    2016-01-01

    Background: Clostridium difficile is the most prevalent cause of antibiotic-associated infectious diarrhea al-around the world. Prevalence of virulent and resistant strains of Clostridium difficile is increasing now a day. The present investigation was carried out to study the prevalence, ribotyping and antibiotic resistance pattern of C. difficile isolated from diarrheic and non-diarrheic pediatrics. Materials and methods: Four-hundred stool specimens were collected from the diarrheic and no...

  20. Exploring geographic distributions of high-risk water, sanitation, and hygiene practices and their association with child diarrhea in Uganda

    Directory of Open Access Journals (Sweden)

    Mitsuaki Hirai

    2016-10-01

    Full Text Available Background: High-risk water, sanitation, and hygiene (WASH practices are still prevalent in most low-income countries. Because of limited access to WASH, children may be put at an increased risk of diarrheal diseases. Objectives: This study aims to 1 develop a new measure of WASH-induced burden, the WASH Resource Index (WRI, and estimate its correlation with child diarrhea and an additive index of high-risk WASH practices; 2 explore the geographic distribution of high-risk WASH practices, child diarrhea, and summary indices at the cluster level; and 3 examine the association between the WRI and child diarrhea at the individual level. Design: A sample of 7,019 children from the Uganda Demographic and Health Survey 2011 were included in this study. Principal component analysis was used to develop a WRI, and households were classified as WASH poorest, poorer, middle, richer, and richest. A hot spot analysis was conducted to assess whether and how high-risk WASH practices and child diarrhea were geographically clustered. A potential association between the WRI and child diarrhea was examined through a nested regression analysis. Results: High-risk WASH practices were clustered at geographically distant regions from Kampala. The 2-week prevalence of child diarrhea, however, was concentrated in Eastern and East Central regions where high-risk WASH practices were not prevalent. At the individual level, none of the high-risk WASH practices were significantly associated with child diarrhea. Being in the highest WASH quintile was, however, significantly associated with 24.9% lower prevalence of child diarrhea compared to being in the lowest quintile (p<0.05. Conclusions: Only a weak association was found between the WRI and child diarrhea in this study. Future research should explore the potential utility of the WRI to examine WASH-induced burden.

  1. Viral Agents of Diarrhea in Young Children in Two Primary Health Centers in Edo State, Nigeria.

    Science.gov (United States)

    Imade, Paul Erhunmwunse; Eghafona, Nosakhare Odeh

    2015-01-01

    Enteric viruses have been shown to be responsible for diarrhea among children during their early childhood. This study was carried out to determine the prevalence of rotavirus, adenovirus, and norovirus infection in young children with diarrhea in two primary health centers in Edo State, Nigeria. A total of 223 stool specimens were collected from children aged 0-36 months with clinical signs of diarrhea and 59 apparently healthy age-matched children as control. These specimens were investigated for three viral agents using immunochromatographic technique (ICT). The overall results showed that at least one viral agent was detected in 95/223 (42.6%) of the children with diarrhea while the control had none. The prevalence of rotavirus was 28.3%, adenovirus 19.3%, and norovirus 3.6%. There was a significant association between age group and infection (P < 0.0001). Seasonal pattern of enteric viruses was not statistically significant (P = 0.17). The overall coinfection rate was 7.6% and rotavirus-adenovirus coinfection had the highest with 5.4%. Rotavirus was the most prevalent viral agent. Coinfections are not uncommon among the population studied. The most commonly associated clinical symptom of viral diarrhea in this study was vomiting. Viral diagnostic tests are advocated for primary health care facilities in this locality.

  2. Diarrhea - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about diarrhea - child; Loose stools - what to ask your doctor - child ... FOODS What foods can make my child's diarrhea worse? How should I prepare the foods for my child? If my child is still breastfeeding or bottle feeding, do I ...

  3. Global burden of childhood diarrhea and interventions.

    Science.gov (United States)

    Das, Jai K; Salam, Rehana A; Bhutta, Zulfiqar A

    2014-10-01

    Diarrhea is a leading cause of morbidity and mortality among children under 5 years in low-income and middle-income countries. Over the past 2 decades under-five mortality has decreased substantially, but reductions have been uneven and unsatisfactory in resource-poor regions. There are known interventions which can prevent diarrhea or manage children who suffer from it. Interventions with proven effectiveness at the prevention level include water, sanitation, and hygiene interventions, breastfeeding, complementary feeding, vitamin A and zinc supplementation, and vaccines for diarrhea (rotavirus and cholera). Oral rehydration solution, zinc treatment, continued feeding, and antibiotic treatment for certain strains of diarrhea (cholera, Shigella, and cryptosporidiosis) are effective strategies for treatment of diarrhea. The recent Lancet series using the 'Lives Saved' tool suggested that if these identified interventions were scaled up to a global coverage to at least 80%, and immunizations to at least 90%; almost all deaths due to diarrhea could be averted. The current childhood mortality burden highlights the need of a focused global diarrhea action plan. The findings suggest that with proper packaging of interventions and delivery platforms, the burden of childhood diarrhea can be reduced to a greater extent. All that is required is greater attention and steps toward right direction.

  4. Effect of mild diarrhea on tacrolimus exposure

    NARCIS (Netherlands)

    Boekel, G.A.J van; Aarnoutse, R.E.; van der Heijden, J.J.; Hoogtanders, K.E.; Hilbrands, L.B.

    2012-01-01

    BACKGROUND: Diarrhea is a frequent adverse event in patients treated with the combination of tacrolimus and mycophenolate mofetil (MMF). In case of severe diarrhea, the total exposure to tacrolimus can substantially increase, which is reflected in a rise of the predose trough level (C0). In mild

  5. Straight Poop on Kids and Diarrhea

    Science.gov (United States)

    ... problems. “If you believe that your child has chronic diarrhea, see a pediatrician,” says Ortiz. Oct. 31, 2011 back to top For More Information Foodborne Illnesses: What You Need to Know American Academy of Pediatrics: What Is the Best Way to Treat Diarrhea? ...

  6. Diarrhea due to Cryptosporidium parvum in immunocompromised ...

    African Journals Online (AJOL)

    Objective: The objective of this study is to search for Cryptosporidium parvum in Sudanese immunocompromised and immunocompetent patients presenting with diarrhea. Methods: Two hundred and thirteen stool specimens were collected from different groups of patients presenting with diarrhea and healthy control ...

  7. Risk Factors for Diarrhea in Children under Five Years of Age Residing in Peri-urban Communities in Cochabamba, Bolivia

    Science.gov (United States)

    George, Christine Marie; Perin, Jamie; Neiswender de Calani, Karen J.; Norman, W. Ray; Perry, Henry; Davis, Thomas P.; Lindquist, Erik D.

    2014-01-01

    This study examined the relationship between childhood diarrhea prevalence and caregiver knowledge of the causes and prevention of diarrhea in a prospective cohort of 952 children < 5 years of age in Cochabamba, Bolivia. The survey of caregiver knowledge found that more than 80% of caregivers were unaware that hand washing with soap could prevent childhood diarrhea. Furthermore, when asked how to keep food safe for children to eat only 17% of caregivers reported hand washing before cooking and feeding a child. Lack of caregiver awareness of the importance of practices related to hygiene and sanitation for diarrhea prevention were significant risk factors for diarrheal disease in this cohort. The knowledge findings from this study suggest that health promotion in these communities should put further emphasis on increasing knowledge of how water treatment, hand washing with soap, proper disposal of child feces, and food preparation relate to childhood diarrhea prevention. PMID:25311693

  8. High frequency of diarrheagenic Escherichia coli in human immunodeficiency virus (HIV) patients with and without diarrhea in Lima, Peru.

    Science.gov (United States)

    Garcia, Coralith; Chincha, Omayra; Leon, Mey; Iglesias, David; Barletta, Francesca; Mercado, Erik; Ochoa, Theresa

    2010-06-01

    Diarrhea is still a prevalent health issue in HIV patients. Our objective was to characterize the different diarrheagenic E. coli (DEC) groups in stools from adult HIV patients. Cross sectional study: We enrolled HIV-positive and -negative patients with and without diarrhea from a tertiary-care center of Lima, Peru. Clinical data was recorded and a stool sample per patient was cultured. Multiplex PCR was used to detect different DECs. One hundred eighty-four participants were enrolled. The frequency of having at least one DEC was more common in HIV-positive than HIV-negative patients with diarrhea (42% versus 20%, P < 0.05). The enterotoxigenic E. coli (ETEC) was the most common DEC in patients with diarrhea, 13% in HIV patients. The diffusely adherent E. coli (DAEC) was only present in HIV positive patients with diarrhea (10.1%). Different types of DEC are frequent in stools from HIV-positive patients.

  9. Nosocomial diarrhea in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Paula Marcon

    Full Text Available We made an epidemiological case-control study to examine risk factors for the development of diarrhea in the intensive care unit (ICU of a public hospital in Santo André, SP, from January to October 2002. Forty-nine patients with diarrhea (cases and 49 patients without diarrhea (controls, matched for age and gender, were included in the study. A stool culture and enzyme immunoassays for Clostridium difficile toxins A and B were performed on fecal specimens from diarrhea patients. Fourteen of them presented positive cultures for Pseudomonas aeruginosa and 22 patients presented positive ELISA for Clostridium diffícile. Nosocomial diarrhea was associated with several factors, including use of antibiotics (P=0.001, use of ceftriaxone (P=0.001, presence of infection (P=0.010 and length of hospital stay (P=0.0001.

  10. DIARRHEA IN CHILDREN: MAIN CAUSES AND WAYS OF TREATMENT

    OpenAIRE

    S.V. Bel’mer; T.V. Gasilina

    2010-01-01

    The article discusses main questions of diagnostics of diarrhea in children. Main cause of acute diarrhea is infection, mainly viral (rotavirus, etc.). Chronic diarrhea frequently has non-infectious origin. The need of multi-aspect diagnostics of diarrhea cause in children is related to the significance of treatment of main disease. Besides, treatment of chronic and acute diarrhea include major component: adsorbents based on smectite. In total treatment of diarrhea has to be complex with the ...

  11. Prevalence and associated risk factors for Giardia lamblia infection among children hospitalized for diarrhea in Goiânia, Goiás State, Brazil Prevalência e fatores de risco associados à infecção por Giardia lamblia em crianças hospitalizadas com diarréia em Goiânia, Goiás, Brasil

    Directory of Open Access Journals (Sweden)

    Maria das Graças Cabral Pereira

    2007-06-01

    Full Text Available The objective of this study was to determine the prevalence and to identify risk factors associated with Giardia lamblia infection in diarrheic children hospitalized for diarrhea in Goiânia, State of Goiás, Brazil. A cross-sectional study was conducted and a comprehensive questionnaire was administered to the child's primary custodian. Fixed effects logistic regression was used to determine the association between infection status for G. lamblia and host, sociodemographic, environmental and zoonotic risk factors. A total of 445 fecal samples were collected and processed by the DFA methodology, and G. lamblia cysts were present in the feces of 44 diarrheic children (9.9%. A variety of factors were found to be associated with giardiasis in these population: age of children (OR, 1.18; 90% CI, 1.0 - 1.36; p = 0.052, number of children in the household (OR 1.45; 90% CI, 1.13 - 1.86; p = 0.015, number of cats in the household (OR, 1.26; 90% CI, 1.03 -1.53; p = 0.059, food hygiene (OR, 2.9; 90% CI, 1.34 - 6.43; p = 0.024, day-care centers attendance (OR, 2.3; 90% CI, 1.20 - 4.36; p = 0.034, living on a rural farm within the past six months prior hospitalization (OR, 5.4; CI 90%, 1.5 - 20.1; p = 0.03 and the number of household adults (OR, 0.59; 90% CI, 0.42 - 0.83; p = 0.012. Such factors appropriately managed may help to reduce the annual incidence of this protozoal infection in the studied population.O objetivo desse estudo foi estimar a prevalência e identificar fatores de risco associados à infecção por Giardia lamblia em crianças hospitalizadas com diarréia no município de Goiânia, Estado de Goiás, Brasil. Foi realizado um estudo transversal e um questionário estruturado foi administrado ao responsável pela criança. Análise multivariada foi realizada por meio de regressão logística para se determinar a associação entre infecção por G. lamblia e as variáveis sociodemográficas, ambientais e zoonóticas relacionadas ao

  12. [Clostridium difficile isolation in children hospitalized with diarrhea].

    Science.gov (United States)

    Santiago, B; Guerra, L; García-Morín, M; González, E; Gonzálvez, A; Izquierdo, G; Martos, A; Santos, M; Navarro, M; Hernández-Sampelayo, M T; Saavedra-Lozano, J

    2015-06-01

    Clostridium difficile is the leading cause of nosocomial and antibiotic-associated diarrhea in adults, and its incidence has substantially risen over the last few years. The prevalence of this infection in children is difficult to assess due to the high rates of colonization in this setting. A one-year retrospective study was conducted on children under 15 years admitted to hospital with acute diarrhea. Epidemiological, clinical, laboratory findings and outcome of children with Clostridium difficile infection (CDI) were compared to other causes of diarrhea. Risk factors for CDI were identified by multivariate analysis. Two hundred and fifty children with acute diarrhea were identified. A microbiological pathogen was identified in 79 (45.4%) of 174 patients who underwent complete testing: 19 CDI (25.6%, 13 of which were enterotoxin-producing), 21 other bacteria (28.6%), and 34 viruses (45.8%; rotavirus n=31; adenovirus n=3). The estimated incidence of CDI was 3 cases/1,000 admissions, with 68.4% of them occurring in children younger than 2 years. Overall, 15.8% were community-acquired. Compared to other causes of diarrhea, CDI was associated with comorbidity (P<.0001), recent contact with the health-care system (P<.0001) or intensive care unit stay (P=.003) and exposure to antibiotics in the previous month (P<.0001). The clinical course of children with CDI was less symptomatic. There were no clinical differences between Clostridium difficile toxin-producers and non-toxin producers. Comorbidity was identified as the main risk factor associated with CDI (OR 40.02, 95% CI 6.84-232.32; P<.0001). The isolation of Clostridium difficile is common in hospitalized children with diarrhea in our setting. CDI is more frequent in children with comorbidity and recent contact with the health-care system, presenting a mostly oligosymptomatic clinical course. Further studies are needed to understand the epidemiology of this infection in pediatrics, especially the percentage of

  13. [Differential therapy of infectious diarrhea].

    Science.gov (United States)

    Grundmann, H

    1994-10-18

    Worldwide, diarrheal diseases caused by communicable pathogens rank first in morbidity and mortality, particularly in young children. Underprivileged groups of poor societies may still suffer from endemic typhus, bacillary dysentery, or cholera. In children however, a significant proportion of recurrent diarrhoeal episodes is caused by toxigenic enterobacteria, non-thyphoidal salmonella, campylobacter, and viruses. Although outbreaks of classical waterborne epidemics have not been reported from industrialized nations, infectious diarrhea is by no means scarce. Industrial cattlebreeding and food production facilitate the spread of nonthyphoidal salmonella, Campylobacter, and possibly Yersinia enterocolitica. Changes in travel patterns, an increasing number of immunocompromised patients, and migration of people from countries with lower sanitary standards warrants awareness to hitherto exceptional pathogens.

  14. Prevalence and characters of Entamoeba histolytica infection in Saudi infants and children admitted with diarrhea at 2 main hospitals at south Jeddah: a re-emerging serious infection with unusual presentation

    Directory of Open Access Journals (Sweden)

    Moustafa Abdelaal Hegazi

    2013-02-01

    Full Text Available In this study, Entamoeba histolytica had high prevalence and unusual presentation by affecting high proportion of infants under 1 year; severe clinical manifestations, and laboratory findings that were known to be usually encountered in invasive amebiasis as significant leukocytosis for age, neutrophilic leukocytosis for age, and positive C-reactive protein were found among more than 50% of admitted Saudi infants and children with E. histolytica infection in our locality. E. histolytica can be a re-emerging serious infection when it finds favorable environmental conditions and host factors which are mainly attributed to inadequate breastfeeding in this study. This may occur in any other area of the world with the same risk factors, so we must be ready to tackle it with effective and more powerful preventive measures.

  15. Convocation address.

    Science.gov (United States)

    Swaminathan, M S

    1998-07-01

    This address delivered to the 40th convocation of the International Institute for Population Sciences in India in 1998 opens by noting that a shortage of jobs for youth is India's most urgent problem but that the problems that attend the increasing numbers of elderly also require serious attention. The address then notes that the Earth's population is growing at an unsustainable rate while economic inequities among countries are increasing, so that, while intellectual property is becoming the most important asset in developed countries, nutritional anemia among pregnant women causes their offspring to be unable to achieve their full intellectual potential from birth. Next, the address uses a discussion of the 18th-century work on population of the Marquis de Condorcet and of Thomas Malthus to lead into a consideration of estimated increased needs of countries like India and China to import food grains in the near future. Next, the progress of demographic transition in Indian states is covered and applied to Mahbub ul Haq's measure of human deprivation developed for and applied to the region of the South Asian Association for Regional Cooperation (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, and the Maldives). The address continues by reiterating some of the major recommendations forwarded by a government of India committee charged in 1995 with drafting a national population policy. Finally, the address suggests specific actions that could be important components of the Hunger-Free India Programme and concludes that all success rests on the successful implementation of appropriate population policies.

  16. Allegheny County Addressing Address Points

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset shows the address points in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data portal...

  17. Antibiotic susceptibilities of Salmonella species prevalent among ...

    African Journals Online (AJOL)

    This study was conducted to assess the prevalence of Salmonella species among children having diarrhea in Katsina State, Nigeria. A total of 220 diarrhea stool samples of children aged five years and below (0-5 years) were collected and screened for Salmonella species using culture technique. Presumptively positive ...

  18. Effective prophylaxis against rotavirus diarrhea using a combination of Lactobacillus rhamnosus GG and antibodies

    Directory of Open Access Journals (Sweden)

    Hammarström Lennart

    2007-09-01

    Full Text Available Abstract Background Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti – rotavirus antibodies in a mouse model of rotavirus diarrhea. Results Of the six probiotic bacteria tested, Lactobacillus rhamnosus strain GG had the strongest influence in reducing prevalence, duration and severity of diarrhea and was therefore chosen for combination treatment with immunoglobulins. The combination treatment reduced the diarrhea outcome measures significantly, prevented histopathological changes and reduced the virus load in the intestines. Conclusion The advantages associated with immunoglobulins and probiotics based therapy is that the treatment provides a rapid therapeutic effect and is cost efficient. These components do not require special storage conditions and could potentially complement the rehydration therapy that is currently used.

  19. Effective prophylaxis against rotavirus diarrhea using a combination of Lactobacillus rhamnosus GG and antibodies.

    Science.gov (United States)

    Pant, Neha; Marcotte, Harold; Brüssow, Harald; Svensson, Lennart; Hammarström, Lennart

    2007-09-27

    Rotavirus is a worldwide cause of infectious infantile diarrhea that claims over 600,000 lives annually. Recently, two new vaccine candidates have been developed but their efficacy in developing countries, still remains to be proven. Oral delivery of specific immunoglobulins provides passive immunity and is a fast acting treatment for rotavirus diarrhea. Probiotic bacteria have also gained considerable attention lately as treatment for rotavirus diarrhea. Here we report an evaluation of the therapeutic potential of different probiotics and their combination with anti - rotavirus antibodies in a mouse model of rotavirus diarrhea. Of the six probiotic bacteria tested, Lactobacillus rhamnosus strain GG had the strongest influence in reducing prevalence, duration and severity of diarrhea and was therefore chosen for combination treatment with immunoglobulins. The combination treatment reduced the diarrhea outcome measures significantly, prevented histopathological changes and reduced the virus load in the intestines. The advantages associated with immunoglobulins and probiotics based therapy is that the treatment provides a rapid therapeutic effect and is cost efficient. These components do not require special storage conditions and could potentially complement the rehydration therapy that is currently used.

  20. Microscopic colitis in patients with chronic diarrhea and normal colonoscopic findings in Southern China.

    Science.gov (United States)

    Gu, Hong-Xiang; Zhi, Fa-Chao; Huang, Ying; Li, Ai-Min; Bai, Yang; Jiang, Bo; Zhang, Ya-Li

    2012-09-01

    Microscopic colitis includes lymphocytic colitis and collagenous colitis. The entity is considered as an important cause for unknown chronic diarrhea, but rarely reported in China before. This study aimed to determine the prevalence of microscopic colitis in patients with chronic diarrhea and normal colonoscopy findings in Southern China, and to reveal the clinical feature of microscopic colitis in these patients. Patients with chronic diarrhea and normal colonoscopic findings were enrolled from three hospitals in Southern China from January, 2009 to June, 2010. Multiple colorectal biopsies were obtained in these patients and histological examination was underwent with hematoxyin and eosin stain, Masson's trichrome stain and immunohistochemistry for tenascin to screen lymphocytic colitis and collagenous colitis. The clinical symptom and risk factor of microscopic colitis were assessed by comparing with controls. The diagnostic overlap between microscopic colitis and irritable bowel syndrome or functional diarrhea was also analyzed. Randomly mucosal biopsies were performed in 613 patients with chronic diarrhea and normal or near normal colonoscopic finding. Fifty-nine cases of lymphocytic colitis and 28 cases of collagenous colitis were found by histological examination. The rates of rheumatoid arthritis in lymphocytic colitis group (15.4 %) and collagenous colitis group (14.3 %) were significant higher than in control group (2.2 %). Rheumatoid arthritis was confirmed as the risk factor of microscopic colitis by logistic regression analysis. There was no difference on the symptoms among the controls, patients with lymphocytic colitis, and patients with collagenous colitis. There were 13.8 % (12/87) of patients with microscopic colitis fulfilled Rome III criteria of irritable bowel syndrome and 42.5 % (37/87) fulfilled the criteria of functional diarrhea. Microscopic colitis is not an uncommon disorder in Chinese population. Rheumatoid arthritis is the risk factor of

  1. Enteric Pathogens Associated with Childhood Diarrhea in Tripoli-Libya

    Science.gov (United States)

    Rahouma, Amal; Klena, John D.; Krema, Zaineb; Abobker, Abdalwahed A.; Treesh, Khalid; Franka, Ezzedin; Abusnena, Omar; Shaheen, Hind I.; El Mohammady, Hanan; Abudher, Abdulhafid; Ghenghesh, Khalifa Sifaw

    2011-01-01

    Stool samples from children < 5 years of age with diarrhea (N = 239) were examined for enteric pathogens using a combination of culture, enzyme-immunoassay, and polymerase chain reaction methods. Pathogens were detected in 122 (51%) stool samples; single pathogens were detected in 37.2% and co-pathogens in 13.8% of samples. Norovirus, rotavirus, and diarrheagenic Escherichia coli (DEC) were the most frequently detected pathogens (15.5%, 13.4%, and 11.2%, respectively); Salmonella, adenovirus, and Aeromonas were detected less frequently (7.9%, 7.1%, and 4.2%). The most commonly detected DEC was enteroaggregative E. coli (5.4%). Resistance to ≥ 3 antimicrobials was observed in 60% (18/30) of the bacterial pathogens. Salmonella resistance to ciprofloxacin (63.1%) has become a concern. Enteric viral pathogens were the most significant causative agents of childhood diarrhea in Tripoli. Bacterial pathogens were also important contributors to pediatric diarrhea. The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authorities PMID:21633024

  2. Serological screening for celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome

    NARCIS (Netherlands)

    H. Wang (Hongling); G. Zhou (Guoying); L. Luo (Linjie); J.B.A. Crusius; A. Yuan (Anlong); J. Kou (Jiguang); G. Yang (Guifang); M. Wang (Min); J. Wu (Jing); B.M.E. von Blomberg (Mary); S.A. Morré (Servaas); A. Salvador Pena; B. Xia (Bing)

    2015-01-01

    textabstractCeliac disease (CD) is common in Caucasians, but thought to be rare in Asians. Our aim was to determine the prevalence of CD in Chinese patients with chronic diarrhea predominant irritable bowel syndrome (IBS-D). From July 2010 to August 2012, 395 adult patients with IBS-D and 363 age

  3. Incidence of Parasitic Diarrhea in Patients with Common Variable Immune Deficiency.

    Science.gov (United States)

    Uysal, Serhat; Tunalı, Varol; Akdur Öztürk, Eylem; Ardeniz, Ömür; Işıkgöz Taşbakan, Meltem; Pullukçu, Hüsnü; Özensoy Töz, Seray; Turgay, Nevin; Arda, Bilgin

    2016-06-01

    Parasites might cause atypical and severe infections in immunocompromised hosts. The prevalence of diarrhea among common variable immune deficiency (CVID) syndrome patients varies between 20% and 94%, which indicates that diarrhea and gastrointestinal system (GIS) complaints could be the second leading cause of morbidity in CVID patients after respiratory tract infections. This study aimed to assess the prevalence of intestinal parasites in CVID patients with GIS complaints and diarrhea. In this study, all cases followed up in the Immunology and Allergy Clinic of Ege University School of Medicine from July 2008 to August 2015 with the diagnosis of CVID were reviewed retrospectively. The stool samples of patients with diarrhea were identified using direct microscopy of native (0.09% NaCl) and Lugol's iodine preparations followed by formol-ethyl acetate concentration to apply modified Kinyoun, trichrome, acid-fast trichrome, and modified trichrome stains for the presence of intestinal parasites. Overall, 26 of 37 CVID patients had diarrhea; white and red blood cells (WBCs and RBCs, respectively) were identified in 11 and 10 of these 26 samples, respectively. Intestinal parasites were found to be present in 7 of the 11 patients with WBCs and 3 of the 10 patients with RBCs. With the addition of patients who neither had WBCs nor RBCs in their stool, a parasitic agent was detected in 13 (50%) of the 26 patients with diarrhea. There was no significant difference between the diarrheic patients with or without intestinal parasites with respect to cramps, fever, nausea and vomiting, tenesmus, bloody feces, and presence of mucus in the stool. Only one patient had malabsorption, which was not associated with intestinal parasites. The most common parasites detected in this study were Cryptosporidium spp. (n=9; 69.2%), Giardia spp. (n=7; 53.8%), and Blastocystis spp. (n=3; 23.1%). We also identified that parasitic diarrhea in CVID patients tended to last longer (M (mean): 16

  4. Solar disinfection improves drinking water quality to prevent diarrhea in under-five children in Sikkim, India

    Directory of Open Access Journals (Sweden)

    B B Rai

    2010-01-01

    Full Text Available Background: Solar radiations improve the microbiological quality of water and offer a method for disinfection of drinking water that requires few resources and no expertise and may reduce the prevalence of diarrhea among under-five children. Aims and Objectives: To find out the reduction in the prevalence of diarrhea in the under-five children after consumption of potable water treated with solar disinfection method. Materials and Methods: This was a population-based interventional prospective study in the urban slum area of Mazegoan, Jorethang, south Sikkim, during the period 1 st May 2007 to 30 th November 2007 on 136 children in the under-five age group in 102 households selected by random sampling. Main outcome measure was the assessment of the reduction of the prevalence of diarrhea among under-five children after consumption of potable water treated with solar disinfection method practiced by the caregivers in the intervention group keeping water in polyethylene terephthalate (PET bottles as directed by the investigators. The data were collected by the interview method using a pre-tested questionnaire prepared on the basis of socio-demographics and prevalence of diarrhea. The data were subjected to percentages and chi-square tests, which were used to find the significance. Results: After four weeks of intervention among the study group, the diarrhea prevalence was 7.69% among solar disinfection (SODIS users, while 31.82% prevalence was observed among non-users in that period; the reduction in prevalence of diarrhea was 75.83%. After eight weeks of intervention, the prevalence of diarrhea was 7.58% among SODIS users and 31.43% among non-users; the reduction in diarrhea was 75.88% in the study group. The findings were found to be statistically significant. Conclusions: In our study, we observed that the prevalence of diarrhea decreased significantly after solar disinfection of water was practiced by the caregivers keeping potable water in

  5. Antidiarrheal Medicines: OTC Relief for Diarrhea

    Science.gov (United States)

    ... Imodium) and bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol). Bismuth subsalicylate can also be used for upset stomach and ... you have less diarrhea and more formed stools.Bismuth subsalicylate works by balancing the way fluid moves through ...

  6. [Medication in infectious acute diarrhea in children].

    Science.gov (United States)

    Cézard, J-P; Bellaiche, M; Viala, J; Hugot, J-P

    2007-10-01

    Acute infectious diarrhea in children remain still a frequent cause of morbidity. 50 % of them are due to rotavirus. Oral rehydration therapy and early realimentation have drastically reduced their mortality and morbidity. Beside oral or eventually IV rehydration therapy no medication has proven its efficacy based on the main HMO criteria (reduction of over 30 % of the stool output) except racecadotril and loperamide which is contre-indicated for the last one in children less than 2 years old. Other medications such as silicates or some probiotics have shown efficacy on diarrhea duration or stool consistency but not on stool output. They have so no formal indication in infectious diarrhea and should be considered as "comfort" treatment. Antibiotics, beside their indication in shigella, cholera and amibiasis could be used in invasive diarrhea in some debilating conditions or infants less than 3 months.

  7. Role of zinc in pediatric diarrhea

    National Research Council Canada - National Science Library

    Bajait, Chaitali; Thawani, Vijay

    2011-01-01

    .... This article reviews the available evidence on the efficacy and safety of zinc supplementation in pediatric diarrhea and convincingly concludes that zinc supplementation has a beneficial impact on the disease outcome.

  8. Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon

    Science.gov (United States)

    Imada, Katiuscia Shirota; de Araújo, Thiago Santos; Muniz, Pascoal Torres; de Pádua, Valter Lúcio

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the contributions of the socioeconomic, hygienic, and sanitation improvements in reducing the prevalence of diarrhea in a city of the Amazon. METHODS In this population-based cross-sectional study, we analyzed data from surveys conducted in the city of Jordão, Acre. In 2005 and 2012, these surveys evaluated, respectively, 466 and 826 children under five years old. Questionnaires were applied on the socioeconomic conditions, construction of houses, food and hygienic habits, and environmental sanitation. We applied Pearson’s Chi-squared test and Poisson regression to verify the relationship between origin of water, construction of homes, age of introduction of cow’s milk in the diet, place of birth and the prevalence of diarrhea. RESULTS The prevalence of diarrhea was reduced from 45.1% to 35.4%. We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow’s milk in the first month after birth, and in those living in houses made of paxiúba. Children born at home presented lower risk of diarrhea when compared to those who were born in hospital, with this difference reversing for the 2012 survey. CONCLUSIONS Sanitation conditions improved with the increase of bathrooms with toilets, implementation of the Programa de Saúde da Família (PSF – Family Health Program), and water treatment in the city. The multivariate regression model identified a statistically significant association between use of water from the public network, construction of houses, late introduction of cow’s milk, and access to health service with occurrence of diarrhea. PMID:28099660

  9. The fecal microbiome in cats with diarrhea.

    Directory of Open Access Journals (Sweden)

    Jan S Suchodolski

    Full Text Available Recent studies have revealed that microbes play an important role in the pathogenesis of gastrointestinal (GI diseases in various animal species, but only limited data is available about the microbiome in cats with GI disease. The aim of this study was to evaluate the fecal microbiome in cats with diarrhea. Fecal samples were obtained from healthy cats (n = 21 and cats with acute (n = 19 or chronic diarrhea (n = 29 and analyzed by sequencing of 16S rRNA genes, and PICRUSt was used to predict the functional gene content of the microbiome. Linear discriminant analysis (LDA effect size (LEfSe revealed significant differences in bacterial groups between healthy cats and cats with diarrhea. The order Burkholderiales, the families Enterobacteriaceae, and the genera Streptococcus and Collinsella were significantly increased in diarrheic cats. In contrast the order Campylobacterales, the family Bacteroidaceae, and the genera Megamonas, Helicobacter, and Roseburia were significantly increased in healthy cats. Phylum Bacteroidetes was significantly decreased in cats with chronic diarrhea (>21 days duration, while the class Erysipelotrichi and the genus Lactobacillus were significantly decreased in cats with acute diarrhea. The observed changes in bacterial groups were accompanied by significant differences in functional gene contents: metabolism of fatty acids, biosynthesis of glycosphingolipids, metabolism of biotin, metabolism of tryptophan, and ascorbate and aldarate metabolism, were all significantly (p<0.001 altered in cats with diarrhea. In conclusion, significant differences in the fecal microbiomes between healthy cats and cats with diarrhea were identified. This dysbiosis was accompanied by changes in bacterial functional gene categories. Future studies are warranted to evaluate if these microbial changes correlate with changes in fecal concentrations of microbial metabolites in cats with diarrhea for the identification of potential diagnostic or

  10. Probiotics and Antibiotic-Associated Diarrhea and Clostridium difficile Infection

    Science.gov (United States)

    Surawicz, Christina M.

    Diarrhea is a common side effect of antibiotics. Antibiotics can cause diarrhea in 5-25% of individuals who take them but its occurrence is unpredictable. Diarrhea due to antibiotics is called antibiotic-associated diarrhea (AAD). Diarrhea may be mild and resolve when antibiotics are discontinued, or it may be more severe. The most severe form of AAD is caused by overgrowth of Clostridium difficile which can cause severe diarrhea, colitis, pseudomembranous colitis, or even fatal toxic megacolon. Rates of diarrhea vary with the specific antibiotic as well as with the individual susceptibility.

  11. A study of dietetic on the diarrhea

    Directory of Open Access Journals (Sweden)

    Tae-Hyeun Baek

    2006-06-01

    Full Text Available Objectives : This research examined about dietary therapy on the diarrhea based on the literary findings, for clinical treatment and prevention of the diarrhea. Methods : This Research examined on histories, compositions, applications, and effects of the diarrhea on about 100 cases of dietary therapy of the diarrhea from recent Chinese literatures Results : 1. Various vegetables, animals and mineral materials including herbs, grains, vegetables, fruits, food and drink were used for the dietary therapy. 2. Methods of the preparation for use as therapeutics were decoction, pulvis, gruel, medicinal wine, cake, tea, paste and gelatin and etc. 3. Frequently used materials were sesame oil, honey, ear mushroom, shiitake mushroom, kelp, walnut seed, hemp seed, groundnut, glutinous rice, apricot stone, yellow bean peel, radish, potato, spinage, and spring onion. Conclusion : Though dietary therapy for the diarrhea is not based on clinical or experimental data, but through experience. It is mostly based on Yin-Yang and five elements, visceral manifestation, channels and their collateral channels and chinese herbal medicine theories. If we use them properly according to oriental medicine method, it will be effective on treating and preventing the diarrhea.

  12. A study of nosocomial diarrhea in Calcutta.

    Science.gov (United States)

    Das, A S; Mazumder, D N; Pal, D; Chattopadhyay, U K

    1996-01-01

    Nosocomial infection is a major problem in hospitalized patients, particularly those who are debilitated. These infections may manifest as diarrhea. The spectrum of infections agents causing nosocomial diarrhea in our country is not known. Thirty-two patients, admitted to the hospital with various complaints, who developed diarrhea during their hospital stay, were studied to identify the causative agents of diarrhea. Hospital food samples were also processed for pathogens. The bacteria isolated from patients included established enteropathogens like Salmonella, enteropathogenic Escherichia coli, Campylobacter species and organisms with low pathogenicity like Serratia marsescens, Pseudomonas aeruginosa and Morganella morganii. The bacterial pathogens isolated were resistant to most antibiotics, suggesting their nosocomial character. Hospital food samples contained Salmonella typhimurium, Campylobacter jejuni (biotype 1) and enteropathogenic Escherichia coli, suggesting that food might have been the vehicle for these infections. Nosocomial infection was found to be an important cause of diarrhea (34%), EPEC and Salmonell being the predominant pathogens. Water, egg and milk were the source of infection in these cases. Special measures to obtain uneffected items will prevent occurrence of nosocomial diarrhea in our hospitals.

  13. Spectrum of Drug-induced Chronic Diarrhea.

    Science.gov (United States)

    Philip, Nissy A; Ahmed, Nazir; Pitchumoni, Capecomorin S

    2017-02-01

    The evaluation of a patient with chronic diarrhea can be quite frustrating, as it is expensive and involves multiple diagnostic studies. Moreover, identification of a drug as a cause of chronic diarrhea is a challenge in patients taking multiple medications. The disease may either be associated with intestinal mucosal changes, mimicking diseases such as celiac disease, or purely functional, with no histopathologic change. Drug-induced diarrhea may or may not be associated with malabsorption of nutrients, and a clinical improvement may occur within days of discontinuation of the drug, or may take longer when associated with mucosal injury. Diarrhea in diabetics, often attributed to poor management and lack of control, may be due to oral hypoglycaemic agents. Chemotherapy can result in diffuse or segmental colitis, whereas olmesartan and a few other medications infrequently induce a disease that mimics celiac disease, but is not associated with gluten intolerance. In short, increased awareness of a drug, as a cause for diarrhea and a clear understanding of the clinical manifestations will help clinicians to solve this challenging problem. This article aims to review drug-induced diarrhea to (a) understand known pathophysiological mechanisms; (b) assess the risk associated with frequently prescribed medications, and discuss the pathogenesis; and (c) provide easily retrievable data in tables to help identify known offending medication/s and a list of top 100 prescribed medications in the United States as a useful comprehensive reference.

  14. Antirotavirus Immunoglobulin A Neutralizes Virus In Vitro after Transcytosis through Epithelial Cells and Protects Infant Mice from Diarrhea

    OpenAIRE

    Ruggeri, Franco M.; Johansen, Kari; Basile, Gino; Kraehenbuhl, Jean-Pierre; Svensson, Lennart

    1998-01-01

    Rotaviruses are the major cause of severe diarrhea in infants and young children worldwide. Due to their restricted site of replication, i.e., mature enterocytes, local intestinal antibodies have been proposed to play a major role in protective immunity. Whether secretory immunoglobulin A (IgA) antibodies alone can provide protection against rotavirus diarrhea has not been fully established. To address this question, a library of IgA monoclonal antibodies (MAbs) previously developed against d...

  15. The Most Important Recommended Times of Hand Washing with Soap and Water in Preventing the Occurrence of Acute Diarrhea Among Children Under Five Years of Age in Slums of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Adane, Metadel; Mengistie, Bezatu; Mulat, Worku; Medhin, Girmay; Kloos, Helmut

    2017-11-15

    Adequate hand washing with soap at five recommended times is particularly important in urban slums in developing countries, but which of the recommended times are the most important in the prevention of diarrhea among children under five years of age living in these areas remains unclear. To address this gap, a community-based cross-sectional study was undertaken in the slums of Addis Ababa, Ethiopia between September and November 2014. Data were collected using a pre-tested structured questionnaire and an observational checklist. Multivariable logistic regression with 95% confidence interval (CI) was used for data analysis. Only 4.4% of the households had hand washing facilities within or near a latrine with soap and water access. The average prevalence of hand washing with soap at the five recommended times was 19.8%. One quarter (24.8%) of caregivers washed their hands with soap before feeding a child, 23.8% before preparing food, and 17.1% after defecation. The most important recommended times in preventing acute diarrhea were before preparing food [adjusted odds ratio (AOR) 0.2; 95% CI 0.1-0.7] and after defecation (AOR 0.3; 95% CI 0.1-0.9). Household size of six or more persons (AOR 2.3; 95% CI 1.4-3.9) and low monthly household income (AOR 2.4; 95% CI 1.4-4.0) were significantly associated with acute diarrhea. Promoting hand washing with soap and advocacy programs at the five recommended times, especially before preparing food and after defecation, and implementation of socioeconomic development programs targeting poor households are essential for increasing the prevalence of hand washing with soap and preventing acute diarrhea in the slums of Addis Ababa.

  16. Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

    Directory of Open Access Journals (Sweden)

    Balakrishna Kalakheti

    2016-12-01

    Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

  17. Campylobacter enteritis in adult patients with acute diarrhea from 2005 to 2009 in Beijing, China.

    Science.gov (United States)

    Chen, Jie; Sun, Xin-Ting; Zeng, Zheng; Yu, Yan-Yan

    2011-05-01

    There has been a marked global increase in the incidence of human Campylobacter enteritis in recent years. This study investigated the epidemiological and clinical features of Campylobacter enteritis in adult patients suffering from acute diarrhea. This was a retrospective review of Campylobacter enteritis in adult patients with acute diarrhea presenting at Beijing University First Hospital, Beijing, China, in the summer and autumn (April to October) of 2005 to 2009. The data collected included the species of campylobacter identified, and the age, gender, clinical manifestations and results of laboratory test on stool samples collected from the patients. Campylobacter sensitivity tests to various antimicrobial agents were conducted on 80 specimens. Chi-square tests were applied using SPSS13.0 software and a two-sided P value of Campylobacter spp. isolated from the stool specimens of 142 patients with diarrhea represented 14.9% of all the cases examined. C. jejuni was identified in 127 patients (89.4%) and C. coli in 15 others (10.6%). The infection incidence was highest in the age range of 21 - 30 years which comprised 21.7% of the total cases examined. Most cases of diarrhea (46 patients) occurred in June. Watery diarrhea (97.2%), abdominal pain (72.5%) and fever (64.8%) were the most common manifestations of enteric campylobacteriosis. Only four patients (2.8%) had bloody diarrhea. The antimicrobial resistance rates were: cefoperazone (100%), levofloxacin (61.3%), gentamicin (12.5%), erythromycin (6.3%), and azithromycin (2.5%). Campylobacter was prevalent among adults with acute diarrhea from 2005 to 2009 in Beijing, China. The large number of those afflicted by the disease warrants the commission of a large multicenter study to determine the extent of enteric campylobacteriosis in this region.

  18. Probiotics for Infectious Diarrhea and Traveler's Diarrhea - What Do We Really Know?

    Science.gov (United States)

    Hibberd, Patricia L.

    Worldwide, diarrhea is the sixth leading cause of premature death (Lopez et al., 2006), accounting for more than two million deaths each year. The majority of the burden is borne in lower and middle income countries, and in children under age 5 (Kosek et al., 2003). Even in the United States where there is easy access to “safe” food and water, there are an estimated 211-375 million episodes of acute diarrhea each year, resulting in 900,000 hospitalizations and 6,000 deaths (Herikstad et al., 2002; Mead et al., 1999). While mortality from diarrhea has decreased over the last 30 years, the incidence and morbidity associated with diarrhea has not improved (Kosek et al., 2003). During the same time period an ever increasing number of enteric pathogens as well as non-infectious conditions have been recognized as causes of acute diarrhea (Guerrant et al., 2001).

  19. Opening Address

    Science.gov (United States)

    Yamada, T.

    2014-12-01

    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  20. Role of the Gut Microbiota of Children in Diarrhea Due to the Protozoan Parasite Entamoeba histolytica.

    Science.gov (United States)

    Gilchrist, Carol A; Petri, Sarah E; Schneider, Brittany N; Reichman, Daniel J; Jiang, Nona; Begum, Sharmin; Watanabe, Koji; Jansen, Caroline S; Elliott, K Pamela; Burgess, Stacey L; Ma, Jennie Z; Alam, Masud; Kabir, Mamun; Haque, Rashidul; Petri, William A

    2016-05-15

    An estimated 1 million children die each year before their fifth birthday from diarrhea. Previous population-based surveys of pediatric diarrheal diseases have identified the protozoan parasite Entamoeba histolytica, the etiological agent of amebiasis, as one of the causes of moderate-to-severe diarrhea in sub-Saharan Africa and South Asia. We prospectively studied the natural history of E. histolytica colonization and diarrhea among infants in an urban slum of Dhaka, Bangladesh. Approximately 80% of children were infected with E. histolytica by the age of 2 years. Fecal anti-galactose/N-acetylgalactosamine lectin immunoglobulin A was associated with protection from reinfection, while a high parasite burden and expansion of the Prevotella copri level was associated with diarrhea. E. histolytica infection was prevalent in this population, with most infections asymptomatic and diarrhea associated with both the amount of parasite and the composition of the microbiota. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  1. Prevalence of enteropathogens and their association with diarrhea ...

    African Journals Online (AJOL)

    Entamoeba histolytica and Giardian lamblia) in diarrhoeic stools was evident. There was no significant (X2 = 0.44; P > 0.05) difference between infection and sex. All infections declined gradually with age but it was not statistically significant (X2 ...

  2. Guidelines for the prevention and treatment of travelers' diarrhea: a graded expert panel report.

    Science.gov (United States)

    Riddle, Mark S; Connor, Bradley A; Beeching, Nicholas J; DuPont, Herbert L; Hamer, Davidson H; Kozarsky, Phyllis; Libman, Michael; Steffen, Robert; Taylor, David; Tribble, David R; Vila, Jordi; Zanger, Philipp; Ericsson, Charles D

    2017-04-01

    : Travelers' diarrhea causes significant morbidity including some sequelae, lost travel time and opportunity cost to both travelers and countries receiving travelers. Effective prevention and treatment are needed to reduce these negative impacts. : This critical appraisal of the literature and expert consensus guideline development effort asked several key questions related to antibiotic and non-antibiotic prophylaxis and treatment, utility of available diagnostics, impact of multi-drug resistant (MDR) colonization associated with travel and travelers' diarrhea, and how our understanding of the gastrointestinal microbiome should influence current practice and future research. Studies related to these key clinical areas were assessed for relevance and quality. Based on this critical appraisal, guidelines were developed and voted on using current standards for clinical guideline development methodology. : New definitions for severity of travelers' diarrhea were developed. A total of 20 graded recommendations on the topics of prophylaxis, diagnosis, therapy and follow-up were developed. In addition, three non-graded consensus-based statements were adopted. : Prevention and treatment of travelers' diarrhea requires action at the provider, traveler and research community levels. Strong evidence supports the effectiveness of antimicrobial therapy in most cases of moderate to severe travelers' diarrhea, while either increasing intake of fluids only or loperamide or bismuth subsalicylate may suffice for most cases of mild diarrhea. Further studies are needed to address knowledge gaps regarding optimal therapies, the individual, community and global health risks of MDR acquisition, manipulation of the microbiome in prevention and treatment and the utility of laboratory testing in returning travelers with persistent diarrhea.

  3. Persistent diarrhea in the returned traveler.

    Science.gov (United States)

    Thielman, N M; Guerrant, R L

    1998-06-01

    In conclusion, the causes of chronic diarrhea in the returned traveler are protean. Careful evaluation requires an understanding of where the traveler has been, when they were there, the type of diarrheal illness, medications taken, and knowledge of the patients' other medical problems. Protozoa, particularly G. lamblia, C. parvum, and C. cayatenensis, are among the more commonly identified agents. If the patient is immunocompromised, microsporidia and Isospora become more likely, and a prior history of antimicrobial use raises the possibility of C. difficile colitis. Occasionally helminths, which establish intimate contact with the intestinal mucosa, may also cause prolonged diarrhea. If these and other gastrointestinal insults, such as tropical sprue, small bowel overgrowth, lactose intolerance, and processes unrelated to travel are excluded by more invasive studies or clinical history, the patient can be reassured that idiopathic chronic diarrhea is usually self-limited.

  4. Association of Blastocystis subtypes with diarrhea in children

    Science.gov (United States)

    Zulfa, F.; Sari, I. P.; Kurniawan, A.

    2017-08-01

    Blastocystis hominis is an intestinal zoonotic protozoa that epidemiological surveys have shown, is highly prevalent among children and may cause chronic diarrhea. This study aimed to identify Blastocystis subtypes among children and associate those subtypes to pathology. The study’s population was children aged 6-12 years old divided into asymptomatic and symptomatic (diarrhea) groups. The asymptomatic samples were obtained from primary school students in the Bukit Duri area of South Jakarta, while the symptomatic samples were obtained from patients who visited nearby primary health centers (Puskesmas). Symptomatic stool samples were examined inParasitology Laboratory FKUI. Microscopic examination of the stool samples was performed to screen for single Blastocystic infection, followed by culture, PCR of 18S rRNA, and sequencing. In the study, 53.2% of children (n = 156) harbored intestinal parasites, Blastocysts sp. A single infection of Blastocystis sp. was present in 69 (44.23%) samples, comprised of 36 symptomatic and 33 asymptomatic participants. The Blastocystis subtypes (STs) identified in this study were STs 1-4 ST3 was the most dominant and was observed with statistically significant higher frequency in the symptomatic group. ST4 was only found in one sample in the symptomatic group. While ST1 and ST2 were found more frequently in the asymptomatic group, no statistical association was observed. ST3 is more likely to be associated with clinical symptoms than ST1 and ST2.

  5. [Enteropathogens relating to diarrhea in HIV patients on antiretroviral therapy].

    Science.gov (United States)

    Pupulin, Aurea Regina Telles; Carvalho, Paula Galdino; Nishi, Letícia; Nakamura, Celso Vataru; Guilherme, Ana Lucia Falavigna

    2009-01-01

    The etiology of the diarrheic process in AIDS may be caused by viruses, bacteria, fungi, protozoa or helminths, as well as HIV itself. This study evaluated enteropathogens relating to diarrhea in HIV patients who were on antiretroviral therapy. The parasitological methods used were Faust, Hoffmann and Kinyoun. Isolation and culturing of fungi were carried out in accordance with the methodology recommended by the NCCLS M27-A standard. The yeast species were identified using the polymerase chain reaction (PCR). Bacteria were isolated on MacConkey and SS agar and the species were identified using Enterokit B (Probac do Brasil) and biochemical methods. Forty-nine patients were evaluated: 44.89% presented enteroparasites and 48.1% presented Candida sp, of which 61.5% were Candida albicans, 7.6% were Candida sp and 30.7% were Candida non-albicans. Bacteria were isolated from 72% of the patients, of which 49% were Escherichia coli, 13% Salmonella parathyphi, Klebsiella sp or Proteus and 6% Citrobacter freundii or Yersinia sp. There was high prevalence of Candida sp in HIV patients with diarrhea and non-albicans species were isolated. Their presence could be taken to mean that they were accomplices in or causes of the infection.

  6. Campylobacter spp among children with acute diarrhea attending Mulago hospital in Kampala--Uganda.

    Science.gov (United States)

    Mshana, S E; Joloba, M; Kakooza, A; Kaddu-Mulindwa, D

    2009-09-01

    Campylobacter infections occur worldwide. A recent study in Kampala, Uganda, found that 87% of broiler chickens had Campylobacter jejuni; these are potential source of human infection. Isolation rate in developing countries is between 5-35%. This study aimed at finding prevalence of children with campylobacter infection among children with acute diarrhea attending Mulago hospital. The objective was to establish the proportion of children infected with Campylobacter spp among children with acute diarrhea at Mulago hospital. A crossectional study from July to October 2005 was conducted involved 226 children with acute diarrhea. Serial sampling was done a total of 226 stool specimens were obtained and cultured on selective media. Identification was done using biochemical test and susceptibility using standard discs diffusion method. Campylobacter spp were isolated in 21 (9.3%) of 226 stool specimens analyzed. Campylobacter jejuni 17 (80.9%), Campylobacter lari 2 (9.5%), Campylobacter coli 1 (4.5%) and Campylobacter jejuni/coli 1(4.5%). All Campylobacter isolates were sensitive to erythromycin, and 20% had intermediate resistance to Ampicillin. Campylobacter spp are prevalent among children with acute diarrhea in Kampala- Uganda. A large multicenter study should be undertaken so that the extent of campylobacter infection in our setting can be established.

  7. Detection of diarrheagenic Escherichia coli from children with and without diarrhea in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Vanessa Bueris

    2007-11-01

    Full Text Available We identified different diarrheagenic (DEC Escherichia coli pathotypes isolated from 1,207 children with and without acute endemic diarrhea in Salvador, Bahia, Brazil collected as part of a case-control study. Since the identification of DEC cannot be based on only biochemical and culture criteria, we used a multiplex polymerase chain reaction developed by combining five specific primer pairs for Enteropathogenic Escherichia coli (EPEC, Shiga toxin-producing E. coli/ Enterohaemorrhagic E. coli (STEC/EHEC, Enterotoxigenic E. coli (ETEC and Enteroaggregative E. coli (EAEC to detect these pathotypes simultaneously in a single-step reaction. In order to distinguish typical and atypical EPEC strains, these were tested for the presence of EAF plasmid. The prevalence of diarrheagenic E. coli in this sample of a global case-control study was 25.4% (259 patients and 18.7% (35 patients in the diarrhea group (1,020 patients and the control group (187 patients, respectively. The most frequently isolated pathotype was EAEC (10.7%, followed by atypical EPEC (9.4%, ETEC (3.7%, and STEC (0.6%. Typical EPEC was detected only in one sample. The prevalence of the pathotypes studied in children with diarrhea was not significantly different from that in children without diarrhea.

  8. Campylobacter spp.: prevalencia y caracterización feno-genotípica de aislamientos de pacientes con diarrea y de sus mascotas en la provincia de La Pampa, Argentina Campylobacter spp.: prevalence and pheno-genotypic characterization of isolates recovered from patients suffering from diarrhea and their pets in La Pampa Province, Argentina

    Directory of Open Access Journals (Sweden)

    Ana L Tamborini

    2012-12-01

    Full Text Available Se investigó la prevalencia de Campylobacter spp. en 327 pacientes con diarrea y en 36 animales (perros, gatos y pollos que convivían con pacientes en los que se detectó este patógeno; el estudio se llevó a cabo en Santa Rosa, La Pampa, Argentina. Se aisló Campylobacter spp. en 50/327 pacientes y en 12/36 animales, Campylobacter jejuni fue la especie más frecuente. Se detectó resistencia a ciprofoxacina (65 % y a tetraciclina (32 % en una selección de 35 aislamientos de origen humano. En el análisis por electroforesis de campo pulsado de 13 aislamientos de C. jejuni se identificaron siete subtipos genéticos. Dos subtipos agruparon aislamientos de pacientes y de sus respectivos perros, y un tercer subtipo agrupó 1 aislamiento humano y 2 de pollos de ese paciente. Si bien las aves son reconocidas como el principal reservorio, es importante fortalecer la vigilancia de Campylobacter spp. en mascotas, las cuales pueden ser portadores asintomáticos del patógeno.The prevalence of Campylobacter spp. was investigated in 327 patients suffering from diarrhea and in 36 animals (dogs, cats and chickens owned by the patients that presented infection by Campylobacter in Santa Rosa, La Pampa, Argentina. Campylobacter spp. was isolated in 50/327 patients and in 12/36 animals, being Campylobacter jejuni the most common species. Resistance to ciprofoxacin (65 % and tetracycline (32 % was found among 35 isolates of human origin studied. Seven genetic subtypes were observed among 13 C. jejuni isolates by pulsed feld gel electrophoresis. Two subtypes grouped isolates belonging to patients and their respective dogs whereas another subtype grouped one isolate of human origin and two isolates from the patient´s chickens. The results of this investigation highlight the need to strengthen surveillance of Campylobacter spp. not only in poultry, which is recognized as the main reservoir, but also in pets, which were shown to be asymptomatic carriers of the

  9. Incidence of Diarrhea in Hospitalized Patients with Standard Enteral Formula

    National Research Council Canada - National Science Library

    Shabbu Ahmadi bonakdar; Mahdieh Pouryazdanpanah; Zahra Ganie Far; Saba Ghazanfari; Abdolreza Norouzy

    2014-01-01

    ...`s reports standard enteral formula is inducing diarrhea. In this study our purpose is to evaluate the incidence of diarrhea in hospitalized patients with standard Enteral Nutrition (EN) formula intake...

  10. Location of food consumption and travelers' diarrhea.

    Science.gov (United States)

    Tjoa, W S; DuPont, H L; Sullivan, P; Pickering, L K; Holguin, A H; Olarte, J; Evans, D G; Evans, D J

    1977-07-01

    Daily food histories for one month were obtained in summer, 1975, from students attending a Mexican university to determine the influence of food consumption on the development and etiology of diarrhea. In newly-arrived students from the U.S. who ate half or more of their meals in the school cafeteria and public restaurants there were significant increases in diarrhea (p less than 0.005); shigella infection (p less than 0.05) and toxigenic E. coli infection (p less than 0.025) compared to the students eating a comparable number of meals in private homes. In the summer U.S. students there was also an association of diarrhea and eating from street vendors (p less than 0.05). In full-time U.S. students who had lived in Mexico a year or longer as well as in Latin American students a relationship between location of meals and occurrence of enteric disease was not apparent. High numbers of enteric bacteria were recovered from food from the school's cafeteria, public restaurants, street vendors and small grocery stores. Shigella were isolated from cooked and uncooked hamburger patties from the school cafeteria. Four shigella carriers were found among kitchen personnel at the school. This study demonstrates that food serves as a major vehicle through which travelers' diarrhea occurs.

  11. Microscopic colitis as a missed cause of chronic diarrhea.

    Science.gov (United States)

    Mohamed, Nooroudien; Marais, Monique; Bezuidenhout, Juanita

    2011-04-21

    To determine the prevalence of increased intraepithelial lymphocytes, using immunohistochemistry in patients with normal colonoscopy and near normal biopsy. We retrospectively reviewed all non-malignant colon mucosal biopsies between 2005 and 2007, reported as normal, chronic inflammation or melanosis coli in patients who were undergoing routine colonoscopy. Immunohistochemistry using CD3 was performed on all mucosal biopsies and an intraepithelial lymphocyte count (IEL) was determined. Cases with an IEL count of ≥ 20 IELs per 100 surface epithelial cells were correlated with demographic, clinical and follow-up data. A further subgroup was evaluated for lymphocytic colitis. Twenty (8.3%) of 241 cases revealed an IEL count ≥ 20. Six (2.5%) patients were identified as having lymphocytic colitis (P colitis with an IEL count microscopic colitis in patients with diarrhea-predominant IBS.

  12. Home management of diarrhea among underfives in a rural community in Kenya: household perceptions and practices.

    Science.gov (United States)

    Othero, Doreen M; Orago, Alloys S S; Groenewegen, Ted; Kaseje, Dan O; Otengah, P A

    2008-12-01

    Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. A household longitudinal study was conducted in Nyando district, Kenya in 2004-2006 adopting both qualitative and quantitative approaches. A total of 927 mothers/caregivers of under-fives participated in the study. Perceived causes of childhood diarrhoea, action taken during diarrhea, fluid intake, recognition of signs of dehydration, feeding during convalescence, adherence to treatment and advice. Majority of the respondents 807 (87.1%) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48% of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524 (55.6%), contaminated food 508 (54.9%), bad eye 464 (50.0%), false teeth 423 (45.6%) and breast milk 331 (35.8%). More than 70% of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour, rice water and selected herbs as anti-diarrheal agents. During illness, 239 (27.8%) of the children were reported not to have drunk any fluids at all, 487 (52.5%) drunk much less and only 93 (10.0%) were reported to have drunk more than usual. A significant 831 (89.6%) withheld milk including breast milk with the notion that it enhanced diarrhea. Based on these findings, there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and misconceptions and

  13. Loop-Mediated Isothermal Amplification (LAMP) for Detection of Campylobacter jejuni and C. coli in Thai Children with Diarrhea.

    Science.gov (United States)

    Pham, Ngan Thi Kim; Trinh, Quang Duy; Khamrin, Pattara; Ukarapol, Nuthapong; Kongsricharoern, Tipachan; Yamazaki, Wataru; Komine-Aizawa, Shihoko; Okitsu, Shoko; Maneekarn, Niwat; Hayakawa, Satoshi; Ushijima, Hiroshi

    2015-01-01

    Campylobacter species are common causes of bacterial diarrhea, and Campylobacter jejuni and C. coli are known as the predominant causative agents in humans. Recent studies suggested that loop-mediated isothermal amplification (LAMP) is an efficient and practical tool for rapid detection of C. jejuni and C. coli in clinical samples. We used LAMP to screen 151 stool samples for Campylobacter; these samples were collected in 2012 from Thai children with diarrhea. The PCR method discriminated C. jejuni and C. coli among the detected Campylobacter strains; these species were subjected to sequencing of the hipO gene (in C. jejuni) or the ask gene (in C. coli). The results suggest that the prevalence of Campylobacter infection among Thai children with diarrhea is 8.6%, and C. jejuni is the most prevalent species.

  14. Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.

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    Xin Wang

    Full Text Available In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region and Henan Province (developing region, and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC and enteroaggregative E.coli (EAggEC were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC and red blood cells (RBC positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.

  15. Protozoan enteric infection in AIDS related diarrhea in Thailand.

    Science.gov (United States)

    Waywa, D; Kongkriengdaj, S; Chaidatch, S; Tiengrim, S; Kowadisaiburana, B; Chaikachonpat, S; Suwanagool, S; Chaiprasert, A; Curry, A; Bailey, W; Suputtamongkol, Y; Beeching, N J

    2001-01-01

    The aim of this study was to determine the prevalence of enteric protozoa and other pathogens in AIDS patients with diarrhea in Bangkok, Thailand. Of 288 consecutive patients screened in the 10 month period between November 1999-August 2000 inclusive, 55 (19.2%) had Cryptosporidium spp, 13 (4.5%) had Isospora oocyst, 11 (3.8%) had Giardia lamblia, 3 (0.9%) had Entamoeba histolytica, and 1 (0.3%) had Iodamoeba butschlii infection. The prevalence of microsporidia was 11% in this study. Of 251 patients for whom stool culture for bacteria was performed, enteric bacterial pathogens isolated were Campylobacter spp in 18 (7.1%), Salmonella spp in 11 (4.3%), and Shigella spp in 1 (0.5%). Other pathogens found in these patients were Clostridium difficile in 16/102 (15.6%). Mycobacterium spp in 18/287 (6.2%), and Strongyloides stercoralis in 23/288 (8.0%). Overall, parasitic and bacterial pathogens were identified in 140 (48.6%) patients. These pathogens were identified by the routine simple wet smear technique in 32, formalin-ether concentration method in 46, culture for S. stercoralis in 5, and culture for bacteria in 30. Additional test, using modified Ziehl-Neelsen staining, identified cryptosporidial oocyst, isospora oocyst, and Mycobacterium spp in 72. The microsporidia, initially identified by modified trichrome blue staining, all were then determined to be Enterocytozoon bieneusi by thin sectioning electron microscopy. Protozoan and bacterial pathogens were confirmed to be important etiologic agents in diarrhea in AIDS in Thailand. They were all associated with increased mortality. Routine stool examination by simple wet smear detected only one-fourth of these pathogens. Therefore all diagnostic techniques for these organisms should be made more widely available in Thailand.

  16. Diarrhea: Cancer-Related Causes and How to Cope

    Science.gov (United States)

    ... a diet of clear liquids, such as water, apple juice, clear broth and ice pops. Avoid milk products, as lactose intolerance may be part of your diarrhea. When you have diarrhea, you may need to drink eight to 12 cups of liquid a day. Eat low-fiber foods. As your diarrhea starts ...

  17. 9 CFR 113.311 - Bovine Virus Diarrhea Vaccine.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bovine Virus Diarrhea Vaccine. 113.311... Virus Vaccines § 113.311 Bovine Virus Diarrhea Vaccine. Bovine Virus Diarrhea Vaccine shall be prepared..., and immunogenic shall be used for preparing the production seed virus for vaccine production. All...

  18. Incidence of Diarrhea in Hospitalized Patients with Standard Enteral Formula

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    Shabbu Ahmadi bonakdar

    2014-10-01

    Conclusion: Evaluation of patients receiving Milatech standard formula showed that diarrhea wasn’t seen in hospitalized patients. Diarrhea was reported by the nurses may refer to other diarrhea genic causes including of long length of stay, entral duration or medical side effects or infections.

  19. original article the prevalence of intestinal coccidian parasites ...

    African Journals Online (AJOL)

    boaz

    infections often present as diarrhea and significant disease has been recorded in 50-96% of cases with 90% prevalence rate reported in Africa [3].Infective causes of chronic diarrhea may satisfactorily be managed because with the exception of cryptosporidiosis and. HIV-related enteropathy, good response to treatment.

  20. Diarrheal Illness and Healthcare Seeking Behavior among a Population at High Risk for Diarrhea in Dhaka, Bangladesh.

    Directory of Open Access Journals (Sweden)

    Fahima Chowdhury

    Full Text Available Diarrhea remains one of the major causes of death in Bangladesh. We studied diarrheal disease risk and healthcare seeking behavior among populations at high risk for diarrhea in Dhaka, Bangladesh. Data were obtained from a cross-sectional survey conducted during April and September 2010. The prevalence of diarrhea was calculated by age-group and sex. A generalized estimating equation with logit link function was used to predict diarrheal disease risk and seeking care from a professional healthcare provider. Of 316,766 individuals, 10% were young children (<5 years. The prevalence of diarrhea was 16 per 1000 persons among all ages; young children accounted for 44 per 1000 persons. Prevalence of diarrhea was significantly higher (p=.003 among younger males (<15 years compared to that among younger females. In contrast, prevalence of diarrhea was significantly higher (p<.0001 among older females (≥15 years compared to that among older males. An increased risk for diarrhea was observed in young children, males, and those staying in rented houses, lower family members in the house, using non-sanitary toilets, living in the area for short times, living in a community with less educated persons, living in a community with less use of safe water source for drinking, or living close to the hospital. About 80% of those with diarrhea sought care initially from a non-professional healthcare provider. Choice of the professional healthcare provider was driven by age of the patient, educational status of the household head, and hygienic practices by the household. The study reaffirms that young children are at greater risk for diarrhea. Like other developing countries most people in this impoverished setting of Dhaka are less likely to seek care from a professional healthcare provider than from a non-professional healthcare provider, which could be attributed to a higher number of diarrheal deaths among young children in Bangladesh. Dissemination of

  1. Prevalence of intestinal microsporidiosis in Human Immunodeficiency Virus-infected patients with diarrhea in major United States cities Prevalência de microsporidiose intestinal em pacientes infectados pelo HIV com diarréia nas principais cidades dos Estados Unidos da América do Norte

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    Mark S. Dworkin

    2007-12-01

    Full Text Available To determine the prevalence of intestinal microsporidiosis in HIV-infected patients, we performed a prospective study of HIV-infected patients with diarrheal illnesses in three US hospitals and examined an observational database of HIV-infected patients in 10 US cities. Among 737 specimens from the three hospitals, results were positive for 11 (prevalence 1.5%; seven (64% acquired HIV through male-to-male sexual contact, two (18% through male-to-male sexual contact and injection drug use, and one (9% through heterosexual contact; one (9% had an undetermined mode of transmission. Median CD4 count within six months of diagnosis of microsporidiosis was 33 cells/µL (range 3 to 319 cells/µL. For the national observational database (n = 24,098, the overall prevalence of microsporidiosis was 0.16%. Prevalence of microsporidiosis among HIV-infected patients with diarrheal disease is low, and microsporidiosis is most often diagnosed in patients with very low CD4+ cell counts. Testing for microsporidia appears to be indicated, especially for patients with very low CD4+ cell counts.Para determinar a prevalência de microsporidiose intestinal em pacientes infectados pelo HIV foi realizado um estudo prospectivo em três hospitais dos Estados Unidos da América do Norte (EUA e analizada uma base de dados nacional composta de dados coletados de pacientes infectados pelo HIV em 10 cidades dos EUA. De um total de 737 amostras de fezes de pacientes infectados pelo HIV que apresentavam diarréia, amostras de 11 pacientes (prevalência de 1,5% foram positivas para microsporídios. Todos os positivos eram do sexo masculino e, entre eles, sete (64% pacientes adquiriram a infecção pelo HIV através de relação homossexual, dois (18% através de relação sexual e drogas injetáveis e um (9% através de contato heterosexual, enquanto que em um paciente o modo de transmissão do HIV não foi determinado. A contagem média de linfócitos CD4 realizada até seis

  2. Etiology of acute diarrhea in the elderly in China: A six-year observational study.

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    Zike Zhang

    Full Text Available Acute diarrhea leads to a substantial disease burden among the elderly worldwide. However, in the context of increasingly aging trend in China, the prevalence of etiological agents among elderly diarrheal patients was undetermined. This study aimed to explore the major enteropathogens of acute diarrhea among outpatients older than 65 years in China, and also the epidemiological features of the pathogens. Demographic and clinical data for acute diarrhea among outpatients older than 65 years were collected from 213 participating hospitals from 2009 to 2014. Stool specimens were collected and tested for 13 enteric viruses and bacteria. The proportion of outpatients positive for targeted pathogens was analyzed by residential areas and seasonal patterns. Among the 7,725 patients enrolled, 1,617 (20.9%were positive for any one of the 13 study pathogens. The predominant pathogen was norovirus (9.0%, followed by diarrheagenic Escherichia coli (DEC (5.5%, rotavirus (3.9%, non-typhoidal Salmonella (NTS (2.9%, and Shigella spp. (2.5%. The prevalence of Shigella spp. among rural patients (6.9% was higher than that among urban patients (1.6% (p < 0.001, with opposite trend for DEC (3.6% versus 5.9%, p = 0.007. An obvious seasonal pattern was observed for major pathogens, with peak for norovirus in autumn, rotavirus in winter and DEC, NTS, and Shigella spp. in summer. A wide variety of enteropathogens were detected among the elderly with acute diarrhea in China, with norovirus and DEC being the most commonly isolated pathogens. A strong seasonal pattern was observed for major pathogens of acute diarrhea among the elderly.

  3. Epidemiology of rotavirus diarrhea in children under 5 years in Northern Cameroon.

    Science.gov (United States)

    Ndze, Valentine Ngum; Akum, Achidi Eric; Kamga, Gonsu Hortense; Enjema, Lyonga Emilia; Esona, Mathew Dioh; Banyai, Krisztian; Therese, Obama Abena Marie

    2012-01-01

    Rotavirus still remains the major cause of diarrhea in children below 5 years. No data on rotavirus epidemiology is available in the Northern regions of Cameroon. We aimed to determine the prevalence of group A rotavirus (RVA) in children below 5 years with diarrhea in two regions of Northern Cameroon (North West and Far North Regions) so as to improve our knowledge on the burden of rotavirus disease for imminent introduction of a rotavirus vaccine. Stool samples were collected during 2010 and 2011 from 390 children below 5 years presenting with diarrhea in four hospitals in Northern Cameroon and were screened for rotavirus group A by reverse transcription-polymerase chain reaction. This study revealed that 42.8% of the children below 5 years had group A rotavirus infection, 46.5% in the Far North region while the North West had a prevalence of 33.9%. Of the 252 hospitalized and the 138 outpatient children, 124(49.2%) and 43(31.2%) (P=0.00085), respectively, were positive for group A rotavirus. Children below 24 months were most affected (44.7%), while the age group 49-60 months had the lowest prevalence (25%). The RVA prevalence was 44.6% in the urban and 28.9% in the rural settings of our study. It was observed that the proportion of children with diarrhea who had rotavirus accompanied with fever and vomiting in the outpatient group and inpatient group were 13.0% and 28.6% respectively, P=0.03. This study showed high incidence of rotavirus infection especially among hospitalized children in Northern Cameroon, suggesting that rotavirus is a major cause of childhood morbidity and mortality in this area.

  4. Impacts of diarrhea on the immune system, intestinal environment, and expression of PGRPs in New Zealand rabbits

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    Yang Chen

    2017-11-01

    Full Text Available Diarrhea is a syndrome of digestive disorders in young rabbits and may lead to secondary infections resulting in reduced immunity and higher mortality in baby rabbits, with serious impacts on rabbit farming. In this study, we investigated the effects of diarrhea on the health of baby rabbits in terms of intestinal mucosal development, immune function, and intestinal microbial diversity. We found that the duodenal villus length and the villus/crypt ratio in rabbits with diarrhea were significantly reduced compared with those in healthy rabbits (P < 0.01. Rabbits with diarrhea had significantly lower concentrations of acetic acid (P < 0.05, higher pH levels (P < 0.05, and higher levels of ammonia nitrogen (P < 0.01 in the cecum. Moreover, diarrhea in baby rabbits led to significantly reduced levels of total serum protein (P < 0.05 and markedly increased levels of alkaline phosphatase, urea nitrogen, TNF-α, and IL-6 (P < 0.05. Transcriptional analysis of peptidoglycan recognition proteins (PGRPs, including PGLYRP-1, PGLYRP-2, and PGLYRP-3 using real-time PCR revealed that diarrhea induced the upregulation of PGRPs in the cecum and duodenum. Furthermore, through pyrosequencing of the 16S rRNA V4 region in cecum samples, we found that the total number and diversity of microbes were not significantly different between healthy rabbits and those with diarrhea, though there were noticeable differences in the prevalences of Clostridium, Roseburia, and Alistipes. Our results will contribute to a better understanding of the pathological mechanisms of diarrhea in young rabbits.

  5. Prospective Case-Control Study of the Association between Common Enteric Protozoal Parasites and Diarrhea in Bangladesh

    Science.gov (United States)

    Haque, Rashidul; Mondal, Dinesh; Karim, Anwarul; Molla, Imarot Hossain; Rahim, Abdur; Faruque, Abu S. G.; Ahmad, Nooruddin; Kirkpatrick, Beth D.; Houpt, Eric; Snider, Cynthia; Petri, William A.

    2010-01-01

    Background The parasitic causes of diarrhea have historically been identified by use of microscopy; however, the use of this technique does not allow one to distinguish between subspecies or genotypes of parasites. Our objective was to determine, by use of modern diagnostic methods, the proportion of diarrhea cases in Bangladesh attributable to Cryptosporidium hominis, Cryptosporidium parvum, Entamoeba histolytica, and Giardia lamblia assemblages A and B. Methods A prospective case-control study was performed involving 3646 case patients (both children and adults) who presented with diarrhea to the Dhaka hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, and 2575 control subjects with asymptomatic infection. Parasitic infection was detected by use of a stool parasite antigen test, and the parasite load and the species and/or genotypes were determined by use of polymerase chain reaction (PCR). Results Cryptosporidium species and E. histolytica were more prevalent in patients with acute diarrhea than in healthy control subjects, for all ages (2.1% vs. 1.4%; P =.039) and, specifically, for those 0–12 months of age (2.2% vs. 0.4%; P =.009). G. lamblia assemblage A was also more prevalent in case patients with diarrhea than in healthy control subjects (20% vs. 5%; P <.001). For case patients with diarrhea, the parasite load in feces, as measured by quantitative real-time PCR cycle threshold, was not higher that that for control subjects with asymptomatic infection. Case patients with diarrhea and cryptosporidiosis were less likely to have abdominal pain, compared with control subjects (15% vs. 37%; P <.001); case patients with amebiasis more likely to have visible blood in stool, compared with control subjects (8% vs. 1.6%; P <.001); and case patients with giardiasis more likely to be dehydrated, compared with control subjects (81% vs. 71%; P =.001). Conclusion E. histolytica, C. hominis, C. parvum, and G. lamblia assemblage A infections

  6. Protection against diarrhea associated with Giardia intestinalis is lost with Multi-Nutrient Supplementation: A Study in Tanzanian Children

    NARCIS (Netherlands)

    Veenemans, J.; Mank, T.; Ottenhof, M.; Baidjoe, A.Y.; Mbugi, E.V.; Demir, A.Y.; Wielders, J.P.M.; Savelkoul, H.F.J.; Verhoef, J.C.M.

    2011-01-01

    Background - Asymptomatic carriage of Giardia intestinalis is highly prevalent among children in developing countries, and evidence regarding its role as a diarrhea-causing agent in these settings is controversial. Impaired linear growth and cognition have been associated with giardiasis, presumably

  7. Traveler's Diarrhea in Foreign Travelers in Southeast Asia: A Cross-Sectional Survey Study in Bangkok, Thailand.

    Science.gov (United States)

    Kittitrakul, Chatporn; Lawpoolsri, Saranath; Kusolsuk, Teera; Olanwijitwong, Jutarmas; Tangkanakul, Waraluk; Piyaphanee, Watcharapong

    2015-09-01

    The effect of origin and destination country on traveler's diarrhea incidence rates in Southeast Asia is poorly understood, and research generally only addresses diarrhea in travelers from the developed world. This study evaluated the attack rate and effects of traveler's diarrhea by origin and destination and analyzed key risk factors. A self-administered questionnaire was provided to foreign travelers departing Southeast Asia from Suvarnabhumi Airport, Bangkok, Thailand. It evaluated traveler demographics, relevant knowledge and practices, experiences of diarrhea, and the details and consequences of each diarrheal episode. A total of 7,963 questionnaires were completed between April 2010 and July 2011. Respondents were 56% male (mean age 35) with a mean and median duration of stay of 28 days and 10 days, respectively. Most respondents were from Europe (36.8%) or East Asia (33.4%). The attack rate of traveler's diarrhea was 16.1%, with an incidence rate of 32.05 per 100 person months. Travelers' origin and destination countries significantly related to diarrhea risk. Oceanians had the highest risk (32.9%) and East Asians the lowest (2.6%). Vietnam and Indonesia were the highest risk destinations (19.3%). Other significant factors were youth, trip duration, number of countries visited, and frequently drinking beverages with ice. © The American Society of Tropical Medicine and Hygiene.

  8. Management of acute diarrhea in emergency room.

    Science.gov (United States)

    Dekate, Parag; Jayashree, M; Singhi, Sunit C

    2013-03-01

    Acute diarrhea is the second leading cause of under-five mortality in India. It is defined as the passage of frequent watery stools (>3/24 h). Recent change in consistency of stools is more important than frequency. Acute diarrhea is caused by variety of viral, bacterial and parasitic agents. The common ones are: Rotavirus, E. coli, Shigella, Cholera, and Salmonella. Campylobacter jejuni, Giardia and E. histolytica are also not uncommon. The most important concern in management of acute diarrhea in Emergency room (ER) is fluid and electrolyte imbalances and treatment of underlying infection, wherever applicable. It includes, initial stabilization (identification and treatment of shock), assessment of hydration and rehydration therapy, recognition and treatment of electrolyte imbalance, and use of appropriate antimicrobials wherever indicated. For assessment of hydration clinical signs are generally reliable; however, in severely malnourished children sunken eyes and skin turgor are unreliable. Oral Rehydration Therapy is the cornerstone of management of dehydration. Intravenous fluids are not routinely recommended except in cases of persistent vomiting and/or shock. Majority of cases can be managed in ER and at home. Hospitalization is indicated in infants <3 mo, children with severe dehydration, severe malnutrition, toxic look, persistent vomiting and suspected surgical abdomen. Supplementations with zinc and probiotics have been shown to reduce severity and duration of diarrhea; however evidence does not support the use of antisecretary, antimotility and binding agents. Education of parents about hand hygiene, safe weaning and safe drinking water etc., can help in reducing incidence of this important health problem in the country.

  9. Probiotics for Prevention and Treatment of Diarrhea.

    Science.gov (United States)

    Guarino, Alfredo; Guandalini, Stefano; Lo Vecchio, Andrea

    2015-01-01

    Probiotics are increasingly used for prevention and treatment of diarrhea more in children than in adults. Given the broad spectrum of diarrhea, this review focuses on the main etiologies: acute gastroenteritis, antibiotic-associated diarrhea (AAD), and necrotizing enterocolitis (NEC). For each, we reviewed randomized controlled trials, meta-analyses, and guidelines. For acute gastroenteritis we found 12 guidelines: 5 recommended probiotics and 7 did not. However, the guidelines containing positive recommendations provided proof of evidence from clinical trials and meta-analyses. Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii had the most compelling evidence of efficacy as they reduced the duration of the disease by 1 day. For AAD 4 meta-analyses were found, reporting variable efficacy of probiotics in preventing diarrhea, based on the setting, patient's age, and antibiotics. The most effective strains were LGG and S. boulardii. For NEC, we found 3 randomized controlled trials, 5 meta-analyses, and 4 position papers. Probiotics reduced the risk of NEC enterocolitis and mortality in preterm babies. Guidelines did not support a routine use of probiotics and asked for further data for such sensitive implications. In conclusion, there is strong and solid proof of efficacy of probiotics as active treatment of gastroenteritis in addition to rehydration. There is solid evidence that probiotics have some efficacy in prevention of AAD, but the number needed to treat is an issue. For both etiologies LGG and S. boulardii have the strongest evidence. In NEC the indications are more debated, yet on the basis of available data and their implications, probiotics should be carefully considered.

  10. Antibiotic Resistance in Children with Bloody Diarrhea

    OpenAIRE

    Hamedi Abdolkarim

    2009-01-01

    Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX); however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroqui...

  11. Rota virus Diarrhea in Hospitalized Children.

    Science.gov (United States)

    Habib, Muhammad Irfan; Kazi, Sayyeda Ghazala; Ahmed Khan, Khalid Mehmood; Zia, Nukhba

    2014-02-01

    To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. A cross-sectional, observational study. National Institute of Child Health, Karachi, from January to June 2007. A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of Rota virus in stool was done by enzyme linked immunoassay. Out of 300 children, 188 (63%) tested positive and 112 (37%) tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was (n = 34, 18.08%). Overall, 151 (80.3%) children with Rota virus were less than 3 years old. 182 (60.7%) had fever, 118 (39.3%) had vomiting and 156 (82.9%) children had both fever and vomiting. This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study.

  12. Antibiotic Resistance in Children with Bloody Diarrhea

    Directory of Open Access Journals (Sweden)

    Hamedi Abdolkarim

    2009-05-01

    Full Text Available Shigellosis is an important public health problem, especially in developing countries. Antibiotic treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(TMP-SMX; however multidrug-resistance has occurred and careful antibiotic selection must be considered in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroquinolones may be used in adults and oral third-generation cephalosporins and nalidixic acid in children. All children (n=2400 with acute diarrhea who were admitted to the Pediatric department of Dr.sheykh Hospital Mashhad, Iran from March 2004 to March 2005 were selected and their stool culture were obtained, then positive cultures (312 cases,13% were evaluated by antibiogram. This study showed that in heavily populated areas of IRAN like Mashhad, 97% shigella strain isolated from children with bloody diarrhea were sensitive to nalidixic acid, ciprofloxacin and cefixime and rarely susceptible to ampicillin and cotrimoxazole. There is increasing resistance of Shigella to most of the antibiotics in use, and for this reason, careful selection of antibiotics must use considered in each area. Development and use of new drugs are expensive and have severe limitations in the third world. Simple prophylactic alternatives are therefore, required, such as awareness of hygienic child care practices and early promotion of breast feeding. For treatment of shigellosis in infants Ceftriaxon, and in children Nalidixic Acid is recommended.

  13. NEGATIVE IMPACT OF PROLONGED ANTIBIOTICS OR PERSISTENT DIARRHEA ON VITAMIN K1 LEVELS IN 2-24 WEEKS AGED EGYPTIAN INFANTS

    Directory of Open Access Journals (Sweden)

    Mohsen Elalfy

    2018-01-01

    Full Text Available Objectives: To evaluate the hazard of prolonged antibiotic therapy and/or persistent diarrhea on vitamin K1 (VK1 level and bleeding profile in infants (2-24 weeks. Methods: A one-year case-control study, conducted at Ain Shams University, Egypt. 338 infants (2-24 weeks were recruited and divided into 3 groups (1:1:3 ratios; group A (n= 67 patients who received antibiotics for ≥10 days, group B (n= 67 who had persistent diarrhea ≥ 14 days and group C (n=204 age- and gender-matched infants who were not either received antibiotics nor had diarrhea. All subjected to clinical assessment, bleeding history and had their complete blood count (CBC, PT and PTT, liver transaminases and VK1 level assayed.  Results: There was a significant increase in the frequency of VKDB (vitamin K deficiency bleeding and abnormal bleeding profile in cases than the control group. There was a significant negative correlation between VK1 level and duration of diarrhea, length of antibiotics used and bleeding profile. Antibiotic usage has a dangerous effect on the VK1 level in those with diarrhea; more patients were receiving antibiotic in those with persistent diarrhea and VKDB (N=55 than those with persistent diarrhea and normal VK1 (N=12. The longer duration of antibiotic therapy the lower level of VK1.  Combining cephalosporins/penicillins therapy and/or diarrhea, in particular, had an impact on the VK1 level. Conclusion: VKDB, a preventable cause of life-threatening hemorrhage, is still a major health problem in Egyptian infants, where persistent diarrhea and misuse of antibiotics are prevalent, necessitate a booster dose of VK in those high risk infants. Keyword: Prolonged Antibiotics; Persistent Diarrhea; Vitamin K1; Egyptian

  14. Antibiotic susceptibilities of Salmonella species prevalent among ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    2016-03-21

    Mar 21, 2016 ... contaminated food or drinking-water, or from person-to-person as a result ..... children and adults. The prevalence of diarrhea is also shown to generally reduce as the children grow due to these factors.38. Low prevalence in the 0-12 months of age group could ... Antibodies in breast milk protect them from.

  15. Harmful practices in the management of childhood diarrhea in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Carter, Emily; Bryce, Jennifer; Perin, Jamie; Newby, Holly

    2015-08-18

    Harmful practices in the management of childhood diarrhea are associated with negative health outcomes, and conflict with WHO treatment guidelines. These practices include restriction of fluids, breast milk and/or food intake during diarrhea episodes, and incorrect use of modern medicines. We conducted a systematic review of English-language literature published since 1990 to assess the documented prevalence of these four harmful practices, and beliefs, motivations, and contextual factors associated with harmful practices in low- and middle-income countries. We electronically searched PubMed, Embase, Ovid Global Health, and the WHO Global Health Library. Publications reporting the prevalence or substantive findings on beliefs, motivations, or context related to at least one of the four harmful practices were included, regardless of study design or representativeness of the sample population. Of the 114 articles included in the review, 79 reported the prevalence of at least one harmful practice and 35 studies reported on beliefs, motivations, or context for harmful practices. Most studies relied on sub-national population samples and many were limited to small sample sizes. Study design, study population, and definition of harmful practices varied across studies. Reported prevalence of harmful practices varied greatly across study populations, and we were unable to identify clearly defined patterns across regions, countries, or time periods. Caregivers reported that diarrhea management practices were based on the advice of others (health workers, relatives, community members), as well as their own observations or understanding of the efficacy of certain treatments for diarrhea. Others reported following traditionally held beliefs on the causes and cures for specific diarrheal diseases. Available evidence suggests that harmful practices in diarrhea treatment are common in some countries with a high burden of diarrhea-related mortality. These practices can reduce

  16. Effect of a probiotic on prevention of diarrhea and Clostridium difficile and Clostridium perfringens shedding in foals

    DEFF Research Database (Denmark)

    Schoster, Angelika; Staempfli, H R; Abrahams, M

    2015-01-01

    of incidence and duration of diarrhea and fecal shedding of Clostridium perfringens and Clostridium difficile between treatment and age groups. RESULTS: The overall incidence of diarrhea was 41 of 72 (59%) and did not differ (P = 0.37) between treatment groups. Foals treated with probiotics were more likely...... of C. perfringens shedding was 55% with no difference between treatment groups (P = 0.23). The prevalence of C. difficile shedding was 11%. CONCLUSION AND CLINICAL IMPORTANCE: There was no benefit of administering a 3-week course of probiotics, but potential adverse effects were noted. Whether...

  17. Fecal calprotectin concentrations in adult dogs with chronic diarrhea.

    Science.gov (United States)

    Grellet, Aurélien; Heilmann, Romy M; Lecoindre, Patrick; Feugier, Alexandre; Day, Michael J; Peeters, Dominique; Freiche, Valérie; Hernandez, Juan; Grandjean, Dominique; Suchodolski, Jan S; Steiner, Jorg M

    2013-05-01

    To evaluate fecal calprotectin concentrations in healthy dogs and dogs with chronic diarrhea, to identify cutoff values for fecal calprotectin concentrations for use in differentiating dogs with chronic diarrhea and a canine chronic enteropathy clinical activity index (CCECAI) chronic diarrhea and a CCECAI ≥ 12, and to evaluate the association between histologic evidence of intestinal mucosal changes and fecal calprotectin concentrations in dogs with chronic diarrhea. Fecal samples from 96 adult dogs (27 dogs with chronic diarrhea and 69 healthy control dogs). Severity of clinical signs was evaluated on the basis of the CCECAI scoring system. Endoscopy was performed in all dogs with chronic diarrhea, and mucosal biopsy specimens were evaluated histologically. Fecal calprotectin concentration was quantified via radioimmunoassay. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea than in healthy control dogs. Fecal calprotectin concentrations were also significantly higher in dogs with a CCECAI ≥ 12, compared with concentrations for dogs with a CCECAI between 4 and 11. Fecal calprotectin concentrations were significantly higher in dogs with chronic diarrhea associated with histologic lesions, compared with concentrations in control dogs, and were significantly correlated with the severity of histologic intestinal lesions. Among dogs with chronic diarrhea, the best cutoff fecal calprotectin concentration for predicting a CCECAI ≥ 12 was 48.9 μg/g (sensitivity, 53.3%; specificity, 91.7%). Fecal calprotectin may be a useful biomarker in dogs with chronic diarrhea, especially dogs with histologic lesions.

  18. Hypoalbuminemia as a predictor of diarrhea caused by blastocystis hominis.

    Science.gov (United States)

    Laodim, Pongsakorn; Intapan, Pewpan M; Sawanyawisuth, Kittisak; Prasongdee, Thidarat K; Laummaunwai, Porntip; Maleewong, Wanchai

    2013-05-01

    Blastocystis hominis is an intestinal protozoan found worldwide, particularly in developing countries, that may cause gastrointestinal symptoms, including diarrhea. We conducted a hospital-based study to identify clinical factors predictive of diarrhea caused by B. hominis. We studied patients with positive stool samples for B. hominis by formalin ethyl acetate concentration technique at Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand between 2003 and 2010. Patients were divided into diarrhea and non-diarrhea groups. Diarrhea patients were categorized if the diarrhea was associated with B. hominis only. In total, 81 patients with isolated B. hominis infection were studied. Of those, 17 patients (21%) had diarrhea associated with B. hominis infection. Eight variables were included in the final model predicting diarrhea caused by B. hominis on multiple logistic regression analysis. Only serum albumin level was significantly associated with diarrhea cases in this study with an adjusted OR of 0.162 and a 95% CI of 0.027- 0.957. Hypoalbuminemia is associated with diarrhea associated with blastocystosis.

  19. Cryptosporidiosis Among HIV-infected Patients with Diarrhea in Edo State, Midwesten Nigeria

    Directory of Open Access Journals (Sweden)

    Akinbo, F. O.

    2010-01-01

    Full Text Available To determine the prevalence of cryptosporidiosis among HIV infected and HIV non-infected patients with diarrhea in Edo State, Nigeria, as well as the effect of CD4+ lymphocyte count on the prevalence of cryptosporidial infection among the HIV patients. Stool samples were collected from 300 patients consisting of 200 HIV-infected and 100 HIV non-infected patients with diarrhea. Blood samples were collected from the HIV-infected patients. The stool samples were processed to detect Cryptosporidium species using a modified Ziehl-Neelsen stain, as well as other intestinal parasites using saline and iodine preparations. The blood samples were used to determine CD4+ lymphocyte count. The prevalence of intestinal parasites was higher in HIV-infected patients compared with their HIV non-infected counterparts (39% vs 24% respectively, p=0.0097. Cryptosporidiosis was diagnosed only among HIV-infected patients and was the only parasite whose prevalence was significantly different between HIV-infected and HIV non-infected patients. CD4+ lymphocyte count of <200 cells/µL among HIV-infected was a risk factor for acquiring cryptosporidial infection (OR=18.776, 95% CI=6.299, 55.964. A cryptosporidial infection prevalence of 18% among HIV-infected patients was observed and CD4+ count of <200 cells/µL was a risk factor for acquiring the disease. Routine examination of diarrhogenic stools of HIVinfected patients for cryptosporidiosis is advocated.

  20. The Relation between Helicobacter pylori Infection and Acute Bacterial Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    Maryam Monajemzadeh

    2014-01-01

    Full Text Available Background. H. pylori infection leads to chronic gastritis in both children and adults. But recently, there are arising theories of its protective effect in diarrheal diseases. Aim. To explore the prevalence of H. pylori infection in children with bacterial diarrhea and compare it with healthy controls. Patients and Methods. Two matched groups consisted of 122 consecutive children, aged 24–72 months old, with acute bacterial diarrhea, who had Shigellosis (N=68 and Salmonellosis (N=54 as patients group and 204 healthy asymptomatic children as control group enrolled in this study. Results. The prevalence of H. pylori infection in healthy control children was significantly higher than in patients group, (odds ratio = 3.6, 95% CI: 1.33–9.5, P=0.007. In our study, only 2/54 Salmonella infected patients and 3/68 of Shigellosis had evidence of H. pylori infection, while normal control children had 27/204 infected individuals. Conclusion. H. pylori infection may play a protective role against bacterial diarrhea in children. So it is important to consider all of the positive and negative aspects of H. pylori infection before its eradication.

  1. Epidemiological Survey of Group A Rotaviruses Infection among Children under 5 Years with Acute Diarrhea

    Directory of Open Access Journals (Sweden)

    Mohammad Kargar

    2012-08-01

    Full Text Available Background: Rotaviruses are one of the most important causes of acute gastroenteritis and death in children worldwide. WHO suggested hospital based surveillance all over the world in order to evaluate the prevalence of rotavirus diarrhea. This study was conducted to determine the prevalence of rotavirus gastroenteritis in hospitalized children in Shiraz. Materials and Methods: In this study 138 stool samples from children aged 3 loose watery stools per 24 hours, hospitalized at Shaheed Dastgheib and Nemazee hospitals in Shiraz, were collected during 2006-2007. All the stool specimens were evaluated for Group A of rotaviruses with enzyme immunoassays (EIA. Then demographic and clinical data were analyzed by SPSS software.Results: Out of total collected samples rotavirus infection was detected in 48(34.78%. The highest infection rate was among children less than two years old (70.83%. Diarrhea (97.92%, vomiting (77.08% and fever (52.08% were the most frequent reported clinical symptoms in children with rotavirus infection. The highest of isolation of virus was observed in autumn (45.83% and the lowest in spring (8.33% (p=0.012. Also, there was no significant difference between the frequency of the rotavirus diarrhea and the pattern of nutrition (p= 0.236.Conclusion: Regarding to high frequency of rotavirus infection, concurrently surveillance of rotavirus gastroenteritis in other hospitals of Iran is recommended.

  2. Diarrheal Illness and Healthcare Seeking Behavior among a Population at High Risk for Diarrhea in Dhaka, Bangladesh

    Science.gov (United States)

    Chowdhury, Fahima; Khan, Iqbal Ansary; Patel, Sweta; Siddiq, Ashraf Uddin; Saha, Nirod Chandra; Khan, Ashraful I.; Saha, Amit; Cravioto, Alejandro; Clemens, John; Qadri, Firdausi; Ali, Mohammad

    2015-01-01

    Diarrhea remains one of the major causes of death in Bangladesh. We studied diarrheal disease risk and healthcare seeking behavior among populations at high risk for diarrhea in Dhaka, Bangladesh. Data were obtained from a cross-sectional survey conducted during April and September 2010. The prevalence of diarrhea was calculated by age-group and sex. A generalized estimating equation with logit link function was used to predict diarrheal disease risk and seeking care from a professional healthcare provider. Of 316,766 individuals, 10% were young children (Bangladesh. Dissemination of information on health education, increasing the supply of skilled healthcare providers, and low-cost and quality healthcare services may encourage more people to seek care from professional healthcare providers, thus may help reduce child mortality in the country. Further studies are warranted to validate the results. PMID:26121650

  3. Loperamide therapy for acute diarrhea in children: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Su-Ting T Li

    2007-03-01

    Full Text Available BACKGROUND: Loperamide is widely used in adults for acute diarrhea. However, its use in children has been discouraged by the World Health Organization and the American Academy of Pediatrics owing to concerns over safety and efficacy in young children. METHODS AND FINDINGS: To assess the efficacy and adverse effects of loperamide compared with placebo for acute diarrhea in children, we reviewed Medline, EMBase, the Cochrane Central Register of Controlled Trials, and bibliographies of known clinical trials and of review articles, and we also interviewed key investigators in the field. We undertook a systematic review and meta-analysis of randomized controlled trials of children younger than 12 y of age with acute diarrhea, comparing loperamide with placebo. Included trials reported data on diarrhea duration or severity, or provided data on adverse effects. Compared with patients who received placebo, patients allocated to loperamide were less likely to continue to have diarrhea at 24 h (prevalence ratio 0.66, 95% confidence interval [CI]: 0.57 to 0.78, had a shorter duration of diarrhea by 0.8 d (95% CI: 0.7 to 0.9 d, and had a lower count of stools at 24 h (0.84, 95% CI: 0.77 to 0.92. Results were similar when random-effects summaries were estimated. Serious adverse events, defined as ileus, lethargy, or death, were reported in eight out of 927 children allocated to loperamide (0.9%, 95% CI: 0.4% to 1.7%. Serious adverse events were not reported in any of the 764 children allocated to placebo (0%, 95% CI: 0% to 0.5%. Among the children allocated to loperamide, serious adverse events were reported only among children younger than 3 y. CONCLUSIONS: In children who are younger than 3 y, malnourished, moderately or severely dehydrated, systemically ill, or have bloody diarrhea, adverse events outweigh benefits even at doses

  4. [Efficacy of nutrition support therapy in children with chronic diarrhea].

    Science.gov (United States)

    Xu, Luo-Jia; Chen, Jie

    2016-06-01

    To investigate the efficacy of nutrition support therapy in children with chronic diarrhea. A retrospective analysis was performed for the clinical data of 48 children with chronic diarrhea who were hospitalized between July 2012 and July 2014. These children were divided into chronic diarrhea, and 24 children (50%) had unknown causes. In the aspect of nutritional assessment on admission, the diarrhea were relieved after treatment. Among 27 children receiving nutritional therapy, 4 were not improved, and the other children achieved remission of symptoms and improvements in nutritional status. Besides etiological treatment, nutrition support therapy can be applied as part of multimodality therapy in children with chronic diarrhea. This can effectively improve nutritional status and relieve the symptoms of diarrhea.

  5. Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea.

    Science.gov (United States)

    Camilleri, Michael; Sellin, Joseph H; Barrett, Kim E

    2017-02-01

    Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (>4 weeks in duration) are more elusive. We review the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extraepithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in the assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Intestinal coccidia in Cuban pediatric patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Núñez FA

    2003-01-01

    Full Text Available From May to August 1999, we evaluated 401 patients from a pediatric hospital of Havana City. One group was composed of 113 patients with diarrhea admitted to the Gastroenterology ward and a second consisted of 288 patients without diarrhea, admitted for other reasons, and hospitalized within the same time period. Three stool samples were collected from each child and were examined using three parasitological techniques. When we compared the frequency of parasite species between both groups, we found Cryptosporidium spp. and Cyclospora cayetanensis, only in the group of children with diarrhea (P 0.05. In addition, in those children infected with Cryptosporidium, the diarrhea had a more prolonged duration (P < 0.01, while those infected with Cyclospora, the abdominal cramps or pain, and acute diarrhea were more frequently detected (P < 0.01. Our results showed that emerging intestinal coccidia are pathogens strongly associated in this group of children with diarrhea.

  7. Fluorescence in situ hybridization investigation of potentially pathogenic bacteria involved in neonatal porcine diarrhea

    DEFF Research Database (Denmark)

    Jonach, Beata Renata; Boye, Mette; Stockmarr, Anders

    2014-01-01

    pathogens. The microorganisms that for decades have been associated with enteritis and diarrhea in suckling piglets are: rotavirus A, coronavirus, enterotoxigenic Escherichia coli (ETEC), Clostridium perfringens type C, Cryptosporidium spp., Giardia spp., Cystoisospora suis and Strongyloides ransomi...... by common pathogens. The primary aim of this study was to investigate the role of E. coli, Enterococcus spp., C. perfringens and C. difficile in the pathogenesis of neonatal porcine diarrhea with no established casual agents. Fluorescence in situ hybridization with oligonucleotide probes was applied....... Results The prevalence of fluorescence signals specific for E. coli, C. perfringens and C. difficile was similar in both groups of piglets. However, Enterococcus spp. was primarily detected in the diarrheic piglets. Furthermore, adherent bacteria were detected in 37 % diarrheic and 14 % non...

  8. Zinc: Role in the management of diarrhea and cholera

    OpenAIRE

    Qadir, M Imran; Arshad, Arfa; Ahmad, Bashir

    2013-01-01

    Diarrhea and cholera are major health problems. Vibrio cholera, the causative agent of cholera, infects the small intestine, resulting in vomiting, massive watery diarrhea and dehydration. Reduced water and electrolyte absorption is also due to zinc deficiency. Zinc has an important role in recovery from the disease. The combination of zinc with cholera vaccine and oral rehydration solutions has a positive impact on cholera and diarrhea. It has led to a decrease in the mortality and morbidity...

  9. Characteristics of rotavirus diarrhea in hospitalized children in kosovo.

    Science.gov (United States)

    Ismaili-Jaha, Vlora; Shala, Muje; Azemi, Mehmedali; Hoxha-Kamberi, Teuta; Avdiu, Muharrem; Spahiu, Shqipe; Jaha, Luan

    2014-10-01

    Diarrhea is a leading cause of child mortality worldwide. Rotavirus is one of the most common causes of severe diarrhea and dehydration in children. Authors reviewed epidemiological and clinical data of the rotavirus diarrhea in Kosovo. This is a prospective study carried between January 1st and December 31st 2011. All data, comprising demographics, nutrition, clinical presentation, laboratory findings, management and outcome of the rotavirus diarrhea are collected on the specially designed form. 116 children with rotavirus diarrhea are included in the study. The majority boys (74.4%) and children aged 0 - 12 months (82.75%). Mean age of children in the study was 16.38 months. Almost every third child in the study was hypotrophic (29.2%). More than half of the infants (55.2%) were on mixed food, somewhat more than every third was breast feeding (36.45%), and every twelfth (8.33%) was on artificial milk (animal or formula). Apart from diarrhea, present in all patients, vomiting (97.41%) and fever (43.96%) were characteristics of the clinical presentation of the diarrhea. Two thirds of the children had mild grade dehydration (70.7%). All patients recovered with no sequels. Rotavirus continues to be responsible for a significant portion of acute diarrhea in Kosovo. Clinical features, epidemiological data and the agglutination test are safe enough to establish the diagnosis. Treated correctly rotavirus diarrhea has a favorable outcome.

  10. Impact of Diarrhea on the Clinical Presentation and Outcome of Severe Pneumonia in Bangladeshi Children.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Duke, Trevor; Salam, Mohammed Abdus; Shahunja, K M; Shahid, Abu S M S B; Bardhan, Pradip Kumar; Faruque, Abu S G; Ahmed, Tahmeed

    2016-10-01

    We compared clinical presentation and outcome of 225 children with severe pneumonia between those with and those without diarrhea. Having diarrhea was associated with metabolic acidosis (P diarrhea versus 3/112 (3%) without diarrhea. Diarrhea is an important comorbidity in Bangladeshi children with severe pneumonia requiring attention for improved case management.

  11. [Enterohemorrhagic Escherichia coli as the cause of diarrhea in the Czech Republic, 1965-2013].

    Science.gov (United States)

    Marejková, M; Petráš, P

    2014-09-01

    Enterohemorrhagic Escherichia coli (EHEC) is the cause of diarrhea, bloody diarrhea, and haemolytic uremic syndrome (HUS) worldwide. The role of EHEC in the etiology of HUS in the Czech Republic has recently been described, but the prevalence, characteristics, and epidemiology of EHEC causing diarrhea have not been fully known. Therefore, this study analyzed the serotypes, stx genotypes, and virulence factors in EHEC strains isolated in 1965-2013 from patients with diarrhea or bloody diarrhea and their family contacts. In addition, we characterized diagnostically relevant phenotypes of EHEC strains, their antimicrobial susceptibility, seasonal trends, and distribution by administrative region. Serogrouped E. coli isolates from patients were referred to the National Reference Laboratory (NRL) for E. coli and Shigella for the detection of Stx. Specimens of both human and non-human origin were referred to the NRL for epidemiological investigation. Serotyping was performed by conventional and molecular methods, PCR was applied to stx genotyping and identification of non-stx virulence factors, and standard methods were used for phenotypic analysis and antimicrobial susceptibility testing. The epidemiological link between the human and animal isolates was confirmed using pulsed-field gel electrophoresis (PFGE). Of 50 EHEC strains, 24 were recovered from patients with diarrhea without blood, 19 from patients with bloody diarrhea, six from family contacts, and one from an epidemiologically linked animal. EHEC cases were reported during the whole year, with peaks in May through October, most often in the Central Bohemian and Hradec Králové Regions. EHEC outbreaks occurred in three families: in one of them sheep-to-human transmission of EHEC was detected. The EHEC strains were assigned to five serotypes, with more than half of them being non-sorbitol fermenting (NSF) O157:H7/NM[fliCH7] and a third being strains O26:H11/NM[fliCH11]; serotypes O111:NM[fliCH8], O118:NM

  12. Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Shelby E Wilson

    Full Text Available INTRODUCTION: To design effective national diarrhea control programs, including oral rehydration solution (ORS and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices. METHODS: A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥ 3 liquid or semi-liquid stools/day. Multiple logistic regression models were used to examine factors associated with illness recognition and treatment. RESULTS: Clinically defined diarrhea was present in 7.6% (95% CI: 7.1-8.1% of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55% of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area. CONCLUSIONS: Caregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional

  13. Developing a scorecard to assess global progress in scaling up diarrhea control tools: a qualitative study of academic leaders and implementers.

    Directory of Open Access Journals (Sweden)

    Alexander Anthony Rosinski

    Full Text Available BACKGROUND: In 2010, diarrhea caused 0.75 million child deaths, accounting for nearly 12% of all under-five mortality worldwide. Many evidence-based interventions can reduce diarrhea mortality, including oral rehydration solution (ORS, zinc, and improved sanitation. Yet global coverage levels of such interventions remain low. A new scorecard of diarrhea control, showing how different countries are performing in their control efforts, could draw greater attention to the low coverage levels of proven interventions. METHODS: We conducted in-depth qualitative interviews with 21 experts, purposively sampled for their relevant academic or implementation expertise, to explore their views on (a the value of a scorecard of global diarrhea control and (b which indicators should be included in such a scorecard. We then conducted a ranking exercise in which we compiled a list of all 49 indicators suggested by the experts, sent the list to the 21 experts, and asked them to choose 10 indicators that they would include and 10 that they would exclude from such a scorecard. Finally, we created a "prototype" scorecard based on the 9 highest-ranked indicators. RESULTS: Key themes that emerged from coding the interview transcripts were: a scorecard could facilitate country comparisons; it could help to identify best practices, set priorities, and spur donor action; and it could help with goal-setting and accountability in diarrhea control. The nine highest ranking indicators, in descending order, were ORS coverage, rotavirus vaccine coverage, zinc coverage, diarrhea-specific mortality rate, diarrhea prevalence, proportion of population with access to improved sanitation, proportion with access to improved drinking water, exclusive breastfeeding coverage, and measles vaccine coverage. CONCLUSION: A new scorecard of global diarrhea control could help track progress, focus prevention and treatment efforts on the most effective interventions, establish transparency and

  14. Management of acute diarrhea in infants.

    Science.gov (United States)

    Rhoads, M

    1999-01-01

    In 1999, children seen in the emergency room of a developed country for watery diarrhea and dehydration will most likely receive an intravenous infusion of fluid, followed by instructions to give oral rehydration solution (ORS) and clear liquids for a day, followed by half-strength lactose-free formula. In fact, the majority of these children could best be managed with supervised ORS followed by early (within 4-6 h) refeeding of their normal diet, based on large numbers of clinical trials and a meta-analysis. In the next decade, effective therapy in addition to glucose-containing oral rehydration solutions should be available which should reduce diarrheal volume and duration of purging. These include amino acid-supplemented "Super ORSs," ORS with soluble fibers, liquid zinc, and probiotic milks containing bacteria which boost the immune response and reduce stool number. In addition, children wealthy enough to be able to afford the new tetravalent vaccine will be largely protected from dehydrating rotavirus diarrhea, the most common cause of dehydration in infants.

  15. Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Kany-Kany Angelique Luabeya

    2007-06-01

    Full Text Available Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.Randomized, double-blind, controlled trial.Rural community in South Africa.THREE COHORTS: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.Children received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly.Primary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker.Among HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852. Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857. Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts.When compared with vitamin A alone, supplementation with zinc, or with zinc and multiple

  16. Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain.

    Science.gov (United States)

    Talley, Nicholas J; Holtmann, Gerald; Nguyen, Quoc Nam; Gibson, Peter; Bampton, Peter; Veysey, Martin; Wong, James; Philcox, Stephen; Koloski, Natasha; Bunby, Lisa; Jones, Michael

    2017-11-01

    A previous UK study showed that 6.1% of patients with diarrhea-predominant irritable bowel syndrome (IBS-D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEI based on fecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and/or diarrhea and/or IBS-D. Patients aged over 40 years presenting to hospital outpatient clinics from six sites within Australia with unexplained abdominal pain and/or diarrhea for at least 3 months and/or IBS-D were studied. Patients completed validated questionnaires and donated a stool sample in which elastase concentration was measured by ELISA. A concentration of chronic pancreatitis. One in 50 patients with IBS-D or otherwise unexplained abdominal pain or diarrhea have an abnormal fecal elastase, but unexpected pancreatic insufficiency was detected in only a minority of these. This study failed to confirm the high prevalence of PEI among patients with unexplained GI symptoms previously reported. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  17. [Hypokalemia-induced paraplegia secondary to acute diarrhea].

    Science.gov (United States)

    Ortuño Andériz, F; Cabello Clotet, N; de Diego Gamarra, R; Salaverría Garzón, I; Vázquez Rizaldos, S

    2002-02-01

    Hypokalemia can give a variety of syntomatology but more often courses without it or with inespecific clinical manifestations. In our enviroment the etiology of hypokalemia is wide but one of the most common causes in third world countries are diarrheas. We describe a case of severe hypokalemia due to acute diarrhea which was manifested with severe neurologic symtoms but improves with conventional treatment.

  18. Predictors of under-five childhood diarrhea: Mecha District, West ...

    African Journals Online (AJOL)

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    regression analyses were undertaken to identify predictors of childhood diarrhea. Results: The ... Maternal education (AOR=5.6, 95% CI: 1.5 - 19.4), maternal history of recent diarrhea (AOR, 5.5; 95% CI, 2.9 - 9.8), ..... compared to early rainy season, and a limitation to the ... health in Mexico Demographic and Health Survey.

  19. Maternal Education and Diarrhea among Children aged 0-24 ...

    African Journals Online (AJOL)

    USER

    Chronic diarrhea can affect children of any age but its occurrence varies across childhood period. In this study, children aged between 7 and. 18 months were found to experience higher occurrence of diarrhea than those below 7 months and those above 18 months. This pattern could be explained that this age range is the ...

  20. Myths, experiences and home management of childhood diarrhea ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major threat to child survival due to its devastating complication of dehydration. Several home remedies inclusive of oral rehydration therapy have benefited many people. This study assessed nursing mothers' knowledge and experiences of home management of childhood diarrhea. Methodology: ...

  1. Diarrhea after laparoscopic cholecystectomy: Associated factors and predictors

    Directory of Open Access Journals (Sweden)

    Tuan-Pin Yueh

    2014-10-01

    Conclusion: We advise patients who have undergone laparoscopic cholecystectomy to follow a low-fat diet for at least 1 week to reduce the possibility of diarrhea, especially when they are ≤45 years of age, of male sex, and had a high preoperative tendency for diarrhea.

  2. Recurrent diarrhea associated with enterotoxigenic Clostridium perfringens in 2 dogs.

    OpenAIRE

    Weese, J. S.; Greenwood, S J; Staempfli, H.R.

    2001-01-01

    Two dogs were diagnosed with enterotoxigenic Clostridium perfringens-associated diarrhea. Diarrhea was responsive to antimicrobial therapy, but recurred after treatment was ceased. Clostridium perfringens enterotoxin was present in feces during diarrheic episodes but not when feces were normal. Both dogs responded to a prolonged course of oral cephalexin and dietary modification.

  3. Incomplete carbohydrate absorption from fruit juice consumption after acute diarrhea

    OpenAIRE

    Ribeiro Jr, Hugo; Ribeiro, Tereza Cristina; Valois, Sandra; Mattos, Angela; Lifshitz, Fima

    2001-01-01

    Texto completo: acesso restrito. p. 325–327 We carried out a double-blind, randomized study in 60 children with acute diarrhea to determine their capacity to tolerate commonly consumed fruit juices. Feedings of juice with high fructose/glucose ratios and sorbitol resulted in incomplete carbohydrate absorption and recurrence of diarrhea during the phase immediately after improvement of the illness.

  4. Management of VIP Associated Diarrhea in a Case with Neuroblastoma

    Directory of Open Access Journals (Sweden)

    Begul Yagci-Kupeli

    2013-06-01

    Full Text Available Watery diarrhea associated with hypokalemia and achlorhydria (WDHA syndrome is commonly caused by vasoactive intestinal peptide (VIP secreting tumors in adults and generally associated with neural crest tumors in pediatric population. VIP secretion is associated with neuroblastic cell differentiation. Octreotide treatment can be a choice for diarrhea in such cases. However, its benefit is controversial and surgery is usually needed. A 14-month-old female with diagnosis of inoperable undifferantiated intraabdominal neuroblastoma who developed chronic diarrhea at first year of chemotherapy is reported. Octreotide treatment was used to control diarrhea. Because of the failure of octreotide treatment, debulking surgery was performed and diarrhea subsided after the surgery. [Cukurova Med J 2013; 38(3.000: 528-530

  5. Occurrence of acute respiratory infection, diarrhea and jaundice among Afghan pilgrims, 2010.

    Science.gov (United States)

    Saeed, Khwaja Mir Islam; Mofleh, Jawad; Rasooly, M Hafiz; Aman, M Iabal

    2012-12-01

    Annually 30,000 Afghans attend the Hajj in Saudi Arabia that is one of the largest mass gathering events in the world. We aimed to determine the prevalence of three syndromes of interest diarrhea, acute respiratory infections (ARI) and jaundice-among Hajjis gathering at the four transit sites in Afghanistan before, during, and after their voyage. A total of 1659 Hajjis at four transit sites were selected and included a cross-sectional study. Information was collected prior Hajjis departure and upon their return from Saudi Arabia regarding demographics and experience of diarrhea, ARI and jaundice. Standardized case definitions were used for the three health outcomes of interest. The occurrence of diarrhea and jaundice remained constant over time. However, ARI increased from 1.4% at pre-transit to 4% at transit area and 37% during the Hajj. ARI rates among residents from the Central and Northern regions of Afghanistan were significantly higher at the post-Hajj stage, at 50% and 69%, respectively. There was no difference in ARI by sex among Hajjis. There is a need to review the quality and effectiveness of the flu vaccine. Authorities should come up with the sound strategies to overcome ARI problems during Hajj. Copyright © 2012 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  6. Group A rotavirus-associated diarrhea in children seeking treatment in Indonesia.

    Science.gov (United States)

    Putnam, Shannon D; Sedyaningsih, Endang R; Listiyaningsih, Erlin; Pulungsih, Sri Pandam; Komalarini; Soenarto, Yati; Salim, Octavianus Ch; Subekti, Decy; Riddle, Mark S; Burgess, Timothy H; Blair, Patrick J

    2007-12-01

    Globally, group A rotavirus causes significant morbidity and mortality among children. Limited data exist on the epidemiology of rotavirus disease among Indonesian children. We describe the epidemiology of rotavirus-associated diarrhea among Indonesian children Rotavirus positivity was defined by a positive result from either EIA or RT-PCR. A semi-nested RT-PCR was used to determine specific rotavirus genotypes. 1660 stools were tested for pathogens. The overall rotavirus prevalence was 45.5%. Children with rotavirus-associated diarrhea were significantly younger (protavirus included, vomiting, fever, nausea, fatigue and dehydration, while bloody stool was significantly less common with rotavirus-associated diarrhea. Rotavirus was an important contributor of morbidity to our study sample. Rotavirus genotyping demonstrated a temporal shift from G1-G4 to G9, but this was highly associated with the P[8] gene, suggesting that a multivalent rotavirus vaccine, incorporating G9 P[8] antigen, may reduce the burden of diarrheal illnesses among Indonesian children.

  7. Profile of crofelemer for the symptomatic treatment of diarrhea in HIV-infected persons

    Directory of Open Access Journals (Sweden)

    Leonard C

    2015-01-01

    Full Text Available Christina Leonard,1 Poorvi Chordia,1 Rodger D MacArthur1,2 1Department of Infectious Diseases, Wayne State University, Detroit, MI, USA; 2Newland Immunology Center of Excellence, Southfield, MI, USAAbstract: Diarrhea due to noninfectious causes is a major problem in human immunodeficiency virus (HIV-infected persons, and is frequently related to antiretroviral therapy and HIV-associated enteropathy. Crofelemer is a first-in-class antidiarrheal agent that is United States Food and Drug Administration approved for noninfectious diarrhea in persons with HIV on antiretroviral therapy. Crofelemer is derived from the blood-red sap of Croton lechleri, a South American plant whose latex is associated with various healing attributes. In fact, it has a unique effect on chloride channels in the gastrointestinal lumen, and leads to decreased efflux of sodium molecules and water, thereby decreasing the frequency of stools. Crofelemer – a plant-based compound, discovered and investigated as the result of the increased prevalence of ethnobotany – is a novel and effective agent with a good safety profile. It could potentially improve the quality of life for HIV-infected patients and hopefully, in turn, will improve antiretroviral therapy compliance.Keywords: chloride channels, secretory diarrhea, botanical, sangre de grado, intra-luminal

  8. Does Childhood Diarrhea Influence Cognition Beyond the Diarrhea-Stunting Pathway?

    Science.gov (United States)

    2012-10-31

    1969–1987. 2. Guerrant RL, Oria RB, Moore SR, Oria MO, Lima AA (2008) Malnutrition as an enteric infectious disease with long-term effects on child ... Child Health Epidemiology Reference Group (CHERG). The participation of Dr. Lescano in this project is sponsored by the training grant NIH/FIC 2D43...of morbidity and mortality among children under 5 years of age in low- and middle-income countries [1]. While the most severe diarrhea sequela, child

  9. Allegheny County Address Points

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains address points which represent physical address locations assigned by the Allegheny County addressing authority. Data is updated by County...

  10. Molecular characterization of rotavirus isolated from alpaca (Vicugna pacos) crias with diarrhea in the Andean Region of Cusco, Peru.

    Science.gov (United States)

    Garmendia, Antonio E; Lopez, Wellington; Ortega, Nastassja; Chamorro, Marycris J

    2015-10-22

    Alpacas (Vicugna pacos), a species of South American camelids (SAC), suffer high morbidity and mortality from infectious diseases. Diarrhea is one of the leading causes of alpaca cria mortality in Peru and elsewhere. In order to develop appropriate control and/or treatment, it is necessary to identify infectious pathogens that cause diarrhea in crias. Rotavirus was isolated in cell culture from feces collected from crias with acute diarrhea that tested positive to rotaviral antigen by rapid immunochromatographic methods in an earlier study. The isolates were identified as rotaviruses by RT-PCR run with specific primers for human rotavirus VP7 coding sequences using total RNA extracted from cells displaying cytopathic effects as template. These alpaca isolates were further identified as group A rotaviruses by means of a VP6-specific PCR and were designated as ALRVA-K'ayra/Perú/3368-10 and ALRVA-K'ayra/Perú/3386-10. Molecular G and P typing, placed the former as G3/P11 and the latter as G3/P?. Sequence analysis of two genome segments (coding for VP4 and VP7) from the alpaca isolates revealed partial homologies to swine and human rotaviruses, respectively. These results demonstrate that rotaviruses are associated with a proportion of cases of diarrhea in crias, although prevalence and impact remain to be determined. The isolation of rotaviruses from alpaca crias with diarrhea will contribute positively to further understand the pathogen and its role in the diarrhea complex. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Oral immunoglobulin for the treatment of rotavirus diarrhea in low birth weight infants.

    Science.gov (United States)

    Pammi, Mohan; Haque, Khalid N

    2011-10-05

    were reported: All cause mortality during hospital stay, mortality due to rotavirus infection during hospital stay, duration of diarrhea, need for rehydration, duration of viral excretion, duration of infection control measures, length of hospital stay in days, recurrent diarrhea or chronic diarrhea The two reviewers were to independently abstract data from eligible trials. No data were available for analysis. No eligible randomized controlled trials were found. No randomized controlled trials that assessed the effectiveness or safety of oral immunoglobulin preparations for the treatment of rotavirus diarrhea in hospitalized low birth weight infants were found. Clinical trials that address the issue of oral immunoglobulin treatment of rotavirus infection are needed.

  12. Chronic Diarrhea Associated with High Teriflunomide Blood Concentration.

    Science.gov (United States)

    Duquette, André; Frenette, Anne Julie; Doré, Maxime

    2016-06-01

    To report the case of a patient treated with leflunomide that presented with chronic diarrhea associated with high teriflunomide blood concentration. An 84-year-old woman taking leflunomide 20 mg once daily for the past 2 years to treat rheumatoid arthritis (RA) was investigated for severe chronic diarrhea that had been worsening for the past 5 months. The patient's general condition progressively deteriorated and included electrolyte imbalances and a transient loss of consciousness. Therefore, hospitalization was required. Teriflunomide blood concentration was 156 mg/L. After 11 days of cholestyramine washout therapy, teriflunomide blood concentration was reduced to 6 mg/L. As the teriflunomide levels decreased, diarrhea improved. All other possible causes of diarrhea were ruled out. The patient's diarrhea finally resolved 26 days after treatment with cholestyramine. Diarrhea is a known adverse effect of leflunomide. In this report, the severe diarrhea was associated with high blood teriflunomide concentrations. Available data suggests an association between teriflunomide concentrations greater than 50 mg/L and lower disease activity, but toxic teriflunomide levels still have to be clarified. Further studies are needed to establish the optimal therapeutic levels of teriflunomide. However, therapeutic drug monitoring of teriflunomide blood concentrations may be helpful to improve effectiveness and to prevent toxicity in patients taking leflunomide for RA, particularly in those with suboptimal therapeutic response to leflunomide or in patients with toxicity suspected to be induced by leflunomide.

  13. Burden of Rotavirus Diarrhea in Under five Indian Children.

    Science.gov (United States)

    Kumar, Ashok; Basu, Sriparna; Vashishtha, Vipin; Choudhury, Panna

    2016-07-08

    Rotavirus is the most common cause of severe diarrhea in infants and young children worldwide. The burden of rotavirus diarrhea in Indian children is not well established. The present study reviewed the epidemiology of rotavirus diarrhea in hospitalized children and in the community, molecular serotyping and under-five mortality caused by rotavirus diarrhea. Publications, reporting rotavirus diarrhea in Indian children, were retrieved through a systematic search of databases including Medline, PubMed, IndMed, websites of WHO, UNICEF, National Family Health Survey, Ministry of Health and Family Welfare, and Government of India. Human studies in English language were included. Age group selected was 0 month to 5 years. No restrictions were applied in terms of study design and time frame. Stool sample positivity varied from 4.6% in Kolkata to 89.8% in Manipur, among hospitalized children, and from 4% in Delhi to 33.7% in Manipur in community. Most cases of rotavirus diarrhea in India are caused by G1, G2, and G untypeable strains with distinct regional variations. Rotavirus was identified as an etiological agent in 5.2 to 80.5% cases of nosocomial diarrhea. Data are lacking for rotavirus mortality.

  14. Efficacy and safety of Saccharomyces boulardii for acute diarrhea.

    Science.gov (United States)

    Feizizadeh, Sahar; Salehi-Abargouei, Amin; Akbari, Vajihe

    2014-07-01

    The efficacy of Saccharomyces boulardii for treatment of childhood diarrhea remains unclear. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhea. Our data sources included Medline, Embase, CINAHL, Scopus, and The Cochrane Library up to September 2013 without language restrictions. Randomized controlled trials and non-randomized trials that evaluated effectiveness of S. boulardii for treatment of acute diarrhea in children were included. Two reviewers independently evaluated studies for eligibility and quality and extracted the data. In total, 1248 articles were identified, of which 22 met the inclusion criteria. Pooling data from trials showed that S. boulardii significantly reduced the duration of diarrhea (mean difference [MD], -19.7 hours; 95% confidence interval [CI], -26.05 to -13.34), stool frequency on day 2 (MD, -0.74; 95% CI, -1.38 to -0.10) and day 3 (MD, -1.24; 95% CI, -2.13 to -0.35), the risk for diarrhea on day 3 (risk ratio [RR], 0.41; 95% CI, 0.27 to 0.60) and day 4 (RR, 0.38; 95% CI, 0.24 to 0.59) after intervention compared with control. The studies included in this review were varied in the definition of diarrhea, the termination of diarrhea, inclusion and exclusion criteria, and their methodological quality. This review and meta-analysis show that S. boulardii is safe and has clear beneficial effects in children who have acute diarrhea. However, additional studies using head-to-head comparisons are needed to define the best dosage of S. boulardii for diarrhea with different causes. Copyright © 2014 by the American Academy of Pediatrics.

  15. Antirotavirus immunoglobulin A neutralizes virus in vitro after transcytosis through epithelial cells and protects infant mice from diarrhea.

    Science.gov (United States)

    Ruggeri, F M; Johansen, K; Basile, G; Kraehenbuhl, J P; Svensson, L

    1998-04-01

    Rotaviruses are the major cause of severe diarrhea in infants and young children worldwide. Due to their restricted site of replication, i.e., mature enterocytes, local intestinal antibodies have been proposed to play a major role in protective immunity. Whether secretory immunoglobulin A (IgA) antibodies alone can provide protection against rotavirus diarrhea has not been fully established. To address this question, a library of IgA monoclonal antibodies (MAbs) previously developed against different proteins of rhesus rotavirus was used. A murine hybridoma "backpack tumor" model was established to examine if a single MAb secreted onto mucosal surfaces via the normal epithelial transport pathway was capable of protecting mice against diarrhea upon oral challenge with rotavirus. Of several IgA and IgG MAbs directed against VP8 and VP6 of rotavirus, only IgA VP8 MAbs (four of four) were found to protect newborn mice from diarrhea. An IgG MAb recognizing the same epitope as one of the IgA MAbs tested failed to protect mice from diarrhea. We also investigated if antibodies could be transcytosed in a biologically active form from the basolateral domain to the apical domain through filter-grown Madin-Darby canine kidney (MDCK) cells expressing the polymeric immunoglobulin receptor. Only IgA antibodies with VP8 specificity (four of four) neutralized apically administered virus. The results support the hypothesis that secretory IgA antibodies play a major role in preventing rotavirus diarrhea. Furthermore, the results show that the in vivo and in vitro methods described are useful tools for exploring the mechanisms of viral mucosal immunity.

  16. QUALITY OF LIFE IN CHILDREN WITH CHRONIC DIARRHEA

    Directory of Open Access Journals (Sweden)

    F.F. Zhvaniya

    2009-01-01

    Full Text Available The results of evaluation of quality of life in children from 1 to 3 years old with chronic diarrhea in exacerbation or remission with QUALIN questionnaire is presented in this article. Authors used two types of questionnaire: doctors' and parents'. Obtained data was compared to indices of healthy children. Proved, that children in early age with chronic diarrhea, as in exacerbation, as in remission, have significantly lower rates of quality of life compared to healthy coevals.Key words: children, quality of life, QUALIN questionnaire, chronic diarrhea.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:16-19

  17. Assessing the Association between Thermotolerant Coliforms in Drinking Water and Diarrhea: An Analysis of Individual–Level Data from Multiple Studies

    Science.gov (United States)

    Hodge, James; Chang, Howard H.; Boisson, Sophie; Collin, Simon M.; Peletz, Rachel; Clasen, Thomas

    2016-01-01

    Background: Fecally contaminated drinking water is believed to be a major contributor to the global burden of diarrheal disease and a leading cause of mortality among young children. However, recent systematic reviews and results from blinded studies of water quality interventions have raised questions about the risk associated with fecally contaminated water, particularly as measured by thermotolerant coliform (TTC) bacteria, a WHO-approved indicator of drinking water quality. Objectives: We investigated the association between TTC in drinking water and diarrhea using data from seven previous studies. Methods: We obtained individual-level data from available field studies that measured TTC levels in household-drinking water and reported prevalence of diarrhea among household members during the days prior to the visit. Results: The combined data set included diarrhea prevalence for 26,518 individuals and 8,000 water samples from 4,017 households, yielding 45,052 observations. The odds of diarrhea increased for each log10 increase in TTC/100 mL by 18% (95% CI: 11, 26%) for children 1,000 TTC/100 mL, respectively compared to coliforms in drinking water and diarrhea: an analysis of individual level data from multiple studies. Environ Health Perspect 124:1560–1567; http://dx.doi.org/10.1289/EHP156 PMID:27164618

  18. Assessing the Association between Thermotolerant Coliforms in Drinking Water and Diarrhea: An Analysis of Individual-Level Data from Multiple Studies.

    Science.gov (United States)

    Hodge, James; Chang, Howard H; Boisson, Sophie; Collin, Simon M; Peletz, Rachel; Clasen, Thomas

    2016-10-01

    Fecally contaminated drinking water is believed to be a major contributor to the global burden of diarrheal disease and a leading cause of mortality among young children. However, recent systematic reviews and results from blinded studies of water quality interventions have raised questions about the risk associated with fecally contaminated water, particularly as measured by thermotolerant coliform (TTC) bacteria, a WHO-approved indicator of drinking water quality. We investigated the association between TTC in drinking water and diarrhea using data from seven previous studies. We obtained individual-level data from available field studies that measured TTC levels in household-drinking water and reported prevalence of diarrhea among household members during the days prior to the visit. The combined data set included diarrhea prevalence for 26,518 individuals and 8,000 water samples from 4,017 households, yielding 45,052 observations. The odds of diarrhea increased for each log10 increase in TTC/100 mL by 18% (95% CI: 11, 26%) for children 1,000 TTC/100 mL, respectively compared to coliforms in drinking water and diarrhea: an analysis of individual level data from multiple studies. Environ Health Perspect 124:1560-1567; http://dx.doi.org/10.1289/EHP156.

  19. Bottleneck analysis and strategic planning using Tanahashi model for childhood diarrhea management in Gujarat, Western India.

    Science.gov (United States)

    Rupani, Mihir Prafulbhai; Gaonkar, Narayan T; Bhatt, Gneyaa S

    2016-10-01

    In spite of continued efforts, India is still lagging behind in achieving its MDG goals. The objectives of this study were to identify stake-holders who have a role to play in childhood diarrhea management, to identify gaps in childhood diarrhea management and to propose strategic options for relieving these gaps. Bottleneck analysis exercise was carried out based on the Tanahashi model in six High Priority Districts (HPDs) of Gujarat in period between July-November 2013. The major bottlenecks identified for Childhood Diarrhea management were poor demand generation, unsafe drinking water, poor access to improved sanitation facility and lack of equitable distribution and replenishment mechanisms for Oral Rehydration Solution (ORS) packets and Zinc tablets till the front-line worker level. The main strategic options that were suggested for relieving these bottlenecks were Zinc-ORS roll out in scale-up districts, develop Information Education Communication/Behaviour Change Communication (IEC/BCC) plan for childhood diarrhea management at state/district level, use of Drug Logistics Information Management System (DLIMS) software for supply chain management of Zinc-ORS, strengthening of chlorination activity at household level, monitoring implementation of Nirmal Bharat Abhiyaan (NBA) for constructing improved sanitation facilities at household level and to develop an IEC/BCC plan for hygiene promotion and usage of sanitary latrines. Use of Zinc tablets need to be intensified through an effective scale-up. Adequate demand generation activity is needed. There is need to address safe drinking water and improved sanitation measures at household levels. Multi-sectoral engagements and ownership of Zinc-ORS program is the need of the hour. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. [Travel diarrhea: attempt at a clinical-epidemiologic evaluation].

    Science.gov (United States)

    Kollaritsch, H; Kremsner, P G; Tobisch, P; Ambrosch, F; Stemberger, H

    1987-06-30

    Traveller's diarrhea is the most common tourist's disease in the tropics. Therefore epidemiological data for the evaluation of factors influencing the attack rates and the severity of the disease are being required. This paper deals with the data of 1058 Austrian tourists travelling to warm climate countries. 47.3% of all travellers suffered from an episode of traveller's diarrhea during their stay. However, it could be evaluated that besides the destination seasonal influences were very important. Factors like individual hygiene and accommodation did not influence the attack rates. Age and environmental conditions, however, did partially influence the frequency of diarrhea. Furthermore, additional symptoms were interpreted and it could be seen that suspected heterogenicity of etiology leads to a similar pattern of clinical symptoms. Clinical evaluation proves that traveller's diarrhea is commonly not severe, but due to the incidence and duration of the disease it is a major health problem in modern tourism.

  1. Adenovirus Infection in Children with Diarrhea Disease in ...

    African Journals Online (AJOL)

    Ad40) and type 41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was conducted to delineate the epidemiological features of adenoviruses identified in children with gastroenteritis in Northwestern Nigeria.

  2. Rotavirus Disease Mechanisms Diarrhea, Vomiting and Inflammation : How and Why

    OpenAIRE

    Hagbom, Marie

    2015-01-01

    Rotavirus infections cause diarrhea and vomiting that can lead to severe dehydration. Despite extensive tissue damage and cell death, the inflammatory response is very limited. The focus of this thesis was to study pathophysiological mechanisms behind diarrhea and vomiting during rotavirus infection and also to investigate the mechanism behind the limited inflammatory response. An important discovery in this thesis was that rotavirus infection and the rotavirus toxin NSP4 stimulate release of...

  3. Digestive Disorders in Children with Antibiotic-Associated Diarrhea

    Directory of Open Access Journals (Sweden)

    O.A. Radutna

    2016-08-01

    Full Text Available Introduction. The most notable problem of the widespread use of antibiotics is the changes in microbial ecology, imbalance of intestinal biocenosis, the appearance of antibiotic-resistant strains of microorganisms with pathogenic properties and due to this the pathological changes in the intestine that cause symptoms of digestive disorders in patients with antibiotic-associated diarrhea. Objective. To identify the symptoms of malabsorption in order to improve early diagnosis of antibiotic-associated diarrhea in children. Materials and methods. The object of the study were 116 patients treated with antibiotics, aged 6 months to 18 years. The examination of children included clinical, biochemical, bacteriological, immunoenzyme, immunochromatographic, instrumental, mathematical methods. Results. In the development of diarrhea in patients with negative test on clostridial toxins, such cases were qualified as idiopathic antibiotic-associated diarrhea, with positive — like intestinal Clostridium difficile infection. The study revealed significant differences in scatological indices between the children with acute idiopathic and antibiotic-associated diarrhea caused by clostridial infection. During microscopic and biochemical studies of feces, we have revealed symptomatic signs of impaired digestion and absorption of fats and carbohydrates, which manifested by clinical symptoms of malabsorption. All children with antibiotic-associated diarrhea are characterized by increased concentrations of carbohydrates in feces. Signs of digestive disorders with the development of malabsorption of lipids were detected n children with antibiotic-associated diarrhea, primarily caused by Clostridium difficile infection. Conclusions. Maldigestion and lipid and carbohydrate absorption, as well as symptoms of inflammation in the intestines (leukocytes, occult blood, mucus are the markers of antibiotic-associated diarrhea and can be used for its early diagnosis

  4. Congenital chloride diarrhea: a review of twelve Arabian children

    OpenAIRE

    Elrefae, Fawaz; Elhassanien, Ahmed Farag; Alghiaty, Hesham Abdel-Aziz

    2013-01-01

    Fawaz Elrefae,1 Ahmed Farag Elhassanien,2 Hesham Abdel-Aziz Alghiaty3 1Pediatric Gastroenterology, Al-Adan Hospital, Kuwait; 2Faculty of Medicine, Elmansoura University, El Mansoura, El Dakahleya, Egypt; 3Faculty of Medicine, Benha University, Egypt Background: Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. Objective: To spo...

  5. Management of VIP Associated Diarrhea in a Case with Neuroblastoma

    OpenAIRE

    Begul Yagci-Kupeli; Ali Varan; Turan Bayhan; Hulya Demir; Munevver Buyukpamukcu

    2013-01-01

    Watery diarrhea associated with hypokalemia and achlorhydria (WDHA) syndrome is commonly caused by vasoactive intestinal peptide (VIP) secreting tumors in adults and generally associated with neural crest tumors in pediatric population. VIP secretion is associated with neuroblastic cell differentiation. Octreotide treatment can be a choice for diarrhea in such cases. However, its benefit is controversial and surgery is usually needed. A 14-month-old female with diagnosis of inoperable undiffe...

  6. License Address List

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Address list generated from National Saltwater Angler Registry. Used in conjunction with an address-based sample as per survey design.

  7. Effects of source- versus household contamination of tubewell water on child diarrhea in rural Bangladesh: a randomized controlled trial.

    Science.gov (United States)

    Ercumen, Ayse; Naser, Abu Mohd; Unicomb, Leanne; Arnold, Benjamin F; Colford, John M; Luby, Stephen P

    2015-01-01

    Shallow tubewells are the primary drinking water source for most rural Bangladeshis. Fecal contamination has been detected in tubewells, at low concentrations at the source and at higher levels at the point of use. We conducted a randomized controlled trial to assess whether improving the microbiological quality of tubewell drinking water by household water treatment and safe storage would reduce diarrhea in children water for fecal contamination, and record caregiver-reported child diarrhea prevalence (primary outcome). To assess reporting bias, we also collected data on health outcomes that are not expected to be impacted by our interventions. Both interventions had high uptake. Safe storage, alone or combined with chlorination, reduced heavy contamination of stored water. Compared to controls, diarrhea in index children was reduced by 36% in the chlorine plus safe storage arm (prevalence ratio, PR = 0.64, 0.55-0.73) and 31% in the safe storage arm (PR = 0.69, 0.60-0.80), with no difference between the two intervention arms. One limitation of the study was the non-blinded design with self-reported outcomes. However, the prevalence of health outcomes not expected to be impacted by water interventions did not differ between study arms, suggesting minimal reporting bias. Safe storage significantly improved drinking water quality at the point of use and reduced child diarrhea in rural Bangladesh. There was no added benefit from combining safe storage with chlorination. Efforts should be undertaken to implement and evaluate long-term efforts for safe water storage in Bangladesh. ClinicalTrials.gov NCT01350063.

  8. Rotavirus genotypes associated with acute diarrhea in Egyptian infants.

    Science.gov (United States)

    Ahmed, Salwa F; Mansour, Adel M; Klena, John D; Husain, Tupur S; Hassan, Khaled A; Mohamed, Farag; Steele, Duncan

    2014-01-01

    Before the introduction of rotavirus vaccine in Egypt, information on the burden of disease and the circulating rotavirus genotypes is critical to monitor vaccine effectiveness. A cohort of 348 Egyptian children was followed from birth to 2 years of age with twice-weekly home visits to detect diarrheal illness. VP7 and VP4 genes were genotyped by reverse-transcription polymerase chain reaction and DNA sequencing. Forty percentage of children had rotavirus-associated diarrhea at least once by their second birthday. One hundred and twelve children experienced a single rotavirus diarrheal episodes (RDE) at a median age of 9 months; while 27 infants had their second RDE at a median age of 15 months and 1 infant had 3 RDE at the age of 2, 16 and 22 months. Of the 169 RDE, 82% could be assigned a G-type, while 58% had been identified a P-type. The most prevalent genotype was G2 (32%), followed by G1 (24%) and G9 (19%). G2P[4] rotavirus episodes were significantly associated with fever (P = 0.03) and vomiting (P = 0.06) when compared with other genotypes. G2 strains were the predominant genotype causing 50% of the second RDE while G9 represented 25% of the second RDE. Genotypes identified are similar to those detected globally except for absence of G4. Our finding that 75% of the second RDE were due to G2 and G9 indicates a possible reduction in natural protection afforded by these types compared with G1, where 90% of G1 cases did not experience a second xposure, indicating greater protection against recurrent symptomatic infection.

  9. Molecular diversity of bovine viral diarrhea virus in uruguay.

    Science.gov (United States)

    Maya, L; Puentes, R; Reolón, E; Acuña, P; Riet, F; Rivero, R; Cristina, J; Colina, R

    2016-03-01

    Bovine viral diarrhea (BVD) affects bovine production and reproduction causing significant economic losses all over the world. Two viral species has been recognized: BVDV-1 and BVDV-2, both distributed worldwide. Recently, novel specie of BVDV named HoBi-like pestivirus was discovered. The presence of BVDV was confirmed in 1996 in Uruguay, however, does not exist until today a schedule of compulsory vaccination along the country. Serological studies with samples from all Uruguayan herds were performed during 2000 and 2001 demonstrating that all of them were seropositive to BVDV with a mean prevalence of 69%. In addition, there have been no new studies done since those previously described and it is important to mention that the genetic diversity of BVD has never been described in Uruguay. Nowadays, there is strongly suspect that BVDV is one of the most important causes of reproductive failures in our herds. The aim of this study was to describe for the first time in Uruguay the genetic diversity of BVDV with samples collected from different regions along the country. Serological status of 390 non-vaccinated animals against BVDV with reproductive problems from farms of Rivera, Tacuarembó and Florida departments of Uruguay were studied. All herds were seropositive to BVDV and high proportion of animals were positive (298/390), while 4.1% (16/390) of the animals were positive to Antigen Capture ELISA test and Real Time PCR. Phylogenetic analysis performed with concatenated sequences from the 5'UTR and Npro genomic regions revealed that BVDV-1 and BVDV-2 are infecting our herds, being BVDV-1 the most frequently found. The major subtype was BVDV-1a, followed by BVDV-1i and BVDV-2b. This is the first study that describes the genetic diversity of BVDV in Uruguay and it will contribute to the elaboration of sanitization programs.

  10. Diagnostic utility of abdominal ultrasonography in dogs with chronic diarrhea.

    Science.gov (United States)

    Leib, M S; Larson, M M; Grant, D C; Monroe, W E; Troy, G C; Panciera, D L; Rossmeisl, J H; Werre, S R

    2012-01-01

    Chronic diarrhea is common in dogs and has many causes. Ultrasonographic descriptions of many gastrointestinal diseases have been published, but the diagnostic utility of ultrasonography in dogs with chronic diarrhea has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. 87 pet dogs with chronic diarrhea. Prospective study in which medical records were reviewed and contribution of abdominal ultrasound toward making diagnosis was scored. In 57/87 (66%) of dogs, the same diagnosis would have been reached without ultrasonography. In 13/87 (15%) of dogs, the ultrasound examination was vital or beneficial to making the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with weight loss (P = .0086), palpation of an abdominal or rectal mass (P = .0031), diseases that commonly have mass lesions visible on ultrasound examination (P diarrhea, were identified. Overall, the diagnostic utility of abdominal ultrasonography was low in dogs with chronic diarrhea. Identification of factors associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic diarrhea. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  11. [Chronic, non-infectious diarrhea: diagnostics and therapy].

    Science.gov (United States)

    Ulbricht, Korinna; Layer, Peter; Andresen, Viola

    2016-09-01

    Chronic, non-infectious diarrhea can be caused by a variety of gastrointestinal diseases. In anamnesis, it is important to take accompanying warning symptoms and specific triggers into account. The fecal inflammatory marker calprotectin may help differentiating between organic and functional gastrointestinal disorders, but it is not specific. Among other options, gelling fibres, Loperamide and Cholestyramine as well as probiotics are available for the symptomatic treatment of chronic diarrhea. For long-term treatment of chronic diarrhea with the enkephalinase inhibitor racecadotril, which is approved for acute diarrhea, only limited data are available. Eluxadolin presents a new therapeutic option. It can alleviate abdominal pain and diarrhea by modulation of opioid receptors in the enteric nervous system. Additional approaches in intractable irritable bowel syndrome with diarrhea (IBS-D) include 5-HT3 receptor antagonists, the antibiotic Rifaximin as well as low-dose tricyclic antidepressants. Specific diets such as the low-FODMAP diet can also relieve symptoms in IBS. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Seroprevalence of bovine viral diarrhea virus in crossbred dairy cattle in Bangladesh

    Science.gov (United States)

    Uddin, Mohammed Arif; Ahasan, A. S. M. Lutful; Islam, Kamrul; Islam, Md. Zohorul; Mahmood, Altaf; Islam, Ariful; Islam, Kazi Muhammad Fakhrul; Ahad, Abdul

    2017-01-01

    Aim: The study was conducted to determine the seroprevalence of bovine viral diarrhea virus (BVDV) and hematological features in crossbred dairy cattle in Chittagong, Bangladesh. Materials and Methods: The antibody against BVDV in crossbred dairy cattle serum was detected by indirect enzyme-linked immunosorbent assay. The association of different categorical variables in the prevalence of BVDV has been studied. Blood samples were collected and analyzed to know the hematological variations in the study population. Results: The overall seroprevalence of BVDV in the study area was 51.1% (95% confidence interval [CI], 40.5-61.5). Among different physiological stages of animals, the highest 57.1% (95% CI, 42.2-71.2) prevalence was in case of non-pregnant animals. Aborted cows were found to be significantly (pproduction industry. Therefore, it is necessary to conduct effective control measures to reduce the burden of BVDV. PMID:28919681

  13. Cryptosporidium, Enterocytozoon, and Cyclospora Infections in Pediatric and Adult Patients with Diarrhea in Tanzania.

    OpenAIRE

    Cegielski, J P; Ortega, Y R; McKee, S; Madden, J F; Gaido, L; Schwartz, D A; Manji, K; Jorgensen, A F; Miller, S E; Pulipaka, U P; Msengi, A E; Mwakyusa, D H; Sterling, C R; Reller, L B

    1999-01-01

    Cryptosporidiosis, microsporidiosis, and cyclosporiasis were studied in four groups of Tanzanian inpatients: adults with AIDS-associated diarrhea, children with chronic diarrhea (of whom 23 of 59 were positive [+] for human immunodeficiency virus [HIV]), children with acute diarrhea (of whom 15 of 55 were HIV+), and HIV control children without diarrhea. Cryptosporidium was identified in specimens from 6/86 adults, 5/59 children with chronic diarrhea (3/5, HIV+), 7/55 children with acute diar...

  14. Probiotics in the Treatment of Acute Diarrhea in Young Children

    Directory of Open Access Journals (Sweden)

    Toktam Moghiman

    2009-09-01

    Full Text Available Background: Well-controlled clinical studies in the developedworld have shown that probiotics can shorten the duration ofacute non-bacterial diarrhea. We aimed to evaluate the efficacyof a probiotic consisting of a mixture of Lactobacillus acidophilusand Bifidobacterium bifidum in the treatment of young childrenwith acute diarrhea in Mashad, IranMethods: Sixty-two hospital inpatients aged 6 to 36 monthswith acute non-bloody, non-bacterial diarrhea of a less than 2days' duration and moderate dehydration were enrolled.Thirty-two were treated with probiotic powder three timesdaily for 5 days plus the routine oral rehydration solution(study group and the other 30 were given a placebo plus oralrehydration solution (control group.Results: Mean age at the time of admission was 14.5±7months for the study group and 13.7±6 months for controls.The mean duration of diarrhea was 3.4 days in the study groupand 4.5 days in controls (P = 0.027. Duration of hospital admissionwas 2.1±0.7 days in the probiotic group comparedwith 2.7±0.6 days in the control group (P = 0.033. Averageweight gain was 425 ± 9 and 370 ± 85 g for the study and controlgroups, respectively. Average reduction in the frequencyof diarrhea per day was 4.4 ± 1.5 times for the study groupand 3.6 ± 1.3 times for the control group.Conclusion: Lactobacillus acidophilus and Bifidobacteriumbifidum shortened the duration of diarrhea and hospital stay,and normalized stool frequency. The use of probiotics mightbe recommended for treating acute diarrhea in young children.

  15. Pathogenicity Island O-122 in enteropathogenic Escherichia coli strains is associated with diarrhea severity in children from Lima Peru.

    Science.gov (United States)

    Mercado, Erik H; Piscoche, Cristian; Contreras, Carmen; Durand, David; Riveros, Maribel; Ruiz, Joaquim; Ochoa, Theresa J

    2016-06-01

    EPEC is an attaching and effacing diarrheal pathogen that carries a large pathogenicity island, locus for enterocyte effacement (LEE). Recently, the pathogenicity island PAI O-122 was described among non-LEE effectors and found to be associated with diarrhea among atypical EPEC strains. It is unknown if incomplete PAI O-122 could be associated with diarrhea duration and severity. To identify these virulence determinants we analyzed 379 EPEC strains isolated from Peruvian children. EPEC was diagnosed by PCR(eae+, stx-) and classified as typical(t-EPEC) or atypical(a-EPEC). To characterize PAI O-122 we amplified three modules by PCR: Module 1(pagC), Module 2(senA, nleB and nleE) and Module 3(lifA/efa-1). To characterize the large ORF lifA/efa-1 we amplified the regions known as efa-N, efa-M and efa-C. Clinical information was obtained from the cohort study. A total of 379 EPEC strains were able to analyze PAI O-122 genes, 128 (10.4%) EPEC strains were isolated from 1235 diarrhea episodes and 251(9.2%) from 2734 healthy controls. t-EPEC strains were isolated from 14.8% (19/128) of children with diarrhea and 25/251(10.0%) from healthy controls. The most frequent PAI O-122 genes were nleE(37.7%), senA(34.6%) and nleB(37.5%), with similar prevalence among diarrhea and control samples. However, lifA/efa-1 was more common among diarrhea cases than healthy control cases (30.5% vs. 21.1%, p<0.05). The presence of complete PAI O-122 was associated with diarrhea episodes of higher severity among single pathogen infection (33.3% vs. 1.8%, p<0.05) mainly due to the presence of a complete lifA/efa-1 gene. In summary, the gene lifA/efa-1 is significantly associated with diarrheal episodes of higher severity, suggesting to be an important virulent factor. Copyright © 2016 Elsevier GmbH. All rights reserved.

  16. Isolated and Non-Isolated Enteric Pathogens in Children With Diarrhea and Related Laboratory Characteristics

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    Manijeh Ghods

    2008-05-01

    Full Text Available Background:Diarrhea has been recognised as a major public health problem worldwide. Aprospective study was performed to determine the etiology,seasonal and age prevalence, relevant laboratory investigations,sensitivity of isolated microorganisms to current medication,and practical approaches to the diagnosis and management of diarrhea in Iran,as a developing country.Methods: All infants and children under age five (n=825, mean age 18.9 admitted to Tehran Children’s Hospital,Tehran,with diarrheal symptoms during the period of April 2005 to March 2006 were included in the study; 371 approximately age-matched controls (mean age 19.1 monthsfrom the same hospital but not having diarrhea formed the control group.   Results: The most frequent isolated pathogen was Escherichia coli (18.9%,followed by Shigella spp (0.7%, and Salmonella spp (0.4%. Prevalence of diarrheic children with either isolated or non-isolated pathogens were 66.5% in the colder seasons and 54.4% in warm seasons. E. coli was more prevalent in children younger than two years old while Sigella spp and Salmonella spp were common to all ages. Fecal leukocytes were associated with 100% of isolated Escherichia coli, 19.4% of non-isolated organisms, 2.5% of Shigella spp, 0.5% of Salmonella spp and none in controls. Escherichia coli was also associated with fecal red blood cells (29.4%, as were Shigella spp (83% and Salmonella spp (33.3%. White blood cell counts, polymorphonuclear cells, band cells, erythrocyte sedimentation rate and C-reactive protein measurements had no diagnostic value. Amikacin was the global choice of antimicrobial treatment for Shigella spp in (99% of cases and for Escherichia coli in (91% of isolated cases. Only 70% of patients infected by Salmonella showed sensitivity to Gentamycin.   Conclusion:Diarrheal diseases in either isolated or non-isolated pathogens were more prevalent in the colder seasons and in children younger than two years of age. For

  17. Water filter provision and home-based filter reinforcement reduce diarrhea in Kenyan HIV-infected adults and their household members.

    Science.gov (United States)

    Pavlinac, Patricia B; Naulikha, Jaqueline M; Chaba, Linda; Kimani, Naomi; Sangaré, Laura R; Yuhas, Krista; Singa, Benson O; John-Stewart, Grace; Walson, Judd L

    2014-08-01

    Among human immunodeficiency virus (HIV)-infected adults and children in Africa, diarrheal disease remains a major cause of morbidity and mortality. We evaluated the effectiveness of provision and home-based reinforcement of a point-of-use water filtration device to reduce diarrhea among 361 HIV-infected adults in western Kenya by comparing prevalence of self-reported diarrhea before and after these interventions. After provision of the filter, 8.7% of participants reported diarrhea compared with 17.2% in the 3 months before filter provision (odds ratio [OR] = 0.39, 95% confidence interval [95% CI] = 0.23-0.66, P filter (OR = 0.47, 95% CI = 0.25-0.88, P = 0.019). Educational reinforcement was also associated with a modest reduction in self-reported diarrhea (OR = 0.50, 95% CI = 0.20-0.99, P = 0.047). Provision and reinforcement of water filters may confer significant benefit in reducing diarrhea among HIV-infected persons, even when cotrimoxazole prophylaxis is already being used. © The American Society of Tropical Medicine and Hygiene.

  18. An external evaluation of the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program in Gujarat and Uttar Pradesh, India.

    Science.gov (United States)

    Lamberti, Laura M; Taneja, Sunita; Mazumder, Sarmila; LeFevre, Amnesty; Black, Robert E; Walker, Christa L Fischer

    2015-12-01

    To address inadequate coverage of oral rehydration salts (ORS) and zinc supplements for the treatment of diarrhea among children under-five, the Diarrhea Alleviation through Zinc and ORS Treatment (DAZT) program was carried out from 2011-2013 in Gujarat and from 2011-2014 in Uttar Pradesh (UP), India. The program focused on improving the diarrhea treatment practices of public and private sector providers. We conducted cross-sectional household surveys in program districts at baseline and endline and constructed state-specific logistic regression models with generalized estimating equations to assess changes in ORS and zinc treatment during the program period. Between baseline and endline, zinc coverage increased from 2.5% to 22.4% in Gujarat and from 3.1% to 7.0% in UP; ORS coverage increased from 15.3% to 39.6% in Gujarat but did not change in UP. In comparison to baseline, children with diarrhea in the two-weeks preceding the endline survey had higher odds of receiving zinc treatment in both Gujarat (odds ratio, OR = 11.2; 95% confidence interval (CI) 6.4-19.3) and UP (OR = 2.4; 95% CI 1.4-3.9), but the odds of receiving ORS only increased in Gujarat (OR = 3.6; 95% CI 2.7-4.8; UP OR = 0.9; 95% CI 0.7-1.2). Seeking care outside the home, especially from a public sector source, was associated with higher odds of receiving ORS and zinc. During the duration of the DAZT program, there were modest improvements in the treatment of diarrhea among young children. Future programs should build upon and accelerate this trend with continued investment in public and private sector provider training and supply chain sustainability, in addition to targeted caregiver demand generation activities.

  19. Efficacy and tolerability of racecadotril in acute diarrhea in children.

    Science.gov (United States)

    Cézard, J P; Duhamel, J F; Meyer, M; Pharaon, I; Bellaiche, M; Maurage, C; Ginies, J L; Vaillant, J M; Girardet, J P; Lamireau, T; Poujol, A; Morali, A; Sarles, J; Olives, J P; Whately-Smith, C; Audrain, S; Lecomte, J M

    2001-03-01

    Oral rehydration therapy is the only treatment recommended by the World Health Organization in acute diarrhea in children. Antisecretory drugs available could not be used because of their side effects, except for racecadotril, which is efficient in acute diarrhea in adults. The efficacy and tolerability of racecadotril (1.5 mg/kg administered orally 3 times daily) as adjuvant therapy to oral rehydration were compared with those of placebo in 172 infants aged 3 months to 4 years (mean age, 12.8 months) who had acute diarrhea. The treatment groups were comparable in terms of age, duration of diarrhea, number of stools, and causative microorganism at inclusion. During the first 48 hours of treatment, patients receiving racecadotril had a significantly lower stool output (grams per hour) than those receiving placebo. The 95% confidence interval was 43%-88% for the full data set (n = 166; P = 0.009) and 33%-75% for the per-protocol population (n = 116; P = 0.001). There was no difference between treatments depending on rotavirus status. Significant differences between treatment groups were also found after 24 hours of treatment: full data set (n = 167; P = 0.026) and per-protocol population (n = 121; P = 0.015). Tolerability was good in both groups of patients. This study demonstrates the efficacy (up to 50% reduction in stool output) and tolerability of racecadotril as adjuvant therapy to oral rehydration solution in the treatment of severe diarrhea in infants and children.

  20. [Popular perceptions about childhood diarrheas: diversity and unity].

    Science.gov (United States)

    Desclaux, A

    1998-02-01

    Sickness is defined by culture: each society has its own way of labelling, explaining and treating symptoms. In the case of childhood diarrhea, each population selects some signs and considers them as symptoms, defines a limit between normal and pathologic, arranges symptoms in order to build syndromes that make up a local nosology. Examples from Thailand, China, Algeria, Nicaragua and Burkina Faso show the diversity of popular beliefs about diarrhea. These beliefs depend upon the epidemiological context, but they do not reflect it exactly: thus in Burkina Faso, AIDS has not been integrated in popular beliefs about childhood diarrhea. The examples discussed in this article show how popular beliefs evolve, especially under the influence of biomedicine. Moreover, every individual understands differently the popular nosology according to his (or her) social status and to the level of his (her) knowledge. To the unity of biomedical knowledge responds a great diversity of popular beliefs. In France, contemporary popular beliefs about childhood diarrhea have been seldom studied by social sciences. They seem to be close to biomedical knowledge and share some essential elements with it, but they also show some features--such as the belief that diarrhea is benign when simultaneous to teething--that relate them to popular beliefs which have been described in other cultures. By describing and analysing these popular beliefs, medical anthropology makes it possible to adapt medicine to local knowledges.

  1. Congenital chloride diarrhea: a review of twelve Arabian children

    Directory of Open Access Journals (Sweden)

    Elrefae F

    2013-06-01

    Full Text Available Fawaz Elrefae,1 Ahmed Farag Elhassanien,2 Hesham Abdel-Aziz Alghiaty3 1Pediatric Gastroenterology, Al-Adan Hospital, Kuwait; 2Faculty of Medicine, Elmansoura University, El Mansoura, El Dakahleya, Egypt; 3Faculty of Medicine, Benha University, Egypt Background: Congenital chloride diarrhea (CCD, a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon with high fecal chloride. Objective: To spotlight the common presentation of CCD for early management and prevention of complications. Subjects and methods: This is a retrospective case series study of patients diagnosed as CCD who were followed up in the pediatric department of Al-Adan Hospital, Kuwait. Results: Twelve patients diagnosed with CCD were born to consanguineous parents; had antenatal history of intrauterine growth retardation (IUGR; polyhydramnios; and distended hypoechoic fetal bowel; and presented with abdominal distension, hypotonia and muscle wasting. 90% of patients had maternal hypertension and 75% of patients had absence of normal meconium at birth. Our patients showed a decrease in serum sodium, potassium, chloride and urine chloride. Conclusion: A high level of suspicion for an early diagnosis of CCD should be considered for any infant presenting with chronic diarrhea, especially in the presence of consanguineous marriage, and the characteristic features in antenatal ultrasound. Thus, allowing for early investigations and appropriate management. Keywords: congenital chloride diarrhea, children, chronic diarrhea, metabolic alkalosis, prenatal diagnosis

  2. No direct correlation between rotavirus diarrhea and breast feeding: A meta-analysis.

    Science.gov (United States)

    Shen, Jian; Zhang, Bi-Meng; Zhu, Sheng-Guo; Chen, Jian-Jie

    2017-08-26

    Some studies indicated that children with exclusive breast feeding had a reduction in the prevalence of rotavirus diarrhea, while some others held the opposite views. In this study, we aimed to systematically find the associations between rotavirus diarrhea and breast feeding. A literature search up to June 2016 in electronic literature databases, including PubMed and Embase, was performed. The Newcastle-Ottawa Scale was used to conduct the quality assessment of all the selected studies. Statistical analyses were performed using the R package version 3.12 (R Foundation for Statistical Computing, Beijing1, China, meta package), and odds ratio (OR) and 95% confidence interval (CI) were used to assess the strength of the association. The heterogeneity was assessed by Cochran's Q-statistic and I 2 test, and the sensitivity analysis was performed by trimming one study at a time. A total of 17 articles, which included 10,841 participants, were investigated in the present meta-analysis. There was no significant difference between the case group and control group (OR, 0.59 95% CI 0.33-1.07) in the meta-analysis of exclusive breast feeding, and no significant difference was found between the case group and the control group (OR, 0.86; 95% CI 0.63-1.16) in the meta-analysis of breast feeding. No significant difference was found between the case group and control group (OR, 0.78 95% CI 0.59-1.04) for all quantitative data. There may be no direct correlation between rotavirus diarrhea and breast feeding. Copyright © 2017. Published by Elsevier B.V.

  3. Diagnosis and Management of AIDS-related Diarrhea

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    John F Johanson

    1996-01-01

    Full Text Available The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.

  4. Is racecadotril effective for acute diarrhea in children? -First update.

    Science.gov (United States)

    Sáez, Josefina; Cifuentes, Lorena

    2016-05-06

    This article updates the December 2015 Living FRISBEE (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos), based on the detection of two systematic reviews not identified in the previous version. Gastroenteritis or acute watery diarrhea is usually a self-limited disease, but it is still associated to substantial healthcare costs and remains a frequent demand for medical care. Racecadotril, an intestinal enkephalinase inhibitor, has been used as treatment because it would decrease the duration of acute diarrhea and fluid loss. However there is still no evidence supporting its routine use. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews including nine randomized trials relevant for our question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded racecadotril probably reduces the duration of acute diarrhea in pediatric patients, without increasing adverse effects.

  5. Epidemiology of travelers' diarrhea and relative importance of various pathogens.

    Science.gov (United States)

    Black, R E

    1990-01-01

    Each year 12 million persons travel from an industrialized country to a developing country in the tropics or subtropics. These travelers experience a high rate of diarrhea caused by a wide variety of enteric pathogens acquired by ingestion of contaminated food or water. One or more pathogens can be found in the stool of a majority of ill individuals. Enterotoxigenic Escherichia coli generally are the most frequently identified pathogens, having been found in a median of 42% of travelers' diarrheal episodes in studies in Latin America, 36% in Africa, and 16% in Asia. Other pathogens that cause diarrhea in a smaller fraction of ill travelers include Shigella species, Salmonella species, Campylobacter jejuni, Vibrio, Aeromonas hydrophila, Entamoeba histolytica, Giardia lamblia, rotavirus, and 27-nm viruses, including Norwalk virus. Other organisms that may cause a fraction of the episodes of travelers' diarrhea include Plesiomonas shigelloides, enteroadherent E. coli, adenovirus or other viruses, and Cryptosporidium. Mixed infections of two or more of these pathogens also occur.

  6. Detection of parasites in children with chronic diarrhea.

    Science.gov (United States)

    Maçin, Salih; Kaya, Filiz; Çağdaş, Deniz; Hizarcioglu-Gulsen, Hayriye; Saltik-Temizel, Inci Nur; Tezcan, İlhan; Demir, Hülya; Ergüven, Sibel; Akyön, Yakut

    2016-06-01

    The aim of this study was to investigate the frequency of intestinal parasites in patients with chronic diarrhea and clarify the importance of these parasitic pathogens in such cases. A total of 60 pediatric patients with chronic diarrhea between June 2012 and October 2014 were enrolled in the study. Out of 60 stool samples, five were positive for Giardia lamblia, two, Dientamoeba fragilis, and one, Blastocystis hominis. One stool sample was positive for Entamoeba hartmanni and B. hominis, another one was positive for G. lamblia and B. hominis, another, G. lamblia and E. hartmanni and one sample was positive for Enterobius vermicularis, D. fragilis and B. hominis together. Parasitic infection, which decreases quality of life and increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection. © 2016 Japan Pediatric Society.

  7. Multicentric Castleman's Disease in a Child Revealed by Chronic Diarrhea.

    Science.gov (United States)

    Benmiloud, Sarra; Chaouki, Sana; Atmani, Samir; Hida, Moustapha

    2015-01-01

    Multicentric Castleman's disease is a rare benign and unexplained lymphoproliferative disorder that is extremely uncommon in children. It presents with fever, systemic symptoms, generalized lymphadenopathy, and laboratory markers of inflammation. Its treatment is not standardized and its prognosis is poor. We report a novel case of multicentric Castleman's disease in a 13-year-old girl who had presented with chronic diarrhea as the only initial presenting symptom. The diagnosis of celiac or inflammatory bowel diseases was suspected, but two and a half years later, the diagnosis of multicentric Castleman's disease was brought following the appearance of abdominal mass whose biopsy revealed Castleman's disease in the plasma cell form. The outcome was favorable after treatment by corticosteroid, chemotherapy, and surgery. The occurrence of diarrhea as the initial symptom of multicentric Castleman's disease without lymph node involvement is very rare. This case report underlines the diagnostic difficulties and the long interval between onset and diagnosis when diarrhea occurs first.

  8. Viral Diarrhea in Children: Clinical Manifestations, Innovations in the Treatment

    Directory of Open Access Journals (Sweden)

    S.O. Kramariov

    2014-12-01

    Full Text Available A literature search on the study of the clinical features of viral diarrhea in children has been carried out depending on the pathogen. 1,484 children with acute enteric infections (AEI were examined, they underwent inpatient treatment in infectious disease department of Kyiv city children’s clinical hospital № 2 in 2013. It was found that among patients with AEI, 25.9 % had rotavirus infection, 56 % — AEI of uncertain aetiology, 8 % — salmonellosis, 0.1 % — shigellosis, 10 % — AEI with other origin. A literature search showed the effectiveness of the use of probiotics, containing different strains, for AEI treatment, which manifested with reduction of intoxication syndrome, diarrhea, fever by 2–3 days. It is shown that the use of probiotic Subalin, containing Bacillus subtilis strain 2335/105, is promising as etiopathogenetic therapy in the treatment of viral diarrhea in children under current conditions.

  9. Crofelemer, a novel agent for treatment of secretory diarrhea.

    Science.gov (United States)

    Crutchley, Rustin D; Miller, Jennifer; Garey, Kevin W

    2010-05-01

    To review the chemistry, pharmacology, pharmacokinetics, efficacy, and safety of crofelemer. A literature search using the terms SP-303, Provir, and crofelemer was performed with PubMed (up to April 2010), Google Scholar, and selected Ovid bibliography searches. Additional references from the bibliographies of articles included in the search, as well as company and Food and Drug Administration Web sites, were also assessed. English-language in vitro and clinical studies associated with the safety and efficacy of crofelemer were included. Crofelemer is a first-in-class agent that may be useful for different types of secretory diarrhea, since it prevents chloride and fluid secretion into the bowel by directly inhibiting 2 distinct intestinal chloride channels. Crofelemer significantly brought about faster symptom resolution in patients with traveler's diarrhea, along with lower rates of treatment failure compared to placebo-treated patients. In a post hoc analysis, crofelemer compared to placebo also appears to have reduced abnormal stool weight and frequency in patients with AIDS-associated diarrhea. In a third trial, crofelemer did not offer a significant benefit in improving stool consistency after 12 weeks of treatment in patients with diarrhea-predominant irritable bowel syndrome. However, a significant increase in pain-free days was noted in female patients. Preliminary studies also show that crofelemer may reduce watery stool output in patients with infectious diarrhea such as cholera. Oral crofelemer seemed to be well tolerated in clinical trials, with adverse effect profiles comparable to those with placebo. Crofelemer possesses a novel mechanism of action that shows promise in treating secretory diarrhea of several etiologies. However, results from further Phase 3 clinical trials are still needed in order to fully evaluate the efficacy and safety of this agent.

  10. Role of FODMAP content in enteral nutrition-associated diarrhea.

    Science.gov (United States)

    Halmos, Emma P

    2013-12-01

    Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  11. Phenotypic and phylogenetic analysis of Vibrio parahaemolyticus isolates recovered from diarrhea cases in Guangdong Province, China

    Science.gov (United States)

    Li, Baisheng; Luo, Jinyan; Tan, Hailing; Ke, Bixia; He, Dongmei; Ke, Changwen; Klena, John D.; Zhang, Yonghui

    2015-01-01

    Vibrio parahaemolyticus has emerged as a common foodborne pathogen of global concern. In this study, 108 V. parahaemolyticus isolates that recovered from diarrhea cases (n = 96) and seafood products (n = 12) in Guangdong Province from 2007 to 2011 were characterized by serotyping, tdh and trh toxin gene detection and multilocus sequence typing (MLST). The dominant serotypes from the cases were O3:K6, O4:K8 and O1: KUT (untyped). However, most isolates recovered from seafood products belonged to other serotypes. None of the isolates carried the trh gene, while the major isolates from the cases were tdh positive. MLST analysis revealed 31 sequence types (STs); 17 STs were unique in this study. eBURST analysis revealed four clonal complexes (CC), The majority of the isolates (n = 58, all from cases and tdh+) were grouped into the CC3, which included O3:K6, O4:K68 and O1:KUT isolates. The CC3 was the most prevalent clonal complex, and all of the CC3 isolates were recovered from clinical cases of geographically diverse origin. As to the CC345, which was completely constituted by O4:K8, was another important clonal complex affecting Guangdong Province. Ongoing surveillance of V. parahaemolyticus in diarrhea patients and seafood products remains a public health priority for Guangdong Province, China. PMID:25662708

  12. Molecular Analysis of the Enteric Protozoa Associated with Acute Diarrhea in Hospitalized Children.

    Science.gov (United States)

    Boughattas, Sonia; Behnke, Jerzy M; Al-Ansari, Khalid; Sharma, Aarti; Abu-Alainin, Wafa; Al-Thani, Asma; Abu-Madi, Marawan A

    2017-01-01

    Pediatric diarrhea is a common cause of death among children under 5 years of age. In the current study, we investigated the frequency of intestinal parasites among 580 pediatric patients with chronic diarrhea. Parasitic protozoa (all species combined) were detected by molecular tools in 22.9% of the children and the most common parasite was Cryptosporidium spp. (15.1%). Blastocystis hominis was detected in 4.7%, Dientamoeba fragilis in 4%, Giardia duodenalis in 1.7%, and Entamoeba histolytica in 0.17%. Protozoan infections were observed among all regional groups, but prevalence was highest among Qatari subjects and during the winter season. Typing of Cryptosporidium spp. revealed a predominance of Cryptosporidium parvum in 92% of cases with mostly the IIdA20G1 subtype. Subtypes IIdA19G2, IIdA18G2, IIdA18G1, IIdA17G1, IIdA16G1, and IIdA14G1 were also detected. For Cryptosporidium hominis , IbA10G2 and IbA9G3 subtypes were identified. This study provides supplementary information for implementing prevention and control strategies to reduce the burden of these pediatric protozoan infections. Further analyses are required to better understand the local epidemiology and transmission of Cryptosporidium spp. in Qatar.

  13. Molecular Analysis of the Enteric Protozoa Associated with Acute Diarrhea in Hospitalized Children

    Directory of Open Access Journals (Sweden)

    Sonia Boughattas

    2017-08-01

    Full Text Available Pediatric diarrhea is a common cause of death among children under 5 years of age. In the current study, we investigated the frequency of intestinal parasites among 580 pediatric patients with chronic diarrhea. Parasitic protozoa (all species combined were detected by molecular tools in 22.9% of the children and the most common parasite was Cryptosporidium spp. (15.1%. Blastocystis hominis was detected in 4.7%, Dientamoeba fragilis in 4%, Giardia duodenalis in 1.7%, and Entamoeba histolytica in 0.17%. Protozoan infections were observed among all regional groups, but prevalence was highest among Qatari subjects and during the winter season. Typing of Cryptosporidium spp. revealed a predominance of Cryptosporidium parvum in 92% of cases with mostly the IIdA20G1 subtype. Subtypes IIdA19G2, IIdA18G2, IIdA18G1, IIdA17G1, IIdA16G1, and IIdA14G1 were also detected. For Cryptosporidium hominis, IbA10G2 and IbA9G3 subtypes were identified. This study provides supplementary information for implementing prevention and control strategies to reduce the burden of these pediatric protozoan infections. Further analyses are required to better understand the local epidemiology and transmission of Cryptosporidium spp. in Qatar.

  14. Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient

    OpenAIRE

    Kim, Min Jae; Kim, Woo Ho; Jung, Hyun-Chae; Chai, Jee-Won; Chai, Jong-Yil

    2013-01-01

    Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered p...

  15. Microvillus Inclusion Disease Variant in an Infant with Intractable Diarrhea

    Directory of Open Access Journals (Sweden)

    Badr M. Rasheed Alsaleem

    2017-11-01

    Full Text Available Microvillus inclusion disease (MVID is a rare autosomal recessive congenital enteropathy characterized by intractable secretory diarrhea. We report a case of MVID variant with a homozygous gene mutation in syntaxin 3 (STX3. The patient is a male Saudi infant who presented shortly after birth with severe vomiting, metabolic acidosis, and mild diarrhea. Electron microscopy study for small intestinal biopsy was consistent with MVID. MYO5B gene mutation was excluded; subsequently, whole exome sequencing (WES was performed, which revealed homozygous gene mutation in STX3. Using WES in clinical environment can be a useful tool for diagnosing difficult and rare inherited congenital enteropathies.

  16. Infectious Diarrhea: Norovirus and Clostridium difficile in Older Adults.

    Science.gov (United States)

    White, Mary B; Rajagopalan, Shobita; Yoshikawa, Thomas T

    2016-08-01

    Norovirus infection usually results in acute gastroenteritis, often with incapacitating nausea, vomiting, and diarrhea. It is highly contagious and resistant to eradication with alcohol-based hand sanitizer. Appropriate preventative and infection control measures can mitigate the morbidity and mortality associated with norovirus infection. Clostridium difficile infection is the leading cause of health care-associated diarrhea in the United States. Antibiotic use is by far the most common risk factor for C difficile colonization and infection. Appropriate preventive measures and judicious use of antibiotics can help mitigate the morbidity and mortality associated with C difficile infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. [Microscopic colitis - a frequent cause of chronic diarrhea].

    Science.gov (United States)

    Gonciarz, Maciej; Mularczyk, Aldona; Kowalik, Tomasz; Kopała, Marek

    2016-11-25

    Chronic diarrhea is a very common problem in the general population. It requires a physician to differentiate its causes and depending on its etiology referring the patient to a hospital for diagnosis and subsequent treatment. One of the causes of chronic diarrhea may be microscopic colitis, which is characterized by the presence of clinical symptoms without endoscopic or radiological abnormalities. Diagnosis is based on a histopathological examination of the colon and thus clinical suspicion of the disease is so important for further diagnosis and treatment, which is primarily based on the use of topical steroids such as budesonide. © 2016 MEDPRESS.

  18. The Efficacy of Probiotic in Adults with Acute Infectious Diarrhea

    Directory of Open Access Journals (Sweden)

    Mawin Mahen

    2017-04-01

    Full Text Available Diarrhea is a global health problem with high morbidity and mortality. In developing countries, acute diarrhea is most commonly caused by infectious pathogens. Regardless of the cause, diarrhea is primarily treated by fluid replacement therapy to decrease the risk of dehydration and death, although it does not affect the duration of diarrhea. Probiotics are able to shorten the duration of diarrhea in children, but its efficacy in adults is unclear. This study aimed to evaluate the benefit of probiotic in reducing the duration of acute diarrhea in adults as compared to placebo. Systematic search was done using four databases: PubMed, Scopus, ProQuest, and Embase, without limit on the year of publication. Randomized clinical trials were selected as the appropriate study design to answer the clinical question and two studies were considered relevant for appraisal. In conclusion, probiotics could improve the recovery of acute infectious diarrhea in adults (level of evidence 1b however more studies should be carried out since only very few strains of probiotics have been investigated. Keywords: probiotics, treatment efficacy, acute diarrhea, adults.     Efektivitas Probiotik pada Orang Dewasa dengan Diare:  Sebuah Laporan Kasus Berbasis Bukti   Abstrak Diare merupakan masalah kesehatan global dengan angka morbiditas dan mortalitas yang tinggi. Di negara berkembang, diare akut biasanya disebabkan oleh infeksi. Terlepas dari penyebabnya, tata laksana utama diare adalah terapi rehidrasi untuk mengurangi dehidrasi dan kematian walaupun hal tersebut tidak memengaruhi durasi diare. Probiotik dapat memperpendek durasi diare pada anak-anak, namun efektivitasnya pada orang dewasa masih belum jelas. Tujuan penelitian ini adalah untuk mengevaluasi efek probiotik dalam mengurangi durasi diare akut pada orang dewasa dibandingkan plasebo. Pencarian sistematik dilakukan pada empat database: PubMed, Scopus, ProQuest, dan Embase, tanpa membatasi tahun publikasi

  19. Allegheny County Addressing Landmarks

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This table contains the Addressing Landmarks in Allegheny County. If viewing this description on the Western Pennsylvania Regional Data Center’s open data portal...

  20. Addressivity in cogenerative dialogues

    Science.gov (United States)

    Hsu, Pei-Ling

    2014-03-01

    Ashraf Shady's paper provides a first-hand reflection on how a foreign teacher used cogens as culturally adaptive pedagogy to address cultural misalignments with students. In this paper, Shady drew on several cogen sessions to showcase his journey of using different forms of cogens with his students. To improve the quality of cogens, one strategy he used was to adjust the number of participants in cogens. As a result, some cogens worked and others did not. During the course of reading his paper, I was impressed by his creative and flexible use of cogens and at the same time was intrigued by the question of why some cogens work and not others. In searching for an answer, I found that Mikhail Bakhtin's dialogism, especially the concept of addressivity, provides a comprehensive framework to address this question. In this commentary, I reanalyze the cogen episodes described in Shady's paper in the light of dialogism. My analysis suggests that addressivity plays an important role in mediating the success of cogens. Cogens with high addressivity function as internally persuasive discourse that allows diverse consciousnesses to coexist and so likely affords productive dialogues. The implications of addressivity in teaching and learning are further discussed.

  1. Antibiotic misuse among children with diarrhea in China: results from a national survey

    Directory of Open Access Journals (Sweden)

    Ruili Li

    2016-11-01

    Full Text Available Background Antibiotic resistance is one of the world’s biggest public health issues, and the situation in China is particularly grave. The objective of this study is to investigate the antibiotics usage pattern among Chinese children and provide further insight in developing strategies for promoting public health education. Methods This is a cross-sectional study, in the study, participants are from 53,665 guardians of children aged 0–6 years, who were recruited with multistage stratified random cluster sampling in 2013/2014 from 46 community health centers in 14 provinces across China Mainland. Children’s guardians completed surveys on their previous experience on using antibiotics in treating diarrhea of their children without a prescription from any pediatrician. Odds ratios (ORs and 95% confidential intervals (CIs for the association between antibiotic use and its predictors were estimated using multilevel logistic regression models, with antibiotic rational use group as a reference group. Results The prevalence of antibiotic misuse among children with diarrhea in the eastern, middle and western areas of China and associations between antibiotic misuse and its predictors were studied. The average rate of antibiotic misuse is 35.12%. Multilevel logistic regression revealed that living in urban areas (OR = 0.79 (0.76, 0.83, female children (OR = 0.92 (0.88, 0.96, guardians having higher education (OR = 0.60 (0.55, 0.66, being raised by parents (OR = 0.90 (0.85, 0.94, guardians having basic health knowledge (OR = 0.82 (0.79, 0.86 are protective factors and children’s age (1–3 years OR = 1.62 (1.54, 1.71; 4–6 years OR = 1.90 (1.77, 2.03 is a risk factor of antibiotic misuse among children aged 0–6 years with diarrhea in China. Conclusions Our findings confirmed that there has been a high rate of antibiotic misuse without a prescription in children with diarrhea in China, which requires considerable attention. Suitable regulations

  2. Lactobacillus casei strain GG in the treatment of infants with acute watery diarrhea: A randomized, double-blind, placebo controlled clinical trial [ISRCTN67363048

    Directory of Open Access Journals (Sweden)

    Chea-Woo Elsa

    2004-09-01

    Full Text Available Abstract Background Adjuvant therapy to ORT with probiotic bacteria for infants with acute watery diarrhea has been under active investigation. Most studies have been done in the developed world showing benefit only for viral mild gastroenteritis. We evaluated the effect of a milk formula containing one billion (109 cfu/ml of Lactobacillus casei strain GG (LGG upon duration and severity of diarrhea in infants in an environment with more severe acute diarrhea, where etiologic agents other than rotavirus are involved more frequently, and where mixed infections are more prevalent. Methods Male infants aged 3–36 months brought for treatment of acute watery diarrhea of less than 48 hours were eligible. After rehydration was completed with the WHO's oral rehydration solution, patients were randomly assigned to receive a milk formula either containing LGG or not. Stool volume was periodically measured using a devise suited to collect stools separate from urine. Duration of diarrhea was estimated based on stools physical characteristics. Results Eighty nine patients received the placebo milk formula and ninety received the LGG containing formula. Both groups were comparable in their baseline characteristics. Total stool output was significantly larger (p = 0.047 in the LGG group (247.8 ml/kg than in the placebo group (195.0 ml/kg. No significant differences were found in duration of diarrhea (58.5 hours with LGG vs. 50.4 hours with placebo, rate of treatment failure (21.1% with LGG vs. 18.0% with placebo, and proportion of patients with unresolved diarrhea after 120 hours (12.2% with LGG vs. 12.5% with placebo. The rate of stools with reducing substances after 24 hours of treatment increased significantly in both groups (from 41.4% to 72.2% with LGG and from 45.9% to 68.0% with placebo. Conclusion This study did not show a positive effect of LGG on the clinical course of acute watery diarrhea. Positive beneficial effects of LGG, as had been reported

  3. Pathogenetic Mechanisms of Diarrhea in Children and Methods for Its Treatment

    Directory of Open Access Journals (Sweden)

    B.I. Krivuschev

    2014-07-01

    Full Text Available The paper presents the current views on the pathogenesis of acute intestinal infections in children and principles of therapy of diarrhea syndrome. Particular attention is paid to antisecretory therapy and the role of racecadotril in relieving diarrhea.

  4. Myasthenia gravis exacerbation and diarrhea associated with erythromycin treatment

    Directory of Open Access Journals (Sweden)

    Sora Yasr

    2017-02-01

    Full Text Available An important problem in management of the case with myasthenia gravis (MG is the control of exacerbation. There are several possible causes of exacerbation of MG including the use of drug. Here, the authors report a case of MG exacerbation and diarrhea associated with erythromycin treatment.

  5. Detection of bovine viral diarrhea virus antibodies in camels ...

    African Journals Online (AJOL)

    This study was carried out to determine the seroprevalence of bovine viral diarrhea virus (BVDV) antibodies in camels presented for slaughter at the Maiduguri abattoir using a BVDV specific indirect enzyme-linked-immunosorbent assay (ELISA). Ninety (90) serum samples collected from adult male and female camels were ...

  6. Diarréia por parasitas Parasites induced diarrheas

    Directory of Open Access Journals (Sweden)

    Maria Eugênia Farias Almeida Motta

    2002-08-01

    Full Text Available A diarréia é uma causa importante de morbimortalidade nos países em desenvolvimento. Os agentes etiológicos mais comuns são os vírus e as bactérias. Este artigo tem o objetivo de analisar a ocorrência de diarréia como manifestação clínica de parasitose. Discute-se quais os protozoários e os helmintos que podem causar diarréia, as bases científicas atuais que explicam os mecanismos fisiopatológicos que desencadeiam a diarréia, bem como os exames complementares e o tratamento adequado para cada parasita implicado.Diarrhea is an important cause of morbidity and mortality in developing countries. The most common etiological agents are viruses and bacteria. This article has the objective of analyzing diarrhea as a clinical symptom of parasitosis. Protozoa and helminthes that may cause diarrhea are discussed, current scientific basis clarifying the pathological and physiological mechanisms causing diarrhea as well as supplementary tests and adequate treatment for each parasite involved are focused.

  7. Frequency of Rotavirus Infection among Children with Diarrhea in ...

    African Journals Online (AJOL)

    Conclusion: Rotavirus frequency was 25% among children less than 5 years. Rotavirus vaccine, routine and proper diagnosis of rotavirus infection in children with acute diarrhea help to determine appropriate treatment, prevents the unnecessary use of antibiotics and minimizes the spread of the disease among susceptible ...

  8. [Nosocomial diarrhea in intensive care unit: other than Clostridium difficile].

    Science.gov (United States)

    Wang, Xiao-Hui; Cai, Lin; Hu, Tian-Yu; Tang, Li; Wu, Dan; Kang, Yan; Zong, Zhi-Yong

    2013-07-01

    To investigate the incidence and clinical features of non-Clostridium difficile (C. difficile) associated nosocomial diarrhea in intensive care unit (ICU) caused by Klebsiella oxytoca and Clostridium perfringens. The faeces of 102 patients with non-C. difficile associated nosocomial diarrhea in ICU of West China Hospital, were collected during April to November, 2012. The target bacterial genes were detected by PCR amplification and sequencing, including toxic gene pehX of Klebsiella oxytoca, species-specific 16S rRNA gene and toxic gene cpa and cpe of Clostridium perfringens, species-specific 16S rRNA gene with mapA and toxic gene hipO of Campylobacter jejuni. Clinical features of the patients with positive results were summarized. Among 102 patients with non-C. difficile associated nosocomial diarrhea, 4 patients (3.9%) were detected with toxic Klebsiella oxytoca while 4 patients (3.9%) were detected with toxic Clostridium perfringens. No toxic Campylobacter jejuni was detected. Most of the patients had severe underlying diseases and poor final outcome, accepted potent antibiotics which disturbed intestinal flora obviously.. Non-C. difficile associated nosocomial diarrhea in ICU caused by Klebsiella oxytoca is and Clostridium perfringens is associated with severe diseases and poor outcome, but the incidence in our hospital is relatively low in our hospital.

  9. Anti-diarrhea and anti-oxidant properties of Magnolol

    African Journals Online (AJOL)

    HP

    stroke, typhoid fever, anxiety and nervous disturbance, diarrhea ... Jianghua Yao Autonomous County, Hunan,. China, in May 2009 ..... defense system. In this study, magnolol administration greatly elevated the total antioxidant capacity in the livers. Magnolol treatment at a dose of 50 mg/kg had the highest increase in total ...

  10. Mothers' Knowledge, Attitude and Practice Regarding Diarrhea and ...

    African Journals Online (AJOL)

    Purpose: To assess diarrhea-related knowledge, attitude and practice through successive educational interventions. Methods: This was an interventional study conducted at nine different locations of Morang district, Nepal from March 2010 to January 2011. Multistage random sampling approach was adopted to sample 630 ...

  11. Examination of small bowel enzymes in chronic diarrhea

    NARCIS (Netherlands)

    Simadibrata, Marcellus; Wanders, Ronald J. A.; Jan, Gerrit; Tytgat, Guido N. J.; Lesmana, Laurentius A.; Daldiyono, N. N.; Ariawan, Iwan

    2003-01-01

    In Indonesia, the proportion of daily carbohydrate intake is approximately 60-80%. A number of small bowel disorders can result in the impairment of absorption and enzyme deficiency. Chronic diarrhea is common in Indonesia. Thirty-four functional dyspeptic patients with an endoscopically normal

  12. Adenovirus Infection in Children with Diarrhea Disease in ...

    African Journals Online (AJOL)

    ANNALS

    41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was conducted to delineate ... dehydration (49%: 31/63), symptoms of upper respiratory tract infection (13%: 8/63) and abdominal pain (5%: 3/63). ... gastroenteritis epidemiology in Africa with the exception of South Africa where their ...

  13. Home Management Of Diarrhea Among Underfives In A Rural ...

    African Journals Online (AJOL)

    Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood ...

  14. Current approach in the management of diarrhea in children: from ...

    African Journals Online (AJOL)

    Current approach in the management of diarrhea in children: from theory and research to practice and pragmatism. A Chiabi, F Monebenimp, J.B Bogne, V Takou, R Ndikontar, M Nankap, J.C Youmba, P.F Tchokoteu, M.T Obama, E Tetanye ...

  15. Assessment of the anti-diarrhea function of compound Chinese ...

    African Journals Online (AJOL)

    Organ bath was used to investigate the effect of COL on peristaltic reflexes and peristaltic waves in vitro. And anti-diarrhea activity of COL was evaluated in clinical. Results: Thin layer chromatography (TLC) and HPLC analyses showed that the contents of Berberine hydrochloride, Magnolol and Honokiol in COL were ...

  16. Porcine Epidemic Diarrhea Virus among Farmed Pigs, Ukraine.

    Science.gov (United States)

    Dastjerdi, Akbar; Carr, John; Ellis, Richard J; Steinbach, Falko; Williamson, Susanna

    2015-12-01

    An outbreak of porcine epidemic diarrhea occurred in the summer of 2014 in Ukraine, severely affecting piglets <10 days of age; the mortality rate approached 100%. Full genome sequencing showed the virus to be closely related to strains reported from North America, showing a sequence identity of up to 99.8%.

  17. Probiotics for the Prevention of Nosocomial Diarrhea in Children

    NARCIS (Netherlands)

    Hojsak, Iva; Szajewska, Hania; Canani, Roberto B.; Guarino, Alfredo; Indrio, Flavia; Kolacek, Sanja; Orel, Rok; Shamir, Raanan; Vandenplas, Yvan; van Goudoever, Johannes B.; Weizman, Zvi

    2018-01-01

    This document provides recommendations developed by the ESPGHAN Working Group on Probiotics and Prebiotics on the role of probiotics in the prevention of nosocomial diarrhea in children based on a systematic review of previously completed systematic reviews and of subsequently published randomized

  18. Molecular identification of rotavirus strains associated with diarrhea ...

    African Journals Online (AJOL)

    The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in Kwara state, Nigeria. A total of 150 stool samples were collected from diarrheic children. The stool samples were screened for rotavirus,using Enzyme linked Immunosorbent assay (ELISA).

  19. molecular identification of rotavirus strains associated with diarrhea

    African Journals Online (AJOL)

    DR. AMINU

    The study was carried out to determine the molecular characteristics of the rotavirus strains associated with diarrhea among children in ... The State has 16 local government areas with human population of 2,591,555 (2006 Census). ..... Infection and Immunity in Children 5: 45-54. Gomwalk, N. E., Gosham, L. T. and Umoh, ...

  20. Stochastic simulation modeling to determine time to detect Bovine Viral Diarrhea antibodies in bulk tank milk

    DEFF Research Database (Denmark)

    Foddai, Alessandro; Enøe, Claes; Krogh, Kaspar

    2014-01-01

    ). With SVANOVIR ELISA the incidenceof PIs and dead born calves could be limited and the impact of the disease on the animalwelfare and income of farmers (before detection) could be minimized. The results from thesimulation modeling can be used to improve the current Danish BVD surveillance programin detecting......A stochastic simulation model was developed to estimate the time from introduction ofBovine Viral Diarrhea Virus (BVDV) in a herd to detection of antibodies in bulk tank milk(BTM) samples using three ELISAs. We assumed that antibodies could be detected, after afixed threshold prevalence...... of seroconverted milking cows was reached in the herd. Differentthresholds were set for each ELISA, according to previous studies. For each test, antibodydetection was simulated in small (70 cows), medium (150 cows) and large (320 cows)herds. The assays included were: (1) the Danish blocking ELISA, (2...

  1. Lactoferrin reduces mortality in preweaned calves with diarrhea.

    Science.gov (United States)

    Habing, G; Harris, K; Schuenemann, G M; Piñeiro, J M; Lakritz, J; Clavijo, X Alcaraz

    2017-05-01

    Calf diarrhea is the most common reason for mortality and antimicrobial therapy in preweaned calves on dairy farms in the United States. Conventional and organic livestock producers require alternative therapies for calf diarrhea to reduce the necessity of conventional antimicrobials. Alternatives administered for mild cases or early in the disease course may be useful to mitigate disease progression and reduce the likelihood of septicemia and negative sequelae. Lactoferrin is a bioactive protein naturally found in colostrum that has been shown to prevent septicemia in high-risk infants. Among organic producers, garlic extract is widely used for the treatment of disease and perceived to be efficacious. The objectives of the study were to determine the effectiveness of lactoferrin and garlic extract to reduce mortality and culling, improve weight gain, and reduce the duration of disease in preweaned calves with the first diagnosis of diarrhea. In total, 628 calves with diarrhea from a single commercial dairy were enrolled in a blinded, randomized field trial. Calves diagnosed with diarrhea (fecal score ≥3), were randomized to 3 consecutive days of oral garlic extract, lactoferrin, or water (control). Calves were clinically evaluated for up to 10 d. Body weight was measured at enrollment and 10 d later. For calves receiving garlic extract, the risk of death or culling was not significantly different than calves in the control group; however, calves that received lactoferrin had approximately half the risk of death or culling in the 120 d following diagnosis. Additionally, the relative risk of death or culling in the 60 d following diagnosis was significantly lower for the subset of calves with severe diarrhea at enrollment. Neither garlic nor lactoferrin had a significant effect on disease duration or average weight gain during the 10-d period. Lactoferrin significantly reduced mortality and culling when administered to preweaned calves with the first diagnosis of

  2. Characterization of the human gut microbiome during travelers' diarrhea.

    Science.gov (United States)

    Youmans, Bonnie P; Ajami, Nadim J; Jiang, Zhi-Dong; Campbell, Frederick; Wadsworth, W Duncan; Petrosino, Joseph F; DuPont, Herbert L; Highlander, Sarah K

    2015-01-01

    Alterations in the gut microbiota are correlated with ailments such as obesity, inflammatory bowel disease, and diarrhea. Up to 60% of individuals traveling from industrialized to developing countries acquire a form of secretory diarrhea known as travelers' diarrhea (TD), and enterotoxigenic Escherichia coli (ETEC) and norovirus (NoV) are the leading causative pathogens. Presumably, TD alters the gut microbiome, however the effect of TD on gut communities has not been studied. We report the first analysis of bacterial gut populations associated with TD. We examined and compared the gut microbiomes of individuals who developed TD associated with ETEC, NoV, or mixed pathogens, and TD with no pathogen identified, to healthy travelers. We observed a signature dysbiotic gut microbiome profile of high Firmicutes:Bacteroidetes ratios in the travelers who developed diarrhea, regardless of etiologic agent or presence of a pathogen. There was no significant difference in α-diversity among travelers. The bacterial composition of the microbiota of the healthy travelers was similar to the diarrheal groups, however the β-diversity of the healthy travelers was significantly different than any pathogen-associated TD group. Further comparison of the healthy traveler microbiota to those from healthy subjects who were part of the Human Microbiome Project also revealed a significantly higher Firmicutes:Bacteriodetes ratio in the healthy travelers and significantly different β-diversity. Thus, the composition of the gut microbiome in healthy, diarrhea-free travelers has characteristics of a dysbiotic gut, suggesting that these alterations could be associated with factors such as travel.

  3. Strategic control of acute diarrhea of newborn calves

    Directory of Open Access Journals (Sweden)

    Siti Chotiah

    2012-10-01

    Full Text Available Economic performance of beef cattle operations can be severely hampered by acute calfhood diarrhea. Accordingly, a study was conducted at Bbalitvet to identify the causal agents, reduce clinical incidence, and increase body weight gain of newborn calves. One potential control is application of suitable vaccines to pregnant cows. The study was begun by identifying cases of diarrhea followed by isolation and identification of the causal agents in 12 beef cattle farms in West Java. A field trial was then designed for controlling calf diarrhea in such farms. Inactive vaccines Ecoli-Closvak polivalen were administered to pregnant cows to increase specific resistance of the newborn calves. At 2 months prepartum, 12 pregnant cows were assigned either to a vaccination or a placebo group, with a booster vaccination 3 weeks prior to parturition. Strict hygenic management was provided to both groups, and all calves were provided adequately with colostrum. Subjects were observed for 5 months, starting from the time of initial vaccination until the calves were 3 months of age. In the initial farm surveys, entero-pathogenic bacteria such as Escherichia coli serotype K99 and Clostridium perfringens type A and C were isolated and identified in fecal samples from 4 beef cattle farms in 3 districts (Garut, Tasikmalaya, Ciamis and 2 beef cattle farms in 2 districts (Tasikmalaya and Ciamis of West Java. In the vaccination trial, good immune responses to E. coli and C. perfringens alpha toxin measured by ELISA were observed. Application of effective control of calf diarrhea including vaccination and good livestock management showed good results. No death or signs of diarrhea were found in the new born calves up to 3 months of age. The rate of body weight gain was significantly higher in calves of vaccinated dams than in calves of non-vaccinated dams.

  4. Racecadotril in the treatment of acute watery diarrhea in children.

    Science.gov (United States)

    Salazar-Lindo, E; Santisteban-Ponce, J; Chea-Woo, E; Gutierrez, M

    2000-08-17

    Racecadotril (acetorphan), an enkephalinase inhibitor with antisecretory and antidiarrheal actions, is an effective and safe treatment for acute diarrhea in adults and children. Whether treatment with racecadotril and oral rehydration therapy is more effective than treatment with oral rehydration alone in hospitalized children with acute watery diarrhea is not known. We treated 135 boys 3 to 35 months of age who had watery diarrhea of five days' duration or less with racecadotril (1.5 mg per kilogram of body weight orally every eight hours) or placebo, in addition to oral rehydration solution. The primary end point was the 48-hour stool output (measured in grams); the total stool output, duration of diarrhea, and total intake of oral rehydration solution were also measured. The mean (+/-SE) 48-hour stool output was 92+/-12 g per kilogram in the racecadotril group and 170+/-15 g per kilogram in the placebo group (Pracecadotril. The results were similar among the 73 boys with rotavirus infections. The total stool output was 157+/-27 g per kilogram in the racecadotril group and 331+/-39 g per kilogram in the placebo group (Pracecadotril group (28 hours regardless of rotavirus status) than in the placebo group (72 and 52 hours, respectively, for rotavirus-positive and rotavirus-negative patients). The intake of oral rehydration solution was significantly lower in the racecadotril group than in the placebo group (PRacecadotril was well tolerated; only seven patients taking racecadotril had adverse effects, which were all mild and transient. In young boys with acute watery diarrhea, racecadotril is an effective and safe treatment.

  5. 9 CFR 113.215 - Bovine Virus Diarrhea Vaccine, Killed Virus.

    Science.gov (United States)

    2010-01-01

    ... vaccine production. All serials of vaccine shall be prepared from the first through the fifth passage from... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Bovine Virus Diarrhea Vaccine, Killed... REQUIREMENTS Killed Virus Vaccines § 113.215 Bovine Virus Diarrhea Vaccine, Killed Virus. Bovine Virus Diarrhea...

  6. Microvillus Inclusion Disease: Prenatal Ultrasound Findings, Molecular Diagnosis and Genetic Counseling of Congenital Diarrhea

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-12-01

    Conclusion: Prenatal sonographic identification of dilated bowel loops in association with polyhydramnios suggests congenital diarrhea and a differential diagnosis of microvillus inclusion disease in addition to congenital chloride diarrhea and congenital sodium diarrhea. Molecular analysis of the MYO5B gene is helpful in genetic counseling and prenatal diagnosis of recurrent microvillus inclusion disease in subsequent pregnancies.

  7. Addressing Sexual Harassment

    Science.gov (United States)

    Young, Ellie L.; Ashbaker, Betty Y.

    2008-01-01

    This article discusses ways on how to address the problem of sexual harassment in schools. Sexual harassment--simply defined as any unwanted and unwelcome sexual behavior--is a sensitive topic. Merely providing students, parents, and staff members with information about the school's sexual harassment policy is insufficient; schools must take…

  8. Addressing Social Issues.

    Science.gov (United States)

    Schoebel, Susan

    1991-01-01

    Maintains that advertising can help people become more aware of social responsibilities. Describes a successful nationwide newspaper advertising competition for college students in which ads address social issues such as literacy, drugs, teen suicide, and teen pregnancy. Notes how the ads have helped grassroots programs throughout the United…

  9. Sesotho Address Forms

    Directory of Open Access Journals (Sweden)

    Akindele, Dele Femi

    2008-01-01

    Full Text Available Address forms constitute an integral part of Basotho sociolinguistic etiquette. They are regarded as a kind of emotional capital that may be invested in putting others at ease. They are indicators of deference, politeness and markers of social distance. (Fasold 1990, Akindele 1990, 1991, 1993 This paper examines the address forms used by the Basotho people. It analyzes and discusses the various types and the factors determining their use. The discussion of address forms in Sesotho focuses on First Name, Title plus First Name, Title plus Last Name, Nickname, Multiple Names, and Teknonym. Drawing data from semi-literate and literate urban and rural population of Maseru district of Lesotho, it was found that the commonest form of address used by the Basotho people is title plus first name. e.g. ntate Thabo (father Thabo, 'm'e Puleng (mother Puleng, ausi Maneo (sister Maneo, abuti Mahao (brother Mahao. It is used by close relations, associates, and familiar people in both formal and informal situations.

  10. Socioeconomic, hygienic, and sanitation factors in reducing diarrhea in the Amazon.

    Science.gov (United States)

    Imada, Katiuscia Shirota; Araújo, Thiago Santos de; Muniz, Pascoal Torres; Pádua, Valter Lúcio de

    2016-12-22

    To analyze the contributions of the socioeconomic, hygienic, and sanitation improvements in reducing the prevalence of diarrhea in a city of the Amazon. In this population-based cross-sectional study, we analyzed data from surveys conducted in the city of Jordão, Acre. In 2005 and 2012, these surveys evaluated, respectively, 466 and 826 children under five years old. Questionnaires were applied on the socioeconomic conditions, construction of houses, food and hygienic habits, and environmental sanitation. We applied Pearson's Chi-squared test and Poisson regression to verify the relationship between origin of water, construction of homes, age of introduction of cow's milk in the diet, place of birth and the prevalence of diarrhea. The prevalence of diarrhea was reduced from 45.1% to 35.4%. We identified higher probability of diarrhea in children who did not use water from the public network, in those receiving cow's milk in the first month after birth, and in those living in houses made of paxiúba. Children born at home presented lower risk of diarrhea when compared to those who were born in hospital, with this difference reversing for the 2012 survey. Sanitation conditions improved with the increase of bathrooms with toilets, implementation of the Programa de Saúde da Família (PSF - Family Health Program), and water treatment in the city. The multivariate regression model identified a statistically significant association between use of water from the public network, construction of houses, late introduction of cow's milk, and access to health service with occurrence of diarrhea. Analisar as contribuições das melhorias socioeconômicas, higiênicas e de saneamento na redução da prevalência de diarreia em uma cidade na Amazônia. Neste estudo transversal de base populacional, foram analisados dados dos inquéritos realizados no município de Jordão, Acre. Em 2005 e 2012, foram avaliadas, respectivamente, 466 e 826 crianças menores de cinco anos. Foram

  11. Perceptions regarding oral rehydration solutions for the management of diarrhea in Guatemalan children: implications for diarrheal management in the Americas.

    Science.gov (United States)

    Arvelo, Wences; Degollado, Jocelyn; Reyes, Lissette; Álvarez, Andrés

    2013-08-01

    To describe knowledge and perceptions regarding the use of oral rehydration solution (ORS) for the management of diarrheal diseases among formal and informal health care providers and community caregivers in the Guatemalan department of Santa Rosa, and to recommend strategies to increase ORS use for management of diarrhea in children. From July to September 2008, in-depth, semi-structured interviews were conducted with formal health care providers; open-ended interviews were conducted with informal health care providers; and focus group discussions and pile sorting were carried out with community caregivers. The study participants attributed episodes of diarrhea in children to culturally recognized or folk ailments (empacho, cuajo, and varillas) that are primarily treated by traditional healers. There were knowledge deficits about 1) dehydration as a manifestation of diarrhea, and 2) management of dehydration, including the use of ORS and the need to continue feedings during diarrheal episodes. Caregivers perceived bottled/ready-made ORS products and the more expensive over-the-counter antidiarrheal medications as superior to ORS packets in the treatment of diarrhea. In Guatemala, folk etiologies of disease differ from those of the biomedical establishment and influence the decisions made by caregivers when treating ill children, including those related to the use of ORS. Public health campaigns addressing the treatment and management of diarrheal diseases in Santa Rosa should recognize the ailments known as empacho, cuajo, and varillas and target them for ORS use by community caregivers as well as health care providers in both the formal and informal health sectors.

  12. Assessment of chronic diarrhea in early infancy in Tehran Tertiary Care Center; Tehran-Iran

    Directory of Open Access Journals (Sweden)

    Farzaneh Motamed

    2015-03-01

    Full Text Available Introduction Chronic diarrhea of infancy is a heterogeneous syndrome that includes several diseases with different etiologies. The aim of this study was investigating chronic diarrhea, its etiologies, clinical features and outcomes in infancy.Materials and Methods Retrospective study investigating infants hospitalized in the gastroenterology department of Tehran tertiary care center.The main demographic data, etiology, characteristics of diarrhea, and outcome were evaluated. Data were analyzed by SPSS software,version 16.Results In this study, 63/9% of cases were female and 36/1% were male. 24 cases (66/7% had osmotic diarrhea and 11 (30/6% had secretory diarrhea. In this study there was no significant statistical correlation between type of diarrhea and sex, gestational Age, severity of dehydration, birth weight and nutrition. The majority of patients with osmotic (58/3% and secretory diarrhea (63/6%, had weight percentile below 3%, which showed a significant statistical difference (p value

  13. Prevalence and antibiogram of Shigella and Salmonella spp. from ...

    African Journals Online (AJOL)

    Diarrheal diseases remain the major cause of morbidity and mortality in children under five years of age. Salmonella and Shigella species are among the leading causes of diarrhea in children. The aim of this study was to determine the prevalence and antimicrobial profiles of Salmonella and Shigella spp. in children less ...

  14. Addressing the innovation gap.

    Science.gov (United States)

    Jeffrey, Phillip; Warne, Peter; Williams, Robert

    2007-05-01

    The 10 years since the mid-1990s have witnessed an unprecedented investment in Drug Discovery driven by both the unraveling of the human genome and the parallel introduction of various high-throughput technologies. During the same period, industry metrics describe a decline in the numbers of new molecular entities launched upon the global pharmaceutical markets. The Society for Medicines Research (SMR) meeting entitled "Addressing the Innovation Gap" brought together a program of expert speakers to comment upon the challenges currently facing the pharmaceutical industry and some of the measures being undertaken to enable future success.

  15. Bioreactors Addressing Diabetes Mellitus

    Science.gov (United States)

    Minteer, Danielle M.; Gerlach, Jorg C.

    2014-01-01

    The concept of bioreactors in biochemical engineering is a well-established process; however, the idea of applying bioreactor technology to biomedical and tissue engineering issues is relatively novel and has been rapidly accepted as a culture model. Tissue engineers have developed and adapted various types of bioreactors in which to culture many different cell types and therapies addressing several diseases, including diabetes mellitus types 1 and 2. With a rising world of bioreactor development and an ever increasing diagnosis rate of diabetes, this review aims to highlight bioreactor history and emerging bioreactor technologies used for diabetes-related cell culture and therapies. PMID:25160666

  16. Etiology and epidemiology of travelers' diarrhea in Asia.

    Science.gov (United States)

    Taylor, D N; Echeverria, P

    1986-01-01

    Travelers' diarrhea in Asia has been studied among Peace Corps volunteers in Thailand, Japanese travelers, foreign residents in Bangladesh, guests in hotels, and members of various tour groups. Rates of diarrheal attack of greater than 50% during four- to six-week sojourns were reported for these groups. Among travelers with diarrhea, the most commonly isolated pathogen was enterotoxigenic Escherichia coli (20%-34%), followed by Salmonella (11%-15%), Shigella (4%-7%), Campylobacter (2%-5%), and Vibrio parahaemolyticus (1%-13%). In 9%-22% of diarrheal episodes, multiple pathogens were recovered. Among Japanese travelers, Salmonella was more commonly acquired in the Far East; Shigella and Campylobacter, in the Indian subcontinent; and V. parahaemolyticus, in Southeast Asia. Aeromonas hydrophila and Plesiomonas shigelloides were commonly isolated from ill travelers in Thailand but less frequently from other travelers. Protozoa and Vibrio species other than V. parahaemolyticus were isolated in less than 5% of episodes.

  17. Extremely rare cause of congenital diarrhea: enteric anendocrinosis.

    Science.gov (United States)

    Sayar, Ersin; Islek, Ali; Yilmaz, Aygen; Akcam, Mustafa; Flanagan, Sarah E; Artan, Reha

    2013-10-01

    Congenital diarrheal disorders consist of a variety of chronic enteropathies. There are approximately 30 different diseases that can be classified into four groups according to the mechanisms involved in pathogenesis: (i) absorption and transport of nutrients and electrolytes; (ii) enterocyte differentiation and polarization; (iii) enteroendocrine cell differentiation; and (iv) modulation of the intestinal immune response. Affected patients often present with life-threatening diarrhea, in the first few weeks of life. A new disorder, enteric anendocrinosis, which is characterized by severe malabsorptive diarrhea and a lack of intestinal enteroendocrine cells has recently been described in six patients with recessively inherited mutations in the Neurogenin-3 gene. In this report we describe a seventh case with a review of the literature. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  18. Experimental infection of reindeer with bovine viral diarrhea virus

    Directory of Open Access Journals (Sweden)

    J.K. Morton

    1990-08-01

    Full Text Available Two 8-month reindeer (Rangifer tarandus and a 1-month-old Hereford-Holstein calf (Bos taurus were inoculated intranasally with the Singer (cytopathogenic strain of bovine viral diarrhea (BVD virus. Clinical signs in reindeer included loose stools containing blood and mucus, and transient laminitis or coronitis. Signs in the calf were limited to bloody mucus in the stool and lesions in the nasal mucosa. Antibody titers to BVD virus in the reindeer were intermittent, and titers in the calf persisted from days 14 to 63 post-inoculation (PI. Viremia was detected on PI day 4 in one reindeer, days 3-7 in the other, and days 2-7 in the calf. Bovine viral diarrhea virus was isolated from the lung of the calf at necropsy (PI day 63.

  19. Porcine Epidemic Diarrhea Virus Induces Autophagy to Benefit Its Replication

    Directory of Open Access Journals (Sweden)

    Xiaozhen Guo

    2017-03-01

    Full Text Available The new porcine epidemic diarrhea (PED has caused devastating economic losses to the swine industry worldwide. Despite extensive research on the relationship between autophagy and virus infection, the concrete role of autophagy in porcine epidemic diarrhea virus (PEDV infection has not been reported. In this study, autophagy was demonstrated to be triggered by the effective replication of PEDV through transmission electron microscopy, confocal microscopy, and Western blot analysis. Moreover, autophagy was confirmed to benefit PEDV replication by using autophagy regulators and RNA interference. Furthermore, autophagy might be associated with the expression of inflammatory cytokines and have a positive feedback loop with the NF-κB signaling pathway during PEDV infection. This work is the first attempt to explore the complex interplay between autophagy and PEDV infection. Our findings might accelerate our understanding of the pathogenesis of PEDV infection and provide new insights into the development of effective therapeutic strategies.

  20. Current Approaches to the Treatment of Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    О.S. Niankovska

    2015-10-01

    Full Text Available This article considers the current approaches to the treatment of acute diarrhea, taking into account the ESPGHAN guidelines (2014, which involves the use of oral rehydration therapy, zinc at a dose of 10 mg/day in children under 6 months, in children older than 6 months — 20 mg/day for 10–14 days, probiotics, antisecretory and antiemetic drugs, adsorbents and antibiotics.

  1. 'Halloween diarrhea'. An unexpected trick of sorbitol-containing candy.

    Science.gov (United States)

    Breitenbach, R A

    1992-10-01

    When a patient with severe diarrhea and flatulence is afebrile and the results of physical examination are negative, a food source should be suspected as the cause of the problem. Careful scrutiny of the patient's diet and a high index of suspicion may implicate the artificial sweetener sorbitol. Exclusion of sorbitol from the patient's diet is recommended in these cases before embarking on an extensive clinical investigation.

  2. PROBIOTICS AS TREATMENT OF ACUTE DIARRHEA IN INFANT AND CHILDREN

    Directory of Open Access Journals (Sweden)

    I Wayan Wawan

    2013-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Diarrhea is a common disease in children after acute respiratory tract infection. Expected, diarrhea was found approximately one billion cases per year and the first etiology of morbidity and mortality in children in Asia, Africa, and America Latin. The management of acute diarrhea according to WHO recommendation consisted of oral rehydration (low osmolarity ORS, diet, zinc supplementation, selective antibiotic, and education to parents. In several randomized controlled trials (RCT and meta-analysis was showing that probiotics effective for primary and secondary prevention of acute diarrhea.     st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  3. ANTIBIOTIC-ASSOCIATED DIARRHEA AND ANTIBIOTIC-ASSOCIATED COLITIS

    Directory of Open Access Journals (Sweden)

    E. A. Belousova

    2014-01-01

    Full Text Available The article presents most recent data on antibiotic-associated intestinal disorders. The author reviews epidemiology and causative microorganisms in antibiotic-induced diarrhea and pseudomembranous colitis as well as clinical variants of antibiotic-associated disorders. Diagnosis methods are decribed at length with special attention to most sensitive and informative tests. Treatment of different clinical variants of antibiotic-induced disorders is discussed in detail.

  4. Persistent diarrhea: 15 years experience at a tertiary care hospital.

    Science.gov (United States)

    Vithayasai, Niyada; Jennuvat, Siriluck

    2014-06-01

    To determine the risk factors, causative enteric pathogens, final diagnosis and treatment outcomes of persistent diarrhea in children. A retrospective study of the patients who had diarrheal symptoms for at least 14 days diagnosed as persistent diarrhea (PD) and admitted at QSNICH during January 1997 and December 2011. Demographic data, risk factors, causative enteric pathogens, management and outcome were reviewed. The review included 79 PD patients. Excluded were patients who were HIV seropositive, had GI anomalies and/or other underlying immune deficiencies. The demographic data showed mean age 11.42 months and male:female 56:23 (2.43:1). Feeding with infant formula before admission was 43% compared to exclusive breastfeeding that was only 10%. Normal nutritional status was found in half of the cases (52.1%) and protein energy malnutrition (PEM) was present in 42.3%. Stool for enteropathogens was positive only in 49.4% and the most common being mixed enteropathogens. Secondary lactase deficiency was the cause of PD in half (50%) of the patients. Management consisted of rehydration, intravenous antibiotics 53%, and other adjuvant therapies such as cholestyramine, zinc and probiotics. Along with rehydration, all patients received aggressive nutritional management upon admission. The diarrhea subsided in less than 7 days in about 70% of the patients. The present study supports that important risk factors for PD are very young age group (especially under 1 year old), lack of breastfeeding and malnutrition. Enteropathogens were found in only about half of the patients and the most common cause of PD was secondary lactase deficiency. Most of the diarrhea subsided in less than 7 days of admission with proper management and aggressive nutrition upon admission.

  5. Enteropathogenic bacteria isolated from specimens of patients with diarrhea

    OpenAIRE

    Salary M

    1997-01-01

    Acute infectious gastroenteritis is one of the most common infectious diseases of humans in the world. Diarrheal disease still ranks very high as a major cause of illness and death especially in developing nations. This study has been carried out to investigate enteropathogenic bacteria isolated from 2517 specimens of patients with diarrhea. The results obtained are as follow: Salmonella typhimurium: 6 cases 3.1 percent, Salmonella havana: 5 cases 2.6 percent, Shigella dysenteriae: 12 cases 6...

  6. Bovine viral diarrhea virus: affinity chromatography on Crotalaria juncea lectin.

    Science.gov (United States)

    Moreno-Lopez, J; Kristiansen, T; Kårsnas, P

    1981-04-01

    Attempts were made to purify bovine viral diarrhea virus by chromatography on Crotalaria juncea lectin coupled to Sepharose 2B. A recovery of abut 65% of viral infectivity after desorption was obtained. Electron microscopy revealed mostly de-enveloped particles, rather uniform in appearance but differing in size. Immunodiffusion tests with immune calf sera showed precipitation lines of identity between the desorbed virus and extracts from infected cell cultures.

  7. Addressing Environmental Health Inequalities

    Directory of Open Access Journals (Sweden)

    Nelson Gouveia

    2016-08-01

    Full Text Available Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH, “Addressing Environmental Health Inequalities—Proceedings from the ISEE Conference 2015”, we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE, held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics.

  8. Addressing Environmental Health Inequalities.

    Science.gov (United States)

    Gouveia, Nelson

    2016-08-27

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), "Addressing Environmental Health Inequalities-Proceedings from the ISEE Conference 2015", we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics.

  9. Intestinal parasitic infections in leukemic patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Serhat Uysal, Eylem Akdur, Varol Tunalı

    2017-06-01

    Full Text Available Objectives: Leukemic patients are at increased risk of severe infections with parasites. Moreover, intestinal parasites can lead to severe diarrhea in patients with immunosuppression. The purpose of this study is to decide intestinal parasitic infections and clinical aspects in leukemic patients. Methods: Analysis was done of all leukemic patients hospitalized between January 2007 and October 2015 retrospectively. Results: Ninety-one patients were evaluated. Intestinal parasites were diagnosed in nine (9.9% patient. Cryptosporidium was the most frequently identified parasite, recovered from six specimens (6.6%, while Blastocystis (n=3 and Entamoeba (n=1 accounted for 3.3% and 1.1%, respectively. Cryptosporidium spp. and E. histolytica were detected together in one patient. Duration of diarrhea in patients with and without parasite were 16.1±9.3 and 7.9±2.9days, respectively (P=0.037. Abdominal cramps in patients with and without parasite were present in seven (77.8% and 20 (24.4% patients, respectively (P=0.002. In contrast, vomiting in patient with and without parasite were present in five (55.6% and 81 (98.8% patients, respectively (P<0.0005. Conclusion: Parasitic infections should be considered for differential diagnosis in leukemic patients with diarrhea. J Microbiol Infect Dis 2017; 7(2: 63-66

  10. Isolation and antibiotic sensitivity of Aeromonas from children with diarrhea

    Directory of Open Access Journals (Sweden)

    Meiyanti Meiyanti

    2016-02-01

    Full Text Available Aeromonas species are gram-negative, motile, facultative anaerobic, rod shaped, oxidase positive bacteria of the recently assigned family Aeromonadaceae. The significance of Aeromonas species as causative agent of human diarrhoea has recently been established. The aim of the present study was to investigate the distribution, and antibiotic sensitivity of Aeromonas in nonhospitalized children with diarrhea.One hundred and seventeen rectal swabs from children with diarhhea were cultured for isolation of Aeromonas organisms as the etiological agents. In addition to Aeromonas, other enteric pathogens were also isolated. Overall, the isolates of enteric pathogens amounted to 36.8%, consisting of Salmonella, Shigella, Aeromonas, and Vibrio. Aeromonas was only found in 5.1% of cultures, with a ratio of A. caviae and A. hydrophila of 2:1, while Salmonella made up the majority of causative organisms with an isolation frequency of 18.8%, followed by Shigella with 11.1%. In this study no isolates of Vibrio cholerae O1 were found as etiological agents of diarrhea; however, V. cholerae non-O1 and V. parahaemolyticus were found in small numbers (<1%. All isolates of Aeromonas were resistant to ampicillin and tetracycline, but sensitive to ciprofloxacin and ceftriaxone, as were the other enteric pathogens. Although the frequency of isolation of these enteric pathogens was higher than for Vibrio spp., their role in infective diarrhea was less clearcut in comparison with Salmonella and Shigella.

  11. Traveler's diarrhea-I. Definition, etiology and epidemiology.

    Science.gov (United States)

    Broor, S L; Singal, A K

    1989-01-01

    With the development of rapid and convenient means of transportation, several million persons travel from industrialized countries to developing countries every year. From USA alone, approximately 4 million persons visit Mexico annually. These travelers are at risk to develop several infections during their stay abroad, but the most commonly experienced illness is diarrhea. The attack rate of diarrhea in travelers may be as high as 25 to 50 percent; 30 percent of those who get diarrhea are ill enough to be confined to bed and another 40% have to change their scheduled travel plans. The disease affects all ranks and it has achieved worldwide fame by its several euphemisms. Various epithets used to describe this illness include GI trots, Aden gut, Barsa belly, Turkey trot, Delhi belly, Hongkong dog, Montezuma's revenge, gyppsy tummy and turista. There have been considerable advances in our understanding about the etiology and epidemiology of this disease in the last two decades and the purpose of this review is to highlight some of this new information.

  12. Solanum paniculatum root extract reduces diarrhea in rats

    Directory of Open Access Journals (Sweden)

    Jonh A.B. Tenório

    Full Text Available Abstract Solanum paniculatum L., Solanaceae, locally known as "jurubeba", is widely used in Brazil for culinary purposes, and in folk medicine to treat of diverse disorder including gastric dysfunctions. In this study we investigated the antidiarrheal activity of S. paniculatum roots extract in rats at different concentrations (125, 250 and 500 mg/kg, p.o using different experimental models such as castor oil-induced diarrhea, enteropooling and gastrointestinal motility, determined by in vivo experimental models. The major compound of root extract was characterized as chlorogenic acid based in the IR, 1D and 2D NMR analysis. All the extract doses achieved antidiarrheal potency, as indicated by reduced weight of feces in castor oil-induced diarrhea, decreased intestinal motility and significantly inhibited castor oil-induced enteropooling compared to the vehicle group. The highest dose (500 mg/kg produced greater anti-motility effect and better reduction of enteropooling, similar to the reference drug Loperamide (5 mg/kg. Extract from S. paniculatum L. roots had antidiarrheal activity, as shown by the lower weight of the feces as well as decrease in the accumulation of intestinal fluid and slower transit, justifying the traditional use of plant for diarrhea.

  13. Congenital chloride diarrhea: a review of twelve Arabian children.

    Science.gov (United States)

    Elrefae, Fawaz; Elhassanien, Ahmed Farag; Alghiaty, Hesham Abdel-Aziz

    2013-01-01

    Congenital chloride diarrhea (CCD), a rare autosomal recessive disorder, is characterized by sustained watery diarrhea (due to defect of active Chloride/HCO3 exchange in the ileum and colon) with high fecal chloride. To spotlight the common presentation of CCD for early management and prevention of complications. This is a retrospective case series study of patients diagnosed as CCD who were followed up in the pediatric department of Al-Adan Hospital, Kuwait. Twelve patients diagnosed with CCD were born to consanguineous parents; had antenatal history of intrauterine growth retardation (IUGR); polyhydramnios; and distended hypoechoic fetal bowel; and presented with abdominal distension, hypotonia and muscle wasting. 90% of patients had maternal hypertension and 75% of patients had absence of normal meconium at birth. Our patients showed a decrease in serum sodium, potassium, chloride and urine chloride. A high level of suspicion for an early diagnosis of CCD should be considered for any infant presenting with chronic diarrhea, especially in the presence of consanguineous marriage, and the characteristic features in antenatal ultrasound. Thus, allowing for early investigations and appropriate management.

  14. Microscopic colitis: Common cause of unexplained nonbloody diarrhea

    Science.gov (United States)

    Ingle, Sachin B; Adgaonkar, Baban D; (Ingle), Chitra R Hinge

    2014-01-01

    Microscopic colitis (MC) is characterized by chronic, watery, secretory diarrhea, with a normal or near normal gross appearance of the colonic mucosa. Biopsy is diagnostic and usually reveals either lymphocytic colitis or collagenous colitis. The symptoms of collagenous colitis appear most commonly in the sixth decade. Patients report watery, nonbloody diarrhea of a chronic, intermittent or chronic recurrent course. With collagenous colitis, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa, and with lymphocytic colitis, an increased number of intraepithelial lymphocytes. Histological workup can confirm a diagnosis of MC and distinguish the two distinct histological forms, namely, collagenous and lymphocytic colitis. Presently, both forms are diagnosed and treated in the same way; thus, the description of the two forms is not of clinical value although this may change in the future. Since microscopic colitis was first described in 1976 and only recently recognized as a common cause of diarrhea, many practicing physicians may not be aware of this entity. In this review, we outline the epidemiology, risk factors associated with MC, its etiopathogenesis, the approach to diagnosis and the management of these individuals. PMID:24891975

  15. Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town.

    Science.gov (United States)

    Adugna, Ayrikim; Kibret, Mulugeta; Abera, Bayeh; Nibret, Endalkachew; Adal, Melaku

    2015-06-01

    Diarrheal disease and its complications remain a major cause of morbidity and mortality in children. The prevalence and antibiogram of E. coli as causative agents of diarrhea vary from region to region, and even within countries in the same geographical area. To determine the serotype and antimicrobial susceptibility of E. coli in children under-five years of age. A cross-sectional study was conducted among 422 children with diarrhea from December 2011 to February 2012. Identification of E. coli and antimicrobial susceptibility testing were done following standard procedures. The overall isolation rate of E. coli was 48.3%. Poly 2 sero-groups, poly 3 sero-groups, poly 4 sero-groups and E. coli O157:H7 accounted for 80 (39.2%), 40 (19.6%), 25 (12.3%), and 59 (28.9%) of the isolates, respectively. Poly 2 sero-groups, constituting isolates belonging to enteropathogenic E. coli were the most commonly isolated serotypes. E. coli exhibited high levels of antimicrobial resistance to ampicillin (86.8%), tetracycline (76%) and cotrimoxazole (76%). Low levels of resistance to ciprofloxacin (6.9%) and norfloxacin (9.3%) were documented. High prevalence of diarrheagenic E. coli compounded by alarming antimicrobial resistances is a serious public health problem. Regular determination of antibiogram and public education are recommended.

  16. Reactivated cytomegalovirus proctitis in an immunocompetent patient presenting as nosocomial diarrhea: a case report and literature review.

    Science.gov (United States)

    Lee, Chun-Yuan; Chen, Yen-Hsu; Lu, Po-Liang

    2017-02-01

    Reactivated cytomegalovirus (CMV) infection has been known to cause significant morbidity and mortality in immunocompromised patients. However, CMV disease rarely develops in immunocompetent patients, and reported cases often present with a mild, self-limiting course, without severe life-threatening sequelae. While the colon is the most common gastrointestinal site affected by CMV disease in immunocompetent patients, rectal involvement is rarely reported. CMV proctitis can present in two distinct forms, primary and reactivated. However, reactivated CMV proctitis is rarely reported as a causative etiology of nosocomial diarrhea, except in transplant patients. Herein we present a case of reactivated CMV proctitis in an immunocompetent patient, presenting as nosocomial diarrhea. Previously reported cases of reactivated CMV proctitis in immunocompetent patients are also reviewed. A 79-year-old female was admitted because of metabolic encephalopathy caused by dehydration and hypernatremia. The patient's consciousness level returned rapidly after fluid supplementation. However, she subsequently presented with abdominal pain and diarrhea on day 8 of admission. Abdominal contrast-enhanced computed tomography on day 10 of admission demonstrated inflammation around the rectum, suggesting proctitis. Colonoscopy on day 16 of admission showed a giant ulcer at the rectum. Pathology of rectal biopsy confirmed CMV infection. The patient recovered without sequelae after 38 days of valganciclovir treatment. Follow-up colonoscopy revealed a healed ulcer over the rectum. Ten cases in the literature, plus our case, with reactivated CMV proctitis in immunocompetent patients were reviewed. We found that most patients were elderly (mean, 72 years) with a high prevalence of diabetes mellitus (54.5%). Cardinal manifestations are often non-specific (diarrhea, hematochezia, tenesmus), and eight (72.7%) developed CMV proctitis following a preceding acute, life-threatening disease, rather

  17. Diarrhea outbreak during U.S. military training in El Salvador.

    Directory of Open Access Journals (Sweden)

    Matthew R Kasper

    Full Text Available Infectious diarrhea remains a major risk to deployed military units worldwide in addition to their impact on travelers and populations living in the developing world. This report describes an outbreak of diarrheal illness in the U.S. military's 130(th Maneuver Enhancement Brigade deployed in San Vicente, El Salvador during a training and humanitarian assistance mission. An outbreak investigation team from U.S. Naval Medical Research Unit-Six conducted an epidemiologic survey and environmental assessment, patient interviews, and collected stool samples for analysis in an at risk population of 287 personnel from May 31(st to June 3(rd, 2011. Personnel (n = 241 completed an epidemiological survey (87% response rate and 67 (27% reported diarrhea and/or vomiting during the past two weeks. The median duration of illness was reported to be 3 days (IQR 2-4 days and abdominal pain was reported among 30 (49% individuals. Presentation to the medical aid station was sought by (62% individuals and 9 (15% had to stop or significantly reduce work for at least one day. Microscopy and PCR analysis of 14 stool samples collected from previously symptomatic patients, Shigella (7, Cryptosporidium (5, and Cyclospora (4 were the most prevalent pathogens detected. Consumption of food from on-base local vendors (RR = 4.01, 95% CI = 1.53-10.5, p-value <0.001 and arriving on base within the past two weeks (RR = 2.79, 95% confidence [CI] = 1.35-5.76, p-value = 0.001 were associated with increased risk of developing diarrheal disease. The risk of infectious diarrhea is great among reserve military personnel during two week training exercises. The consumption of local food, prepared without proper monitoring, is a risk factor for deployed personnel developing diarrheal illness. Additional information is needed to better understand disease risks to personnel conducting humanitarian assistance activities in the Latin America Region.

  18. Probiotic Weisella paramesenteroides on enteropathogenic E. coli-induced diarrhea

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    Aslinar Aslinar

    2014-02-01

    Full Text Available Background Enteropathogenic Escherichia coli (EPEC is a causative agent of intestinal inflammation and microfloral imbalance, leading to diarrhea. The presence of tumor necrosis factor-α (TNF-α in the feces is an indicator of inflammation in the intestinal mucosa. Dadih, (local made of fermented buffalo milk, contains probiotics and is widely consumed by the people in West Sumatera, Indonesia. Weisella paramesenteroides, a probiotic lactic acid bacteria (LAB, has been isolated from dadih and is believed to be useful for improving intestinal microflora balance and inhibiting the activity of harmful microbes. Objective To determine the efficacy of W. paramesenteroides administration in various doses and durations on bowel frequency, stool’s TNF-α levels, and intestinal microflora balance on mice with EPEC-induced diarrhea. Method This randomized experimental animal study examined two factors relating to the effects of W. paramesenteroides on EPEC-induced diarrhea, namely doses of probiotics (factor A, and durations of observation (factor B. The subjects consisted of 100 male white mice (Mus musculus aged 8 weeks, with weights of 25-30 grams. The outcomes measured were bowel frequency, stool’s TNF-α levels, and the balance of intestinal microflora on mice with EPEC-induced diarrhea.  Subjects were divided into 5 groups: the negative control group (received neither EPEC nor probiotic, positive control group (received only EPEC, and three experimental groups (received EPEC and different doses of W. paramesenteroides . Probiotics were given twice at the 12-hours and 24-hours for the experimental groups, while the durations of observation conssited of baseline, 12 hours, 24 hours, and 36 hours. Results After 36 hours, subjects with EPEC-induced diarrhea who received W. Paramesenteroides administration in doses of 2 x 108 (A3, were found to have the largest decline of mean defecation (a 4.4-fold decline and the largest decline of stool’s mean

  19. Growth assessment in Egyptian infants and children with chronic diarrhea.

    Science.gov (United States)

    Ei-Deeb, Marwa T; Hamid, Dalia H Abdel

    2012-12-01

    This study evaluated the various growth parameters among patients presenting with chronic diarrhea and highlight the most common causes of chronic diarrhea among a sample of Egyptian infants and children. This cross-sectional study included 146 patients with chronic diarrhea. They were 87 males and 59 females, with age ranging between 2 and 198 months and a mean age of 27.3 +/- 34.5 months. Each patient was subjected to medical history taking including age of onset and duration of diarrhea, consistency of stools, presence of blood and mucus, vomiting with or without hematemesis, fever, allergic manifestations and family history of atopy. Dietetic history included milk feeding during the first 6 months and age of weaning and age of introduction of cow's milk products. Anthropometric measurements included weight and height and weight for height were assessed and z-scores were calculated using software WHO anthro v3.2.2. Laboratory investigations included stool analysis and culture, CBC and all other investigations necessary for diagnosis of the definite cause including RAST for specific IgE against cow's milk proteins, serology for celiac disease (anti-gliadin and anti tTG), Breath hydrogen test, endoscopy (colonoscopy or esophago-gastrodudenoscopy) and histopathologic assessment of endoscopic biopsies. CMA was diagnosed on basis of withdrawal and open re-challenge technique. Causes included chronic infections (40.4%), CMA (34.9%), celiac disease (10.3%), inflammatory bowel disease (6.8%) and lactose intolerance (3.4%). Rare causes were chronic non-specific diarrhea (1.3%), cystic fibrosis (0.7%), post-surgery short bowel syndrome (0.7%), neuroblastoma (0.7%) and IBS (0.7%).78.7% of patients enrolled in the study had a low WFA z-score (< -2), 75% had low length for age z-score (<-2) and 50.7% showed wasting with low weight for height z-scores (< -2). Patients with IBD had the lowest mean value of WFA and HFA z-scores (-4.03 +/- 3.23, -6.31 +/- 3.74 respectively

  20. Diarrea funcional como causa de diarrea crónica Functional diarrhea as cause of chronic diarrhea

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    Trini Fragoso Arbelo

    2010-12-01

    Full Text Available La diarrea funcional se presenta con frecuencia en la práctica pediátrica, y generalmente no se asocia a alteraciones nutricionales, pero sí a esquemas dietéticos incorrectos. Se actualiza su importancia clínica, se hace énfasis en la patogenia, diagnóstico y en los métodos de tratamiento. Consideramos que es la causa más frecuente de diarrea crónica inespecífica, y que el interrogatorio dirigido según los criterios de Roma es útil para su diagnóstico. La mayoría de los pacientes con esta enfermedad en la infancia deben ser tratados en la atención primaria.The functional diarrhea is frequent in the pediatric practice and in general it is not associated with nutritional alterations, but to incorrect dietary schemes. Its clinical significance is updated and its pathogenesis, diagnosis and treatment methods are emphasized. Authors considered that the functional diarrhea is the more frequent cause of unspecific chronic diarrhea and the questioning directed according the Rome criteria is very useful for its diagnosis. Most of patients presenting with this disease during childhood must to be treated in primary care services.

  1. Duodenal villous atrophy: a cause of chronic diarrhea after solid-organ transplantation.

    Science.gov (United States)

    Weclawiak, H; Ould-Mohamed, A; Bournet, B; Guilbeau-Frugier, C; Fortenfant, F; Muscari, F; Sallusto, F; Dambrin, C; Esposito, L; Guitard, J; Abbal, M; Rostaing, L; Kamar, N

    2011-03-01

    Persistent diarrhea is commonly observed after solid organ transplantation (SOT). A few cases of mycophenolate mofetil (MMF)-induced duodenal villous atrophy (DVA) have been previously reported in kidney-transplant patients with chronic diarrhea. Herein, we report on the incidence and characteristics of DVA in SOT patients with chronic diarrhea. One hundred thirty-two SOT patients with chronic diarrhea underwent an oesophago-gastroduodenoscopy (OGD) and a duodenal biopsy after classical causes of diarrhea have been ruled out. DVA was diagnosed in 21 patients (15.9%). It was attributed to mycophenolic acid (MPA) therapy in 18 patients (85.7%) (MMF [n = 14] and enteric-coated mycophenolate sodium [n = 4]). MPA withdrawal or dose reduction resulted in diarrhea cessation. The incidence of DVA was significantly higher in patients with chronic diarrhea receiving MPA compared to those who did not (24.6% vs. 5.1%, p = 0.003). DVA was attributed to a Giardia lamblia parasitic infection in two patients (9.5%) and the remaining case was attributed to azathioprine. In these three patients, diarrhea ceased after metronidazole therapy or azathioprine dose reduction. In conclusion, DVA is a frequent cause of chronic diarrhea in SOT recipients. MPA therapy is the most frequent cause of DVA. An OGD should be proposed to all transplant recipients who present with persistent diarrhea. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. ROLE OF PROBIOTICS IN PREVENTION AND TREATMENT OF ANTIBIOTIC-ASSOCIATED DIARRHEA IN CHILDREN

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    A. N. Surkov

    2014-01-01

    Full Text Available Numerous scientific studies have proved an important role of microbiota in maintaining adequate functioning of the macroorganism and thrown light upon the various issues associated with functional disturbances. Thus, one of the most common causes of intestinal dysbiosis in children is antibiotic therapy, in the setting whereof antibiotic-associated diarrhea (AAD associated with, but not limited to, pathological activity of Clostridium difficile byproducts — enterotoxin (toxin A, cytotoxin (toxin B and intestinal peristalsis-inhibiting protein — may develop. However, there are only few published research data on AAD prevalence in children all over the world, which is why it appears impossible to assess the large scale of the problem. That is why it is absolutely necessary to continuously upgrade perception of the role of normal microbiota, etiological factors inducing pathological alterations thereof and approaches to correction of dysbiotic disorders by various medical specialists. Analysis of the current scientific literature demonstrated that AAD prevalence in children varies from 6.2 to 80% depending on the country. The most common (23% cause of AAD is associated with amoxicillin/clavulanate intake. Moreover, there are data indicating that the AAD development risk is the highest in under-2 children.At the same time, there are data on the protective effect of probiotics, especially of the complex drugs containing a balancedcombination of bifidus and lactic bacteria, on microbiota. 

  3. Expression of serotonin receptors in the colonic tissue of chronic diarrhea rats.

    Science.gov (United States)

    Zhu, Tong; Qiu, Juanjuan; Wan, Jiajia; Wang, Fengyun; Tang, Xudong; Guo, Huishu

    2016-01-01

    This study aimed to investigate the difference among the expression of serotonin receptors (5-HT3, 5-HT4, and 5-HT7receptors) in colonic tissue of chronic diarrhea rats. A rat model of chronic diarrhea was established by lactose diet. The expression of 5-HT3, 5-HT4, and 5-HT7receptors in the colonic tissue was detected using immunohistochemistry, real-time PCR and Western blotting techniques. There is no significant difference on the protein expression of 5-HT3receptor between the normal group and the chronic diarrhea model group. The mRNA expression of 5-HT3receptor in the chronic diarrhea model group was significantly lower than that in the normal group (n = 10; Pchronic diarrhea model group were significantly higher than those in the normal group (n = 10; Pchronic diarrhea model group were significantly decreased compared with the normal group (n = 10; Pdiarrhea by lactose diet.

  4. Effect of probiotics on diarrhea in children with severe acute malnutrition

    DEFF Research Database (Denmark)

    Grenov, Benedikte; Namusoke, Hanifa; Lanyero, Betty

    2017-01-01

    OBJECTIVES: To assess the effect of probiotics on diarrhea during in- and outpatient treatment of children with severe acute malnutrition (SAM). METHODS: A randomized, double-blind, placebo-controlled study was conducted involving 400 children admitted with SAM. Patients received one daily dose......- and outpatient treatment separately. The primary outcome was number of days with diarrhea during hospitalization. Secondary outcomes included other diarrhea outcomes, pneumonia, weight gain, and recovery. RESULTS: There was no difference in number of days with diarrhea between the probiotic (n = 200) and placebo...... (n = 200) groups during inpatient treatment (adjusted difference +0.2 days, 95% CI -0.8 to 1.2, p = 0.69), however during outpatient treatment, probiotics reduced days with diarrhea (adjusted difference -2.2 days 95% CI -3.5 to -0.3, p = 0.025). There were no effects of probiotics on diarrhea...

  5. Sensitivity and specificity of procalcitonin to determine etiology of diarrhea in children younger than 5 years.

    Science.gov (United States)

    Ismaili-Jaha, Vlora; Shala, Mujë; Azemi, Mehmedali; Spahiu, Shqipe; Hoxha, Teuta; Avdiu, Muharrem; Spahiu, Lidvana

    2014-04-01

    The aim of this study is to assess the sensitivity and specificity of procalcitonin to determine bacterial etiology of diarrhea. For this purpose we conducted the study comprising 115 children aged 1 to 60 months admitted at the Department of Pediatric Gastroenterology, Pediatric Clinic, divided in three groups based on etiology of the diarrhea that has been confirmed with respective tests during the hospitalization. Each group has equal number of patients - 35. The first group was confirmed to have bacterial diarrhea, the second viral diarrhea and the third extra intestinal diarrhea. The determination of procalcitonin has been established with the ELFA methods of producer B.R.A.H.M.S Diagnostica GmbH, Berlin, (Germany). From the total number of 1130 patient with acute diarrhea procalcitonin was assessed in 105. 67 (63.8%) of these patient were male. More than one third (38.14%) of the children in our study were younger then 12 months. Approximately the same was the number of children 13-24 months (33 patients or 31.43%) and 25-60 months (32 patients or 30.43%). The mean value of PRC in children with viral diarrhea was 0.13±0.5 ng/mL in children with bacterial diarrhea was 5.3±4.9 ng/m Land in children with extra intestinal diarrhea was 1.7±2.8 ng/mL. When measured using ANOVA and Turkey HSD tests, results have shown the statistical significance when comparing viral with bacterial and extra intestinal diarrhea but were statistically insignificant when comparing bacterial and extra intestinal diarrhea. Procalcitonin is an important but not conclusive marker of bacterial etiology of acute diarrhea in children younger than 5 years.

  6. Acute Rotavirus-Induced Diarrhea in Children: Clinical Picture, Diagnosis, Treatment

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    S.L. Niankovskyi

    2015-09-01

    Full Text Available The paper considers the current aspects of epidemiology, diagnosis, clinical picture and treatment of acute rotavirus-induced diarrhea in children. There are presented the basic thesis of ESPGHAN consensus (2014 about acute diarrheas. There was analyzed the effectiveness of probiotic Subalin producing interferon for the treatment of acute rotavirus-induced diarrhea. It was demonstrated its effectiveness according to the literature review and own data.

  7. Dientamoeba fragilis as a cause of travelers' diarrhea: report of seven cases.

    Science.gov (United States)

    Stark, Damien; Beebe, Nigel; Marriott, Deborah; Ellis, John; Harkness, John

    2007-01-01

    Dientamoeba fragilis is a pathogenic trichomonad parasite that causes gastrointestinal disease in humans. We report seven cases of travelers' diarrhea caused by D fragilis in patients who had traveled to overseas destinations within Asia or the Pacific which occurred over an 8-month period. Patients presented with diarrhea lasting from 5 days to over 4 weeks. Dientamoeba fragilis should be considered as a cause of diarrhea in returning travelers.

  8. Effect of Prolonged Diarrhea in Renal Transplant Recipients at a Single Center in Taiwan.

    Science.gov (United States)

    Wang, H-Y; Yeh, M-K; Tian, Y-F; Huang, Y-B

    2016-04-01

    Post-renal transplantation diarrhea is a common complication; however, it is easily ignored. This study aimed to determine the factors influencing graft function for renal transplant recipients with diarrhea. A single-center retrospective study with the use of the Hyperion data warehouse was conducted to search and evaluate for renal transplant recipients who came for medical care for diarrhea at our transplant center from January 2009 to August 2015. The clinical features of patients with diarrhea were compared with the features of recipients without diarrhea. The causes and risk factors of post-transplantation diarrhea were also evaluated. For the 67 patients collected for the study, infectious diarrhea (ID) was confirmed in 27 patients (40.3%), and the most common causes were cytomegalovirus and Clostridium difficile infection. A significant difference was found between ID and noninfectious (NID) groups for serum creatinine change (0.31 ± 0.51 vs 0.1 ± 0.27 mg/dL; P = .0319), revealing that the impact of diarrhea on renal function was greater for ID patients. When diarrhea of ≥10 days was used as a cutoff for serum creatinine change, the change of serum creatinine became greater when the diarrhea period was longer (14 d: 0.07 ± 0.22 vs 0.55 ± 0.6 mg/mL; P = .0001). Infectious diarrhea does more damage to the kidney graft than NID in transplant recipients. If the period of diarrhea is lengthened to >10 days, the renal function of the graft would be impaired and irreversible graft loss would be expected. Copyright © 2016. Published by Elsevier Inc.

  9. Assessment of chronic diarrhea in early infancy in Tehran Tertiary Care Center; Tehran-Iran

    OpenAIRE

    Farzaneh Motamed; Naheid Kazemi; Raheleh Nabavizadeh

    2015-01-01

    Introduction Chronic diarrhea of infancy is a heterogeneous syndrome that includes several diseases with different etiologies. The aim of this study was investigating chronic diarrhea, its etiologies, clinical features and outcomes in infancy.Materials and Methods Retrospective study investigating infants hospitalized in the gastroenterology department of Tehran tertiary care center.The main demographic data, etiology, characteristics of diarrhea, and outcome were evaluated. Data were analyze...

  10. [Glutamate dehydrogenase. Its diagnostic value in Clostridioides difficile diarrhea].

    Science.gov (United States)

    Vaustat, Daniela; Rollet, Raquel

    2017-11-14

    Clostridioides difficile is the main etiological agent of diarrhea associated with health care, it produces toxins and glutamate dehydrogenase (GDH), an enzyme that is highly conserved in this species. Rapid diagnosis and effective treatment produce prompt improvement of the patient and subsequent control of the microorganism spread. There are several techniques whose results are interpreted in the context of algorithms. However, the optimal diagnostic method is yet unknown. The performance of GDH as a screening test for the diagnosis of C. difficile diarrhea was assessed. Six hundred and fifteen stool samples were studied. The presence of GDH and toxins presence was determined by TECHLAB® C. DIFF QUIK-CHEK COMPLETE and the samples were cultured for the search of C. difficile. The values of sensitivity, specificity, PPV and NPV were calculated with a p value of 0.05 or less. GDH was detected in 266 samples (43.25%), with a sensitivity of 100% and specificity of 87.10%, IC95: 84.58-91.42; toxin/s were detected in 218 (35.45%) and C. difficile developed in 235 cultures (38.21%). From 48 samples with positive GDH and negative toxin/s, 15 toxigenic and 2 non-toxigenic isolates were obtained, the remaining 31 samples were negative for C. difficile. All GDH-negative samples were negative for toxins or culture, therefore, GDH NPV was 100%, while PPV was 81.9%. We conclude that GDH is a suitable screening test for the diagnostic algorithm of C. difficile diarrhea. Copyright © 2017 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Bovine Viral Diarrhea Virus-Associated Disease in Feedlot Cattle.

    Science.gov (United States)

    Larson, Robert L

    2015-11-01

    Bovine viral diarrhea virus (BVDv) is associated with bovine respiratory disease complex and other diseases of feedlot cattle. Although occasionally a primary pathogen, BVDv's impact on cattle health is through the immunosuppressive effects of the virus and its synergism with other pathogens. The simple presence or absence of BVDv does not result in consistent health outcomes because BVDv is only one of many risk factors that contribute to disease syndromes. Current interventions have limitations and the optimum strategy for their uses to limit the health, production, and economic costs associated with BVDv have to be carefully considered for optimum cost-effectiveness. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Diarrhea as a Presenting Symptom of Disseminated Toxoplasmosis

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    Matthew Glover

    2017-01-01

    Full Text Available Disseminated toxoplasmosis is uncommon in both immunocompetent and immunocompromised hosts with gastrointestinal involvement being rarely described. We report a case of disseminated gastrointestinal toxoplasmosis in an immunocompromised man who presented with one month of diarrhea and abdominal pain. Imaging showed thickening of the ascending colon and cecum. Esophagogastroduodenoscopy and colonoscopy biopsies revealed Toxoplasma gondii, confirmed by immunostain. Symptoms completely resolved following treatment with pyrimethamine, sulfadiazine, and leucovorin. This case highlights the importance of including toxoplasmosis in the differential diagnosis of any immunocompromised individual presenting with gastrointestinal symptoms.

  13. Probiotics for the Prevention of Pediatric Antibiotic-Associated Diarrhea.

    Science.gov (United States)

    Hayes, Shelby R; Vargas, Ashley J

    Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Cochrane Database Syst Rev2015, Issue 12. Art. No.: CD004827. http://dx.doi.org/10.1002/14651858.CD004827.pub4. Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora. The primary objectives were to assess the efficacy and safety of probiotics (any specified strain or dose) used for the prevention of AAD in children. MEDLINE, EMBASE, CENTRAL, CINAHL, AMED, and the Web of Science (inception to November 2014) were searched along with specialized registers including the Cochrane IBD/FBD review group, CISCOM (Centralized Information Service for Complementary Medicine), NHS Evidence, the International Bibliographic Information on Dietary Supplements, as well as trial registries. Letters were sent to authors of included trials, nutraceutical and pharmaceutical companies, and experts in the field requesting additional information on ongoing or unpublished trials. Conference proceedings, dissertation abstracts, and reference lists from included and relevant articles were also searched. Randomized, parallel, controlled trials in children (0-18 years) receiving antibiotics, that compare probiotics to placebo, active alternative prophylaxis, or no treatment and measure the incidence of diarrhea secondary to antibiotic use were considered for inclusion. Study selection, data extraction, and methodological quality assessment using the risk of bias instrument were conducted independently and in duplicate by two authors. Dichotomous data (incidence of diarrhea and adverse events) were combined using a pooled risk ratio (RR) or risk difference (RD), and continuous data (mean duration of diarrhea and mean daily stool frequency) as mean difference (MD

  14. Inactivation of porcine epidemic diarrhea virus using heated water

    Directory of Open Access Journals (Sweden)

    Michele M. Zentkovich

    2016-12-01

    Full Text Available Porcine epidemic diarrhea virus (PEDV is a very contagious swine pathogen that spreads easily via the fecal-oral route, notably from contaminated fomites. The present study investigated heated water as a method for rapid thermal inactivation of PEDV. Cell-culture adapted PEDV was treated with water at varying temperatures and viral titers were measured at multiple time points post-treatment. Viable PEDV was not recovered after a ten second or longer treatment with water heated to ≥76 °C; however, PEDV nucleic acid was detected in all samples regardless of treatment. Hot water decontamination could be considered in settings where chemical disinfection is impractical.

  15. Recurrent diarrhea as a manifestation of temporal lobe epilepsy.

    Science.gov (United States)

    Murai, Tomohiko; Tohyama, Teruhiko; Kinoshita, Masako

    2014-01-01

    A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG), but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale-III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures. Among them is an uncommon

  16. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    Full Text Available A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG, but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale—III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures

  17. Foal Diarrhea: Established and Postulated Causes, Prevention, Diagnostics, and Treatments.

    Science.gov (United States)

    Oliver-Espinosa, Olimpo

    2018-01-30

    Diarrhea is one of the most important diseases in young foals and may occur in more than half of foals until weaning age. Several infectious and noninfectious underlying causes have been implicated but scientific evidence of pathogenesis is evolving. It is important to investigate all known potential causes and identify infectious agents to avoid outbreaks, evaluate the level of systemic compromise, and establish adequate therapy. It is crucial to differentiate foals that can be managed in field conditions from those that should be sent to a referral center. This article reviews these aspects and recent developments in the diagnostic and therapeutic approaches. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Prevalence and clinical profile of rotavirus in children ≤ 5 years admitted in a tertiary care Hospital in Western Maharashtra

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    Chandrashekhar D Aundhakar

    2017-03-01

    Full Text Available Background: Diarrhea is the second leading cause of mortality in children less than 5 years. Rotavirus is the commonest pathogen which causes diarrhea in children. As a result of dehydration and its hazardous consequences, it causes various deleterious effects on a child resulting in growth failure and malnutrition and sometimes leading to death.  Aims & Objectives: To determine the prevalence and elucidate the clinical pattern of rotavirus diarrhea and differentiate it from non-rotavirus diarrhea in children ≤ 5 years hospitalized for acute diarrhea. Material & Methods: It was a cross-sectional study carried out between October 2014 and September 2016 on a total of 189 patients admitted for acute diarrhea in a tertiary care hospital. Stool samples were processed for identification of rotavirus antigen by ELISA. Clinical characteristics along with the seasonal variation of the infection were also studied.  Result: Prevalence of rotavirus in the present study was estimated to be 36.5%. Infection occurred mostly in the age group of 7 – 12 months (46.3% followed by 1 – 6 months (31.8%. Positive cases had associated clinical features as vomiting (69.5%, fever (55% and peri-anal redness (33.3%. Maximum no. of rotavirus cases occurred in the winter season (42%. Conclusion: Rotavirus diarrhea does not follow a specific clinical pattern and lead to substantial morbidity in the study population.

  19. Celiac disease in children with diarrhea in 4 cities in China.

    Science.gov (United States)

    Wang, Xin-qiong; Liu, Wei; Xu, Chun-di; Mei, Hong; Gao, Yuan; Peng, Han-ming; Yuan, Lan; Xu, Jun-jie

    2011-10-01

    The aim of the study was to investigate whether celiac disease (CD) could be the cause of chronic diarrhea in Chinese patients. During the period of January 2005 to December 2008, patients with chronic diarrhea in pediatric hospitals from 4 major cities (Shanghai, Wuhan, Jinan, and Chengdu) in China were included in the study. The clinical history, physical findings, and laboratory data were collected and analyzed. Among 199 patients with chronic diarrhea, 118 were enrolled in the study. Fourteen (11.9%) were diagnosed as being affected by CD. The 14 patients are the first reported cases of CD in Chinese patients with chronic diarrhea.

  20. Prevalence of Cryptosporidium spp. and other intestinal parasites in children with diarrhea

    OpenAIRE

    Mutalip Çiçek; Hasan Yılmaz

    2011-01-01

    This study was planned to determine the role of Cryptosporidium sp. and other intestinal parasites in the diarrheal diseases in children with 0-15 years old Van district.Materials and methods: In this study, stool samples of 450 children were examined for parasites. In the study, nativ-lugol, formaldehyde-ethyl acetate sedimentation methods and trichrome staining methods were used to detect parasites in stool samples. Additionally, sedimentation methods and modified acid fast staining method ...

  1. The gut at war: the consequences of enteropathogenic Escherichia coli infection as a factor of diarrhea and malnutrition

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    Ulysses Fagundes-Neto

    2000-01-01

    Full Text Available Diarrheal disease is still the most prevalent and important public health problem in developing countries, despite advances in knowledge, understanding, and management that have occurred over recent years. Diarrhea is the leading cause of death in children under 5 years of age. The impact of diarrheal diseases is more severe in the earliest periods of life, when taking into account both the numbers of episodes per year and hospital admission rates. This narrative review focuses on one of the major driving forces that attack the host, namely the enteropathogenic Escherichia coli (EPEC and the consequences that generate malnutrition in an early phase of life. EPEC serotypes form dense microcolonies on the surface of tissue-culture cells in a pattern known as localized adherence (LA. When EPEC strains adhere to epithelial cells in vitro or in vivo they cause characteristic changes known as Attaching and Effacement (A/E lesions. Surface abnormalities of the small intestinal mucosa shown by scanning electron microscopy in infants with persistent diarrhea, although non-specific, are intense enough to justify the severity of the clinical aspects displayed in a very young phase in life. Decrease in number and height of microvilli, blunting of borders of enterocytes, loss of the glycocalyx, shortening of villi and presence of a mucus pseudomembrane coating the mucosal surface were the abnormalities observed in the majority of patients. These ultrastructural derangements may be due to an association of the enteric enteropathogenic agent that triggers the diarrheic process and the onset of food intolerance responsible for perpetuation of diarrhea. An aggressive therapeutic approach based on appropriate nutritional support, especially the utilization of human milk and/or lactose-free protein hydrolyzate-based formulas and the adequate correction of the fecal losses, is required to allow complete recovery from the damage caused by this devastating

  2. The Genetic Diversity and Phylogenetic Characteritics of Rotavirus VP4(P Genotypes in Children With Acute Diarrhea

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    Haghshenas Z

    2011-11-01

    Full Text Available Background: Acute gastroenteritis is a major cause of morbidity and mortality among children in developing countries. Rotaviruses are recognized as the most common etiologic factors of gastroenteritis. In this study, we determined the epidemiologic features, clinical symptoms and molecular structure of rotavirus VP4(P genotypes in children with acute diarrhea in Bahrami Hospital in Tehran Iran, during 2009 for justifying the routine use of rotavirus vaccines in children. Methods: One hundred fifty fecal samples from 150 children with acute diarrhea in Bahrami Pediatric Hospital in Tehran, Iran were collected from January to December 2009. The patients’ mean age was 20.90+18.19 years (ranging from 1 month to 14 years. Fecal samples were transported on ice to the laboratory of virology department of Pasture Institute of Iran. The demographic and clinical data for each case were entered in an author-devised questionnaire. Group A rotavirus was detected by dsRNA-PAGE. Subsequently, rotavirus genotyping (VP4 was performed by semi-nested multiple RT-PCR and the phylogenetic tree of the Rotavirus nucleotides was constructed. The data were analyzed by statistical tests including Wilcoxon signed and Mann-Whitney U. Results: Rotavirus was isolated in 19.3% of the samples, more than 90% of which had long RNA patterns. The predominant genotype (VP4 was P[8] (86% and other genotypes respectively were P[6] (6.9% and P[4] (6.9%. Conclusion: A high prevalence of the P[8] genotype was found to be the cause of acute diarrhea. The analysis of P[8] genotype sequence showed a high level of similarity of the virus in this study with those of other Asian countries.

  3. The gut at war: the consequences of enteropathogenic Escherichia coli infection as a factor of diarrhea and malnutrition.

    Science.gov (United States)

    Fagundes-Neto, U; Scaletsky, I C

    2000-01-06

    Diarrheal disease is still the most prevalent and important public health problem in developing countries, despite advances in knowledge, understanding, and management that have occurred over recent years. Diarrhea is the leading cause of death in children under 5 years of age. The impact of diarrheal diseases is more severe in the earliest periods of life, when taking into account both the numbers of episodes per year and hospital admission rates. This narrative review focuses on one of the major driving forces that attack the host, namely the enteropathogenic Escherichia coli (EPEC) and the consequences that generate malnutrition in an early phase of life. EPEC serotypes form dense microcolonies on the surface of tissue-culture cells in a pattern known as localized adherence (LA). When EPEC strains adhere to epithelial cells in vitro or in vivo they cause characteristic changes known as Attaching and Effacement (A/E) lesions. Surface abnormalities of the small intestinal mucosa shown by scanning electron microscopy in infants with persistent diarrhea, although non-specific, are intense enough to justify the severity of the clinical aspects displayed in a very young phase in life. Decrease in number and height of microvilli, blunting of borders of enterocytes, loss of the glycocalyx, shortening of villi and presence of a mucus pseudomembrane coating the mucosal surface were the abnormalities observed in the majority of patients. These ultrastructural derangements may be due to an association of the enteric enteropathogenic agent that triggers the diarrheic process and the onset of food intolerance responsible for perpetuation of diarrhea. An aggressive therapeutic approach based on appropriate nutritional support, especially the utilization of human milk and/or lactose-free protein hydrolyzate-based formulas and the adequate correction of the fecal losses, is required to allow complete recovery from the damage caused by this devastating enteropathogenic agent.

  4. Microscopic colitis and colorectal neoplastic lesion rate in chronic nonbloody diarrhea: a prospective, multicenter study.

    Science.gov (United States)

    Tontini, Gian Eugenio; Pastorelli, Luca; Spina, Luisa; Fabris, Federica; Bruni, Barbara; Clemente, Claudio; de Nucci, Germana; Cavallaro, Flaminia; Marconi, Stefano; Neurath, Markus F; Neumann, Helmut; Tacconi, Milena; Vecchi, Maurizio

    2014-05-01

    Lymphocytic and collagenous colitis are emerging as common findings in subjects undergoing colonoscopy for chronic non-bloody diarrhea (CNBD). Data concerning microscopic colitis (MC) are still limited and affected by controversial epidemiological evidences. Recent converging lines of evidence suggest that MC correlates a lower risk of colorectal neoplasia. Accordingly, we prospectively assessed MC prevalence in a multicenter cohort of subjects submitted to colonoscopy for CNBD, thereby defining whether MC influences the risk of colorectal neoplasia. Consecutive patients with CNBD of unknown origin underwent pan-colonoscopy with multiple biopsies. The prevalence of neoplastic patients in MC was compared with that observed in negative CNBD subjects. Among 8006 colonoscopy, 305 subjects were enrolled for CNBD. Patients with CNBD were more likely to be women than men (odds ratio = 1.5; P = 0.001). Histopathology detected high prevalence of MC (16%) with a clear predominance of collagenous colitis (70%). A striking age-dependent rise in MC-associated risk was observed, depicting outstanding differences among varying age groups, as in the number needed to screen 1 new case. Gender distribution was balanced within MC patients (Female/Male = 1.5/1), especially among lymphocytic colitis (Female/Male = 1.2/1). MC patients were negatively associated with the risk of neoplastic polyps compared with negative CNBD subjects (odds ratio = 0.22; P = 0.035). MC is the first cause of CNBD in subjects submitted to colonoscopy. Multiple biopsies are strongly recommended, even in the case of uneventful endoscopic inspection, especially for age ≥40 years. MC has a reduced risk of colorectal neoplasia, suggesting that this model of chronic inflammation plays a protective effect against colorectal carcinogenesis.

  5. Epidemiology of norovirus infections among diarrhea outpatients in a diarrhea surveillance system in Shanghai, China: a cross-sectional study.

    Science.gov (United States)

    Xue, Ying; Pan, Hao; Hu, Jiayu; Wu, Huanyu; Li, Jian; Xiao, Wenjia; Zhang, Xi; Yuan, Zheng'an; Wu, Fan

    2015-04-15

    Norovirus is an important cause of gastroenteritis both in children and adults. In China, few studies have been conducted on adult populations. This study aimed to determine the contribution of norovirus to gastroenteritis, characterize the features of norovirus infections, compare them with other pathogens, and test the effectiveness of the surveillance system. A citywide surveillance network on diarrhea patients was established. Samples were collected with intervals from both children and adults among diarrhea outpatients in hospitals and tested for viruses using rRT-PCR and for bacteria in CDCs. Patient information was acquired through interviews and recorded into a dedicated online system. The Pearson χ2 test, multivariate logistic regression models and discriminant models were fitted into its comparisons with the non-norovirus group and other pathogens. Norovirus was detected in 22.91% of sampled diarrhea patients. The seasonal distribution of norovirus infections was different from non-norovirus patients (pfever (p=0.046, OR=0.758, 95% CI=0.577-0.996) and abdominal pain (p=0.018, OR=0.815, 95% CI=0.689-0.965). Children were more vulnerable to rotavirus (p=0.008, OR=1.637, 95% CI=1.136-2.358) and bacteria (p=0.027, OR=1.511, 95% CI=1.053-2.169) than norovirus. There was a seasonal difference between the GI and GII genotypes (protavirus and bacteria, children were less frequently affected by norovirus. Nausea and vomiting were typical of norovirus, whereas fever and abdominal pain were uncommon symptoms of this pathogen. GI and GII infections were centered in different seasons. Officials and clerks were more easily affected by GI than GII.

  6. Diagnosis and treatment of diarrhea-predominant irritable bowel syndrome

    Directory of Open Access Journals (Sweden)

    Lacy BE

    2016-02-01

    Full Text Available Brian E Lacy Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA Abstract: Irritable bowel syndrome (IBS is one of the most common gastrointestinal disorders worldwide. The economic impact of IBS on the health care system is substantial, as is the personal impact on patients. Patients with diarrhea-predominant IBS (IBS-D comprise a substantial proportion of the overall IBS population. Primary care providers are often the first point of contact for patients with IBS-D and can accurately diagnose IBS after a careful history and examination without extensive diagnostic tests. Several pharmacologic treatments (eg, loperamide, alosetron, and antidepressants and non-pharmacologic treatments (eg, dietary modification and probiotics are available for IBS-D, but restrictions on use (eg, alosetron or the lack of controlled trial data showing reductions in both global and individual IBS-D symptoms (eg, bloating, pain and stool frequency emphasize the need for alternative treatment options. Two newer medications (eluxadoline and rifaximin were approved in May 2015 for the treatment of IBS-D, and represent new treatment options for this common gastrointestinal condition. Keywords: abdominal pain, antibiotic, bloating, diarrhea, irritable bowel syndrome

  7. Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient

    Science.gov (United States)

    Kim, Min Jae; Kim, Woo Ho; Jung, Hyun-Chae; Chai, Jee-Won

    2013-01-01

    Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea. PMID:23710089

  8. Optimization of Pathogenetic Treatment of Secretory Diarrhea in Infants

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    O.K. Koloskova

    2014-02-01

    Full Text Available The aim of the research was to access clinical efficacy of oral rehydration therapy using III generation solutions in the treatment of secretory diarrhea in infants. To achieve this aim, on the basis of infectious box unit (enteric infections of regional clinical hospital (Chernivtsi we examined 116 infants, randomly selected, with acute gastroenteritis, who admitted to the hospital with signs of exycosis due to secretory diarrhea. Among examined patients, 73 (67.5 % children with the purpose of oral rehydration therapy received rehydration solutions, and 35 (32.4 % patients received other rehydration solutions. Monitoring of the dynamics of patients’ state enabled to state that, when we used III generation mixture as a main component of oral rehydration therapy, rate of positive dynamics in terms of clinical status of patients was significantly faster, in particular, body temperature, frequency and nature of bowel movements normalized significantly earlier, vomiting disappeared. In children treated with rehydration solutions, compared with patients receiving other rehydration solutions, odds ratio to confine only oral rehydration was 3.7 (95% CI 0.4–38.9 with an absolute risk to avoid the need for infusion therapy — 11 %.

  9. Complete genome characterization of porcine epidemic diarrhea virus in Vietnam.

    Science.gov (United States)

    Vui, Dam Thi; Thanh, To Long; Tung, Nguyen; Srijangwad, Anchalee; Tripipat, Thitima; Chuanasa, Taksina; Nilubol, Dachrit

    2015-08-01

    Porcine epidemic diarrhea virus (PEDV) first emerged in Vietnam in 2009. In this study, the complete genomes of three Vietnamese PEDV isolates were characterized. These three isolates were isolated from 3-day-old pigs experiencing diarrhea. Two isolates were from swine farms in the south, and the other was from northern Vietnam. The whole genome sequences of these isolates are 28,035 nucleotides in length and have characteristics similar to those of other PEDV isolates. All three Vietnamese PEDV isolates share 99.8 % and 99.6 % sequence identity at the nucleotide and amino acid level, respectively, and have insertions of four amino acids (GENQ) and one amino acid (N) at positions 56-59 and 140, respectively, and one deletion of two amino acids (DG) at positions 160-161. Phylogenetic analysis based on the whole genome revealed that the three Vietnamese PEDV isolates are grouped together with new variants from China from 2011 to 2012 and are genetically distinct from US isolates and the classical PEDV variant. The results suggest that Vietnamese PEDV isolates are new variants, as evidenced by their genetic composition of insertions and a deletion in the spike gene, and they might have originated from the same ancestor as the Chinese PEDV strain. This study provides a better understanding of the molecular characteristics of PEDV in Vietnam.

  10. Colonoscopic findings in Peruvian patients with chronic diarrhea.

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    Javier Villafuerte-Gálvez

    Full Text Available OBJECTIVE: To report the colonoscopic and pathological findings in patients with chronic diarrhea from a gastroenterology unit during approximately 3 years in a general teaching hospital located in Lima-Peru. MATERIALS AND METHODS: Patients with chronic diarrhea as the motive for colonoscopy from March 2008 to December 2010 were selected from the colonoscopy report computerized database. Colonoscopic findings were registered. Biopsies taken during the procedure were prospectively reviewed. RESULTS: 226 patients were included, of which 162 (71.7% had a colon biopsy available. The average age of the patients was 53.6±16.36. 85.8% of patients were reported to have a normal colon. 14.8% of patients were found to have a normal colonic mucosa or mucosal edema, 35.8% of patients had lymphocytic colitis and 28.4% had paucicelular colitis. CONCLUSIONS: The majority of colonoscopies were reported with unremarkable macroscopic findings. Lymphocytic colitis was unusually frequent compared to previous reports.

  11. [Post-diarrhea hemolytic-uremic syndrome: clinical aspects].

    Science.gov (United States)

    Loirat, C

    2001-09-01

    Every year in France, about 100 children, most of them less than 3 years old, have typical diarrhea-associated HUS (D + HUS). Evidence of exposure to verotoxin producing E. coli (VTEC), mostly the O157: H7 serotype, is demonstrated in about 85% of cases. A prodromal illness of acute gastroenteritis with diarrhea, often bloody, precedes the HUS by 1 to 15 days. HUS onset is sudden, with the typical association of hemolytic anemia with fragmented red blood cells, thrombocytopenia and acute renal insufficiency. Involvement of other organs than the kidneys may occur, such as severe hemorrhagic colitis with rectal prolapse, bowel wall necrosis or secondary stenosis, acute pancreatitis, central nervous system involvement which determines the vital outcome. Early accurate supportive treatment allows a current mortality rate below 5%, with most deaths due to central nervous system involvement. Five to 10% of children develop end stage renal disease, rarely directly, more often after having recovered some renal function with chronic renal insufficiency during a few years. After 15 or more years follow-up, at least one third of patients have some degree of proteinuria and/or hypertension, and eventually chronic or end stage renal failure. Predictive features of poor renal outcome at the acute phase are severe gastrointestinal involvement, severe CNS involvement, polyncleosis over 20,000/mm3, and duration of initial anuria longer than one week. The role of VTEC in D + HUS makes the disease a public health problem. Preventive measures are essential.

  12. Management of acute diarrhea in children by community pharmacists in Lagos, Nigeria

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    Ogbo PU

    2014-03-01

    Full Text Available Background: Acute diarrhea in children leads to dehydration and death if not appropriately managed. World Health Organization (WHO recommends treating diarrhea with oral rehydration therapy (ORT, fluids and foods. Proper management is hinged on accurate assessment of patients to identify the acute watery diarrhea. Objective: To compare the knowledge and attitude of community pharmacists in the management of acute diarrhea in children with their observed practice. Methods: This study was carried out using two instruments: structured self-administered questionnaire to assess knowledge and attitude of community pharmacists in the management of acute diarrhea in children and simulated patient visits to evaluate assessment of patients, recommendation of products and instructions on feeding and fluid intake. The simulated patient visits were done in 186 pharmacies in the city of Lagos, Nigeria. Results: The study reveals that the knowledge and attitude of community pharmacists in the management of acute diarrhea in children was different from their observed practice. The difference was statistically significant (p<0.05. During the simulations, 23% carried out appropriate assessment before recommending any products, and 15% recommended ORT alone. Although information to the pharmacists indicated non-dysentery, non-cholera, acute watery diarrhea, antibiotics and antidiarrheals were irrationally recommended and these were the mainstay of symptoms’ management in practice. Questionnaire data revealed that 24% of pharmacists knew the correct instructions to give on food and fluid intake during diarrhea, whereas 8% followed WHO guideline on food and fluid intake during the visits. Conclusions: Assessment of patients to determine acute diarrhea was inadequate. Observed practice in managing acute diarrhea in children was inappropriate and significantly different from their claims in the questionnaire. The recommendation of ORT was scanty and advice on food

  13. Crofelemer for the treatment of chronic diarrhea in patients living with HIV/AIDS

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    Patel TS

    2013-07-01

    Full Text Available Twisha S Pate, Rustin D Crutchley, Anne M Tucker, Jessica Cottreau, Kevin W Garey Department of Clinical Sciences and Administration, College of Pharmacy, University of Houston, Houston, TX, USA Abstract: Diarrhea is a common comorbidity present in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS who are treated with highly active antiretroviral therapy. With a multifactorial etiology, this diarrhea often becomes difficult to manage. In addition, some antiretrovirals are associated with chronic diarrhea, which potentially creates an adherence barrier to antiretrovirals and may ultimately affect treatment outcomes and future therapeutic options for HIV. A predominant type of diarrhea that develops in HIV patients has secretory characteristics, including increased secretion of chloride ions and water into the intestinal lumen. One proposed mechanism that may lead to this type of secretory diarrhea is explained by the activation of the cystic fibrosis transmembrane conductance regulator and calcium-activated chloride channels. Crofelemer is a novel antidiarrheal agent that works by inhibiting both of these channels. The efficacy and safety of crofelemer has been evaluated in clinical trials for various types of secretory diarrhea, including cholera-related and acute infectious diarrhea. More recently, crofelemer was approved by the US Food and Drug Administration for the symptomatic relief of noninfectious diarrhea in adult patients with HIV/AIDS on antiretroviral therapy. Results from the ADVENT trial showed that crofelemer reduced symptoms of secretory diarrhea in HIV/AIDS patients. Because crofelemer is not systemically absorbed, this agent is well tolerated by patients, and in clinical trials it has been associated with minimal adverse events. Crofelemer has a unique mechanism of action, which may offer a more reliable treatment option for HIV patients who experience chronic secretory diarrhea from

  14. Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial

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    Mamtani Manju

    2009-05-01

    Full Text Available Abstract Background Diarrhea causes an estimated 2.5 million child deaths in developing countries each year, 35% of which are due to acute diarrhea. Zinc and copper stores in the body are known to be depleted during acute diarrhea. Our objectives were to evaluate the efficacy of zinc and copper supplementation when given with standard treatment to children with acute watery or bloody diarrhea. Methods We conducted a double-blind randomized controlled clinical trial in the Department of Pediatrics at Indira Gandhi Government Medical College Nagpur, India. Eight hundred and eight children aged 6 months to 59 months with acute diarrhea were individually randomized to placebo (Pl, zinc (Zn only, and zinc and copper (Zn+Cu together with standard treatment for acute diarrhea. Results The mean duration of diarrhea from enrolment and the mean stool weight during hospital stay were 63.7 hours and 940 grams, respectively, and there were no significant differences in the adjusted means across treatment groups. Similarly, the adjusted means of the amount of oral rehydration solution or intravenous fluids used, the proportion of participants with diarrhea more than 7 days from onset, and the severity of diarrhea indicated by more than three episodes of some dehydration or any episode of severe dehydration after enrolment, did not differ across the three groups. Conclusion The expected beneficial effects of zinc supplementation for acute diarrhea were not observed. Therapeutic Zn or Zn and Cu supplementation may not have a universal beneficial impact on the duration of acute diarrhea in children. Trial registration The study was registered as an International Standard Randomized Controlled Trial (ISRCTN85071383.

  15. Entamoeba spp. diagnosis in patients with inflmmatory diarrhea by staining, copro-antigen ELISA and multiplex PCR methods

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    Zahra Gharibi

    2017-10-01

    Full Text Available Objective: To evaluate Entamoeba spp. diagnosis in patients with inflammatory diarrhea by staining, copro-antigen ELISA and multiplex PCR methods. Methods: In this descriptive cross-sectional survey, 200 stool samples were randomly collected during 2015–2016. The stool samples were evaluated microscopically for the presence of the parasite using direct and formalin-ether concentration and trichrome staining methods. Then, the stool samples were examined by copro-antigen ELISA (Biomerica Company and multiplex PCR methods. Results: Of 200 samples, 17, 29 and 23 cases were positive for Entamoeba species by the staining, copro-antigen ELISA and multiplex PCR methods, respectively. Of 23 positive samples in multiplex PCR test, 13 and 10 samples were positive for Entamoeba dispar (E. dispar and Entamoeba histolytica (E. histolytica, respectively. Conclusions: Our finding indicated a relatively high prevalence of Entamoeba species in patients with inflammatory diarrhea in Ahvaz city. Due to the complications of E. histolytica/ dispar infection, the health authorities of the city must pay more attention to control and prevent the transmission of E. histolytica/dispar to individuals.

  16. Impact of respiratory disease, diarrhea, otitis and arthritis on mortality and carcass traits in white veal calves.

    Science.gov (United States)

    Pardon, Bart; Hostens, Miel; Duchateau, Luc; Dewulf, Jeroen; De Bleecker, Koen; Deprez, Piet

    2013-04-15

    average and decreased carcass quality. Despite the massive use of group and individual treatments to alleviate the most prevalent health issues at the fattening period, the effects of BRD, diarrhea, otitis and arthritis on survival and performance are still considerable, especially in cases of chronic pneumonia with or without arthritis. Controlling calf health by effective preventive and therapeutic strategies and in particular the prevention of chronic BRD is key for the profitability of veal operations.

  17. Surveillance of norovirus among children with diarrhea in four major hospitals in Bhutan: Replacement of GII.21 by GII.3 as a dominant genotype.

    Science.gov (United States)

    Wangchuk, Sonam; Matsumoto, Takashi; Iha, Hidekatsu; Ahmed, Kamruddin

    2017-01-01

    Diarrhea is a major cause of morbidity and mortality among Bhutanese children. The etiology of diarrhea is not well known due to the challenges of conducting routine surveillance with Bhutan's modest research facilities. Establishing an etiology is crucial toward generating evidence that will contribute to policy discussions on a diarrheal disease control program. Our previous study, during 2010-2012, revealed that norovirus (NoV) is an important cause of diarrhea among Bhutanese children, and that GII.21 was the major genotype circulating at that time. In other countries, GII.4 is the major genotype responsible for NoV infections. In this update report, we provide new prevalence data to describe the progression of the transformation and distribution of the NoV genotype among Bhutanese children. From June 2013 through May 2014, diarrheal stool samples were collected at one national referral hospital in Thimphu, two regional referral hospitals in the eastern and central regions, and one general hospital in the western region of Bhutan. NoV was detected by reverse transcription-polymerase chain reaction (RT-PCR), by amplifying the capsid gene. The RT-PCR results were confirmed by nucleotide sequencing of the amplicons. The proportion of NoV-positive stool samples was 23.6% (147/623), of which 76.9% were NoV GII and the remainders were NoV GI. The median age of infected children was 15.5 months, with a fairly balanced female: male ratio. NoV GII was most prevalent in the colder months (late November-mid April) and NoV GI had the highest prevalence in the summer (mid April-late September). Nucleotide sequencing was successful in 99 samples of GII strains. The most common genotypes were GII.3 (42.6%), GII.4 Sydney 2012 (15.8%), and GII.4 unassigned (11.9%). No GII.21 was found in any child in the present study. Phylogenetic analysis showed that GII.3 strains in the present study belonged to an independent cluster in lineage B. These strains shared an ancestor with those

  18. Surveillance of norovirus among children with diarrhea in four major hospitals in Bhutan: Replacement of GII.21 by GII.3 as a dominant genotype.

    Directory of Open Access Journals (Sweden)

    Sonam Wangchuk

    Full Text Available Diarrhea is a major cause of morbidity and mortality among Bhutanese children. The etiology of diarrhea is not well known due to the challenges of conducting routine surveillance with Bhutan's modest research facilities. Establishing an etiology is crucial toward generating evidence that will contribute to policy discussions on a diarrheal disease control program. Our previous study, during 2010-2012, revealed that norovirus (NoV is an important cause of diarrhea among Bhutanese children, and that GII.21 was the major genotype circulating at that time. In other countries, GII.4 is the major genotype responsible for NoV infections. In this update report, we provide new prevalence data to describe the progression of the transformation and distribution of the NoV genotype among Bhutanese children.From June 2013 through May 2014, diarrheal stool samples were collected at one national referral hospital in Thimphu, two regional referral hospitals in the eastern and central regions, and one general hospital in the western region of Bhutan. NoV was detected by reverse transcription-polymerase chain reaction (RT-PCR, by amplifying the capsid gene. The RT-PCR results were confirmed by nucleotide sequencing of the amplicons.The proportion of NoV-positive stool samples was 23.6% (147/623, of which 76.9% were NoV GII and the remainders were NoV GI. The median age of infected children was 15.5 months, with a fairly balanced female: male ratio. NoV GII was most prevalent in the colder months (late November-mid April and NoV GI had the highest prevalence in the summer (mid April-late September. Nucleotide sequencing was successful in 99 samples of GII strains. The most common genotypes were GII.3 (42.6%, GII.4 Sydney 2012 (15.8%, and GII.4 unassigned (11.9%. No GII.21 was found in any child in the present study. Phylogenetic analysis showed that GII.3 strains in the present study belonged to an independent cluster in lineage B. These strains shared an ancestor

  19. Determining bovine viral diarrhea virus genotypes and biotypes circulating in cattle populations in Mexico

    Science.gov (United States)

    Bovine viral diarrhea (BVD) is the disease in cattle that results from infection with bovine viral diarrhea viruses (BVDV). BVDV is found in cattle populations throughout the world. While the term BVD encompasses a wide range of clinical manifestations, including severe respiratory disease, gastroe...

  20. Maternal education and diarrhea among children aged 0-24 months ...

    African Journals Online (AJOL)

    Childhood diarrhea remains a problem in countries like Nigeria where access to potable water, good hygiene and sanitation are lacking. Maternal education is an important determinant of health status of under-five children. Very few studies have investigated the relationship between maternal education and diarrhea in ...

  1. Vibrio parahaemolyticus: A Rare Cause of Chronic Diarrhea in a Heart Transplant Patient

    OpenAIRE

    Shuja, Asim; Dickstein, Aaron; Lee, Hannah M.

    2014-01-01

    Vibrio parahaemolyticus usually causes a self-limiting acute diarrheal illness, and is rarely tested for in cases of chronic diarrhea. We present a rare case of chronic diarrhea caused by V. parahaemolyticus in a heart transplant patient requiring antibiotic treatment.

  2. Fecal Isolation of Corynebacterium equi from a Foal with Chronic Diarrhea

    OpenAIRE

    Smith, K. D.; Butler, D. G.

    1984-01-01

    Corynebacterium equi was isolated from the feces of a foal with chronic diarrhea. The foal had multiple walnut-sized masses associated with the intestine on rectal examination. These were thought to be enlarged lymph nodes and/or abscesses. The foal also had an elevated plasma fibrinogen. The diarrhea was controlled with antibiotics but recurred when the treatment was stopped.

  3. Novel human bufavirus genotype 3 in children with severe diarrhea, Bhutan.

    Science.gov (United States)

    Yahiro, Takaaki; Wangchuk, Sonam; Tshering, Kinlay; Bandhari, Purushotam; Zangmo, Sangay; Dorji, Tshering; Tshering, Karchung; Matsumoto, Takashi; Nishizono, Akira; Söderlund-Venermo, Maria; Ahmed, Kamruddin

    2014-06-01

    We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs.

  4. Differential Yield of Pathogens from Stool Testing of Nosocomial versus Community-Acquired Paediatric Diarrhea

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    Savita Deorari

    1999-01-01

    Full Text Available OBJECTIVES: To evaluate the role of routine stool examination for all pathogens in paediatric nosocomial diarrhea (NAD and community-acquired diarrhea (CAD over a two-year period at Alberta Children’s Hospital and current practices in other Canadian hospitals. A secondary objective was to characterize features that may predict NAD or CAD etiology.

  5. [Adhesion patterns in diffusely adherent Escherichia coli (DAEC) strains isolated from children with and without diarrhea].

    Science.gov (United States)

    Riveros, Maribel; Barletta, Francesca; Cabello, Martín; Durand, David; Mercado, Erik H; Contreras, Carmen; Rivera, Fulton P; Mosquito, Susan; Lluque, Angela; Ochoa, Theresa J

    2011-03-01

    Diffusely adherent E. coli (DAEC) is the sixth recognized group of diarrheagenic E. coli. However, its association with diarrhea remains controversial. Variability in the adherence patterns of clinical strains is unknown. To compare the adherence patterns between strains isolated from children with and without diarrhea. A total of 31 DAEC strains were analyzed, 25 from children with diarrhea and 6 from asymptomatic (control) children, isolated from a cohort study of children under one year of age in the southern districts of Lima. DAEC were identified by PCR (daaD gene). The pattern and adherence score in HEp-2 cell culture were evaluated, Actin polimerization was determined by fluorescence actin staining (FAS) and motility was evaluated by conventional microbiology methods. Diffuse adherence pattern was found in 88% of diarrhea samples and in the total of control strains. The number of bacteria adhered per cell was significantly lower in diarrhea samples (p<0.05). However, actin polymerization was greater in diarrhea samples (60% vs. 17%). Motility test was positive in 60% of the diarrhea samples and in all control samples. Our findings suggest a difference between adherence patterns, actin polymerization and motility between DAEC strains corresponding to diarrhea and control groups. The significance of these results must be confirmed with a bigger number of strains and determining the presence of virulence genes in the strains.

  6. Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Gaffey, Michelle F; Wazny, Kerri; Bassani, Diego G; Bhutta, Zulfiqar A

    2013-01-01

    Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both

  7. Genetic diversity of bovine viral diarrhea virus in cattle from Mexico.

    Science.gov (United States)

    Gómez-Romero, Ninnet; Basurto-Alcántara, Francisco J; Verdugo-Rodríguez, Antonio; Bauermann, Fernando V; Ridpath, Julia F

    2017-05-01

    Bovine viral diarrhea virus (BVDV) infects cattle populations worldwide, causing significant economic losses though its impact on animal health. Previous studies have reported the prevalence of BVDV species and subgenotypes in cattle from the United States and Canada. We investigated the genetic diversity of BVDV strains detected in bovine serum samples from 6 different Mexican regions. Sixty-two BVDV isolates from Mexico were genetically typed based on comparison of sequences from the 5' untranslated region (5'-UTR) of the viral genome. Phylogenetic reconstruction indicated that 60 of the samples belonged to the BVDV-1 genotype and 2 to the BVDV-2 genotype. Comparison of partial 5'-UTR sequences clustered 49 samples within BVDV-1c, 8 samples within BVDV-1a, 3 samples within BVDV-1b, and 2 samples clustered with the BVDV-2a subgenotypes. Our study, combined with information previously published on BVDV field strain diversity in the United States and Canada, benefits the development of effective detection assays, vaccines, and control programs for North America.

  8. Hypernatremia in Children With Diarrhea: Presenting Features, Management, Outcome, and Risk Factors for Death.

    Science.gov (United States)

    Chisti, Mohammad Jobayer; Ahmed, Tahmeed; Ahmed, A M Shamshir; Sarker, Shafiqul Alam; Faruque, Abu Syed Golam; Islam, Md Munirul; Huq, Sayeeda; Shahrin, Lubaba; Bardhan, Pradip Kumar; Salam, Mohammed Abdus

    2016-06-01

    We sought to investigate the magnitude, clinical features, treatment, and outcome of children suffering from hypernatremic diarrhea and to identify risk factors for fatal outcome among them. We reviewed 2 data sets of children hypernatremia (serum sodium ≥150 mmol/L): (a) March 2001 to March 2002 (n = 371) and (b) March 2009 to August 2011 (n = 360). We reviewed their records and collected relevant information for analyses. The prevalence of hypernatremia was 5.1% (371/7212) and 2.4% (360/15 219), case fatality rate was 15% and 19%, respectively. In logistic regression analysis, the risk for death significantly increased in association with serum sodium ≥170 mmol/L, nutritional edema, hypoglycemia, respiratory distress, and absent peripheral pulses and reduced with the sole use of oral rehydration salts (ORS) or ORS following intravenous fluid, if indicated (for all, P hypernatremia using only ORS or ORS following intravenous fluid may help reduce the number of deaths. © The Author(s) 2016.

  9. Dientamoeba fragilis, a neglected cause of diarrhea, successfully treated with secnidazole.

    Science.gov (United States)

    Girginkardeşler, N; Coşkun, S; Cüneyt Balcioğlu, I; Ertan, P; Ok, U Z

    2003-02-01

    To evaluate the pathogenicity of Dientamoeba fragilis by comparing it with Giardia lamblia and to investigate the effect of a single dose of secnidazole in dientamoebiasis. Stool samples of 400 patients, admitted to the Department of Parasitology, Celal Bayar University, were examined by direct wet mount, formalin-ethyl acetate concentration and trichrome staining methods on three consecutive days. All cases positive for D. fragilis were treated with a single dose of secnidazole, 30 mg/kg for children, and 2 g for adults. On the seventh and fourteenth days, at the end of the treatment, stool samples were examined by the same methods, and clinical symptoms were again evaluated. D. fragilis and G. lamblia were detected in 35 (8.8%) and 34 (8.5%) cases, respectively. The most frequent symptoms were found to be abdominal pain and diarrhea in both infections. D. fragilis was eradicated in 34 (97.1%) patients with a single dose of secnidazole, but a second dose was necessary in one patient. Clinical symptoms disappeared in 27 (77.1%) and decreased in eight (22.9%) cases, after eradication. These data suggested that D. fragilis is as prevalent and pathogenic as G. lamblia, and secnidazole seems to be highly effective in achieving parasitologic and clinical cure. To our knowledge, this is the first report of secnidazole being used in the treatment of dientamoebiasis.

  10. First report of Bovine Viral Diarrhea Virus antigen from pneumonic cattle in Sudan

    Directory of Open Access Journals (Sweden)

    Intisar Kamil Saeed

    2015-06-01

    Full Text Available To explore the expected role of Bovine Viral Diarrhea Virus (BVDV in pneumonia in cattle, cattle lungs (n=242 showing signs of pneumonia were collected from slaughter houses of three different localities located at Northern, Central and Western Sudan during 2010–2013. The collected samples were tested for the presence of BVDV antigen using Enzyme-Linked Immunosorbent Assay (ELISA, and Fluorescent Antibody Test (FAT. Twenty six (10.7% out of 242 samples were found to be positive for BVDV. Positive results were seen in all the three studied areas, with the highest prevalence (16.7%; n=4/24 at Gezira State in Central Sudan. BVDV genome could be detected in all ELISA positive samples. The results indicated the existence of BVDV infection in cattle in different areas in Sudan, and its possible association with respiratory infections in cattle. Analysis using BLAST indicated that the sequence was identical to the previously reported BVDV-1 (GenBank accession AF220247.1.; nucleotide A was found in our study at position 9 of our sequence, whereas T was present instead in the reference virus. This is the first report of detecting BVDV antigen, genome, and its sequence analysis collected from cattle lungs in Sudan.

  11. Antiviral activity of Petiveria alliacea against the bovine viral diarrhea virus.

    Science.gov (United States)

    Ruffa, M J; Perusina, M; Alfonso, V; Wagner, M L; Suriano, M; Vicente, C; Campos, R; Cavallaro, L

    2002-07-01

    Natural products are a relevant source of antiviral drugs. Five medicinal plants used in Argentina have been assayed to detect inhibition of viral growth. Antiviral activity of the infusions and methanolic extracts of Aristolochia macroura, Celtis spinosa, Plantago major, Schinus areira, Petiveria alliacea and four extracts obtained from the leaves and stems of the last plant were evaluated by the plaque assay. P. alliacea, unlike A. macroura, C. spinosa, P. major and S. areira, inhibited bovine viral diarrhea virus (BVDV) replication. Neither P. alliacea nor the assays of the other plants were active against herpes simplex virus type 1, poliovirus type 1, adenovirus serotype 7 and vesicular stomatitis virus type 1. Four extracts of P. alliacea were assayed to detect anti-BVDV activity. Ethyl acetate (EC(50) of 25 microg/ml) and dichloromethane (EC(50) of 43 microg/ml) extracts were active; moreover, promising SI (IC(50)/EC(50)) values were obtained. BVDV is highly prevalent in the cattle population, there are no antiviral compounds available; additionally, it is a viral model of the hepatitis C virus. For these reasons and in view of the results obtained, the isolation and characterization of the antiviral components present in the P. alliacea extracts is worth carrying out in the future. Copyright 2002 S. Karger AG, Basel

  12. Bovine viral diarrhea virus (BVDV genetic diversity in Spain: A review

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    Francisco J. Diéguez

    2017-07-01

    Full Text Available Bovine viral diarrhea virus (BVDV, a member of the genus Pestivirus of the family Flaviviridae, causes significant losses in cattle farming worldwide because of reduced milk production, increased mortality of young animals and reproductive, respiratory and intestinal problems. The virus is characterized by an important genetic, and consequently antigenic and pathogenic diversity. Knowing the variability of viral strains present in a population provides valuable information, particularly relevant for control programs development, vaccination recommendations and even identification of likely infection sources. Such information is therefore important at both local and regional levels. This review focuses on the genetic diversity of BVDV isolates infecting cattle in Spain over the last years. According to the published data, the most prevalent BVDV group in Spain was 1b, and to a lesser extent 1d, 1e and 1f. Besides, BVDV-2 has also been found in Spain with several ratified isolates. The studies carried out in Spain also showed increased genetic heterogeneity of BVDV strains, possibly due to a more intensive use of analytical tools available, presenting studies with increasingly greater sample sizes.

  13. Chronic unexplained diarrhea: a logical and cost-effective approach to assessment.

    Science.gov (United States)

    Dosanjh, Grace; Pardi, Darrell S

    2016-01-01

    The workup of chronic unexplained diarrhea can be equally frustrating for care providers and patients. It carries a physical, financial, and social toll. In this review we provide a sensible approach to evaluating and managing chronic diarrhea. Bile acid diarrhea is becoming increasingly recognized as a potential cause behind some cases of chronic diarrhea. A detailed history and physical examination can provide clues that guide a logical approach to the evaluation. We suggest a cost-effective approach to the workup and management of chronic diarrhea based on individual patient factors related to clinical history and physical exam. We find that this approach leads to initiation of treatment in a time-efficient fashion and avoids unnecessary testing.

  14. Efficacy of dioctahedral smectite in acute watery diarrhea in Indian children: a randomized clinical trial.

    Science.gov (United States)

    Mujawar, Quais Mohammad; Naganoor, Ravi; Ali, Mir Dilshad; Malagi, Naushad; Thobbi, Achyut Narayan

    2012-02-01

    To determine the effects and safety of dioctahedral smectite (DS) on the duration of acute watery diarrhea in children. A Randomized, open labeled, clinical controlled trial in a tertiary care hospital outpatient department (OPD) and emergency department. Participants were one hundred and seventeen children without any chronic illness between 2 and 5 years presenting to OPD, having acute watery diarrhea for diarrhea in children aged 2-5 years. There were no adverse effects on the use of DS. DS was acceptable to the children, and its administration was not accompanied with any side effects. DS reduces the duration of diarrhea in Indian children and prevents a prolonged course, and therefore, may consistently reduce the costs in treatment of acute watery diarrhea.

  15. Chronic diarrhea associated with persistent norovirus excretion in patients with chronic lymphocytic leukemia: report of two cases

    National Research Council Canada - National Science Library

    Capizzi, Todd; Makari-Judson, Grace; Steingart, Richard; Mertens, Wilson C

    2011-01-01

    .... Norovirus infection, a major cause of acute epidemic diarrhea, has been described as a cause of chronic diarrhea in patients who are immunosuppressed, including transplant recipients and the very young...

  16. Childhood Diarrhea Exhibits Spatiotemporal Variation in Northwest Ethiopia: A SaTScan Spatial Statistical Analysis.

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    Muluken Azage

    Full Text Available Childhood diarrhea continues to be a public health problem in developing countries, including Ethiopia. Detecting clusters and trends of childhood diarrhea is important to designing effective interventions. Therefore, this study aimed to investigate spatiotemporal clustering and seasonal variability of childhood diarrhea in northwest Ethiopia.Retrospective record review of childhood diarrhea was conducted using quarterly reported data to the district health office for the seven years period beginning July 1, 2007. Thirty three districts were included and geo-coded in this study. Spatial, temporal and space-time scan spatial statistics were employed to identify clusters of childhood diarrhea. Smoothing using a moving average was applied to visualize the trends and seasonal pattern of childhood diarrhea. Statistical analyses were performed using Excel® and SaTScan programs. The maps were plotted using ArcGIS 10.0.Childhood diarrhea in northwest Ethiopia exhibits statistical evidence of spatial, temporal, and spatiotemporal clustering, with seasonal patterns and decreasing temporal trends observed in the study area. A most likely purely spatial cluster was found in the East Gojjam administrative zone of Gozamin district (LLR = 7123.89, p <0.001. The most likely spatiotemporal cluster was detected in all districts of East Gojjam zone and a few districts of the West Gojjam zone (LLR = 24929.90, p<0.001, appearing from July 1, 2009 to June 30, 2011. One high risk period from July 1, 2008 to June 30, 2010 (LLR = 9655.86, p = 0.001 was observed in all districts. Peak childhood diarrhea cases showed a seasonal trend, occurring more frequently from January to March and April to June.Childhood diarrhea did not occur at random. It has spatiotemporal variation and seasonal patterns with a decreasing temporal trend. Accounting for the spatiotemporal variation identified in the study areas is advised for the prevention and control of diarrhea.

  17. A reliable, practical, and economical protocol for inducing diarrhea and severe dehydration in the neonatal calf.

    Science.gov (United States)

    Walker, P G; Constable, P D; Morin, D E; Drackley, J K; Foreman, J H; Thurmon, J C

    1998-01-01

    Fifteen healthy, colostrum-fed, male dairy calves, aged 2 to 7 d were used in a study to develop a diarrhea protocol for neonatal calves that is reliable, practical, and economical. After instrumentation and recording baseline data, diarrhea and dehydration were induced by administering milk replacer [16.5 mL/kg of body weight (BW), PO], sucrose (2 g/kg in a 20% aqueous solution, p.o.), spironolactone and hydrochlorothiazide (1 mg/kg, PO) every 8 h, and furosemide (2 mg/kg, i.m., q6h). Calves were administered sucrose and diuretic agents for 48 h to induce diarrhea and severe dehydration. Clinical changes after 48 h were severe watery diarrhea, severe depression, and marked dehydration (mean, 14% BW loss). Cardiac output, stroke volume, mean central venous pressure, plasma volume, thiocyanate space, blood pH and bicarbonate concentration, base excess, serum chloride concentration, and fetlock temperature were decreased. Plasma lactate concentration, hematocrit, and serum potassium, creatinine, phosphorus, total protein and albumin concentrations were increased. This non-infectious calf diarrhea protocol has a 100% response rate, while providing a consistent and predictable hypovolemic state with diarrhea that reflects most of the clinicopathologic changes observed in osmotic/maldigestive diarrhea caused by infection with rotavirus, coronavirus or cryptosporidia. Limitations of the protocol, when compared to infectious diarrhea models, include failure to induce a severe metabolic acidosis, absence of hyponatremia, renal instead of enteric loss of chloride, renal as well as enteric loss of free water, absence of profound clinical depression and suspected differences in the morphologic and functional effect on intestinal epithelium. Despite these differences, the sucrose/diuretic protocol should be useful in the initial screening of new treatment modalities for calf diarrhea. To confirm their efficacy, the most effective treatment methods should then be examined in

  18. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting

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    Ener Cagri Dinleyici

    2015-08-01

    Full Text Available OBJECTIVE: Two randomized controlled clinical trials have shown thatLactobacillus (L reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea.METHODS: This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1 × 108 CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours. The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded.RESULTS: The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15 h, 60.4 ± 24.5 h [95% CI: 51.0-69.7 h] vs. 74.3 ± 15.3 h [95% CI: 68.7-79.9 h], p < 0.05. The percentage of children with diarrhea was lower in the L. reuteri group (13/29; 44.8% after 48 h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79,p < 0.01. From the 72nd hour of intervention onwards, there was no difference between the two groups in the percentage of children with diarrhea. No adverse effects related to L. reuteri were noted.CONCLUSION:L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea.

  19. Exploring spatial patterns and hotspots of diarrhea in Chiang Mai, Thailand

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    Tripathi Nitin K

    2009-06-01

    Full Text Available Abstract Background Diarrhea is a major public health problem in Thailand. The Ministry of Public Health, Thailand, has been trying to monitor and control this disease for many years. The methodology and the results from this study could be useful for public health officers to develop a system to monitor and prevent diarrhea outbreaks. Methods The objective of this study was to analyse the epidemic outbreak patterns of diarrhea in Chiang Mai province, Northern Thailand, in terms of their geographical distributions and hotspot identification. The data of patients with diarrhea at village level and the 2001–2006 population censuses were collected to achieve the objective. Spatial analysis, using geographic information systems (GIS and other methods, was used to uncover the hidden phenomena from the data. In the data analysis section, spatial statistics such as quadrant analysis (QA, nearest neighbour analysis (NNA, and spatial autocorrelation analysis (SAA, were used to identify the spatial patterns of diarrhea in Chiang Mai province. In addition, local indicators of spatial association (LISA and kernel density (KD estimation were used to detect diarrhea hotspots using data at village level. Results The hotspot maps produced by the LISA and KD techniques showed spatial trend patterns of diarrhea diffusion. Villages in the middle and northern regions revealed higher incidences. Also, the spatial patterns of diarrhea during the years 2001 and 2006 were found to represent spatially clustered patterns, both at global and local scales. Conclusion Spatial analysis methods in GIS revealed the spatial patterns and hotspots of diarrhea in Chiang Mai province from the year 2001 to 2006. To implement specific and geographically appropriate public health risk-reduction programs, the use of such spatial analysis tools may become an integral component in the epidemiologic description, analysis, and risk assessment of diarrhea.

  20. Intestinal infection at onset of mycophenolic acid-associated chronic diarrhea in kidney transplant recipients.

    Science.gov (United States)

    von Moos, S; Cippà, P E; Wüthrich, R P; Mueller, T F

    2016-10-01

    Chronic diarrhea after kidney transplantation is often attributed to mycophenolic acid (MPA) toxicity. We hypothesize that intestinal infections contribute to the pathogenesis of chronic MPA-associated diarrhea. In this retrospective study, all patients (n = 726) receiving a kidney transplant between 2000 and 2010 at the University Hospital Zurich were followed until July 2014 for occurrence of chronic diarrhea (≥4 weeks). Infectious triggers at diarrhea onset were assessed by reviewing medical history, stool microbiology, and histology of colon biopsies. In 46 patients (6.3% of the cohort), a total of 51 episodes of chronic diarrhea during MPA treatment were documented. The diarrhea episodes were often severe, as confirmed by significant weight loss. The cumulative incidence of chronic diarrhea was uniformly distributed throughout the post-transplant period, with 2.0%, 5.1%, and 9.6% at 1, 5, and 10 years, respectively. Evidence was found for intestinal infection at diarrhea onset in 38 episodes (74.5%). Occurrence of diarrhea onset showed a seasonal distribution with peaks in April and October/November. Specific antimicrobial treatment alone was associated with a 19% resolution rate only, whereas combination with dose reduction of MPA or switch from mycophenolate mofetil to enteric-coated mycophenolate sodium resulted in a 22.7% and 76.5% resolution rate, respectively. Change to an MPA-free regimen was associated with a 100% resolution rate. These results provide first evidence for a contribution of intestinal infections in chronic post-transplant diarrhea associated with MPA treatment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. [A solitary kidney patient with diarrhea of 2 weeks duration].

    Science.gov (United States)

    Díaz Aguilar, C M; Recio Ramirez, J M; Vega Romero, M M; Calero Rojas, M T

    2014-01-01

    The case is presented of a 78 year old woman with a history of congenital right renal, who suffered from diarrhea of approximately 2 weeks duration and discomfort due to cramp in both legs. The laboratory results showed severe hyperkalemia, hyponatremia, and slightly elevated creatinine levels, with no symptoms associated with this finding and with the rest of the normal laboratory results. She was admitted to the intensive care unit for treatment, and when her results returned to normal she was transferred to internal medicine. Among the other tests performed, the ACTH was shown to be high, and a left adrenal adenoma was found in the MR scan. The final diagnosis was Addison's syndrome. She was treated with mineralocorticoids with follow-up by internal medicine as an outpatient. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. Chronic diarrhea and juvenile cataracts: think cerebrotendinous xanthomatosis and treat.

    Science.gov (United States)

    Berginer, Vladimir M; Gross, Bella; Morad, Khayat; Kfir, Nechama; Morkos, Siman; Aaref, Salameh; Falik-Zaccai, Tzipora C

    2009-01-01

    Cerebrotendinous xanthomatosis is an autosomal recessive disease of bile acid synthesis caused by 27-hydroxylase deficiency. Treatment with chenodeoxycholic acid normalizes cholestanol concentrations and abrogates progression of the disease. We present 4 patients with cerebrotendinous xanthomatosis within 1 family who were treated with chenodeoxycholic acid for 14 years. Two young sisters started treatment at the preclinical stage before the appearance of major symptoms. Their 2 older uncles, who had already developed the complete phenotypic form of cerebrotendinous xanthomatosis when diagnosed, commenced treatment at the same time as the sisters, thus establishing a natural control group. After 14 years of chenodeoxycholic acid therapy, the cholestanol levels of all 4 patients decreased to normal levels (chronic diarrhea and juvenile cataracts. Prevention is particularly significant in light of the availability of early genetic diagnosis and the devastating effects of this illness if not treated.

  3. [Diarrhea in a patient with Down syndrome and endemic sprue].

    Science.gov (United States)

    Micklefield, G; Wenzel, I U

    2000-02-01

    Down syndrome is associated with disorders such as celiac disease, hypothyroidism, and insulin-dependent diabetes mellitus. In patients with mono- or oligosymptomatic celiac disease the time interval between the onset of symptoms and diagnosis often is unacceptably long. A female patient with Down syndrome is presented who had acute watery diarrhea, which spontaneously ceased but recurred after a few days. After endoscopic and histologic evaluation and measurement of gliadin, endomysium, and reticulin antibodies celiac sprue was diagnosed. Further investigation showed findings of autoimmune hypothyroidism and secondary hyperparathyreoidism. After the patient was put on a gluten-free diet her state quickly improved. Associations between Down syndrome and autoimmune diseases exist. Patients with acute gastrointestinal symptoms should be evaluated as to celiac disease. The time interval between the onset of symptoms and diagnosis of celiac disease can be shortened, if all diagnostic tools are used at the appropriate time.

  4. A 9-Day-Old With Weight Loss and Diarrhea.

    Science.gov (United States)

    Rajbhandari, Prabi; Mandelia, Chetan; Janjua, Halima S; Selvakumar, Praveen Kumar Conjeevaram; Krishna, Sangeeta

    2017-05-01

    A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B Streptococcus who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported issues with feeding or swallowing. The infant had nonmucoid watery stools ∼5 to 15 times per day. Her family history was significant for hypertrophic cardiomyopathy in several of her family members. Her initial vital signs and physical examination were normal. Laboratory data on hospital admission showed a normal complete blood cell count, but her chemistry analysis revealed significant hypernatremia, hyperkalemia, metabolic acidosis, and acute kidney injury. Her hypernatremia was resistant to fluid management. In this article, we discuss the infant's hospital course, our clinical thought process, and how we arrived at our final diagnosis. Copyright © 2017 by the American Academy of Pediatrics.

  5. Medications for the prevention and treatment of travellers' diarrhea.

    Science.gov (United States)

    Taylor, David N; Hamer, Davidson H; Shlim, David R

    2017-04-01

    . Travellers' diarrhea (TD) remains one of the most common illnesses encountered by travellers to less developed areas of the world. Because bacterial pathogens such as enterotoxigenic Escherichia coli (ETEC), enteroaggregative E. coli , Campylobacter spp. and Shigella spp. are the most frequent causes, antibiotics have been useful in both prevention and treatment of TD. Results of trials that assessed the use of medications for the prevention and treatment of TD were identified through PubMed and MEDLINE searches using search terms 'travellers' diarrhea', 'prevention' and 'treatment'. References of articles were also screened for additional relevant studies. Prevention of TD with antibiotics has been recommended only under special circumstances. Doxycycline, trimethoprim-sulfamethoxazole, fluoroquinolones and rifaximin have been used for prevention, but at present the first three antibiotics may have limited use secondary to increasing resistance, leaving rifaximin as the only current option. Bismuth subsalicylate (BSS) (Pepto-Bismol tablets) is also an option for prophylaxis. Treatment with antibiotics has been recommended for moderate to severe TD. Azithromycin is the drug of choice, especially in Asia where Campylobacter is common. Fluoroquinolone antibiotics continue to be effectively used in Latin America and Africa where ETEC is predominant. BSS and loperamide (LOP) also are effective as standalone treatments. LOP may be used alone for treatment of mild TD or in conjunction with antibiotics for treatment of TD. . Historically, antibiotic prophylaxis has not been routinely recommended and has been reserved for special circumstances such as when a traveller with an underlying illness cannot tolerate TD. Antibiotics with or without LOP have been useful in shortening the duration and severity of TD. Emerging antibiotic resistance, limited new antibiotic alternatives and faecal carriage of antibiotic-resistant bacteria by travellers may prompt a re-evaluation of

  6. Impact of porcine epidemic diarrhea on performance of growing pigs.

    Directory of Open Access Journals (Sweden)

    Julio Alvarez

    Full Text Available The impact of porcine epidemic diarrhea virus (PEDv infection on the US pork industry has mainly been attributed to the mortality that it causes in suckling piglets, and, consequently, much effort has been invested in the quantification of its effect in sow farms. However, no information on the performance of surviving pigs that were exposed to the PEDv as piglets is available. Here, a retrospective cohort study to evaluate the impact of porcine epidemic diarrhea virus (PEDv infection on growing pigs' performance, as indicated by mortality, average daily gain (ADG, average daily feed intake (ADFI, and feed conversion ratio (FCR was performed using production records from weaned pigs in nursery and wean-to-finish sites from sow farms that became PEDv-infected between May 2013 and June 2014. Production records from the first batch of growing pigs weaned in infected flows after the PEDv outbreak ("infected batches" were compared with those from pigs weaned within the previous 14 to 120 days ("control batches". Performance records from infected and control batches, paired by flow, were compared using non-parametric paired tests. Mortality, ADG and FCR were significantly different in PEDv-positive (infected compared with PEDv-negative (control batches, with a mean increase of mortality and FCR of 11% and 0.5, respectively, and a decrease of ADG of 0.16 lb/day. Our results demonstrate a poorer performance of growing pigs weaned after a PEDv outbreak compared with those weaned within the previous 14-120 days, suggesting that in addition to the mortality induced by PEDv in suckling pigs, the disease also impairs the performance of surviving pig. These findings help to quantify the impact of PEDv infection in the US and, ultimately, contribute to efforts to quantify the cost-effectiveness of disease prevention and control measures.

  7. Impact of porcine epidemic diarrhea on performance of growing pigs.

    Science.gov (United States)

    Alvarez, Julio; Sarradell, Javier; Morrison, Robert; Perez, Andres

    2015-01-01

    The impact of porcine epidemic diarrhea virus (PEDv) infection on the US pork industry has mainly been attributed to the mortality that it causes in suckling piglets, and, consequently, much effort has been invested in the quantification of its effect in sow farms. However, no information on the performance of surviving pigs that were exposed to the PEDv as piglets is available. Here, a retrospective cohort study to evaluate the impact of porcine epidemic diarrhea virus (PEDv) infection on growing pigs' performance, as indicated by mortality, average daily gain (ADG), average daily feed intake (ADFI), and feed conversion ratio (FCR) was performed using production records from weaned pigs in nursery and wean-to-finish sites from sow farms that became PEDv-infected between May 2013 and June 2014. Production records from the first batch of growing pigs weaned in infected flows after the PEDv outbreak ("infected batches") were compared with those from pigs weaned within the previous 14 to 120 days ("control batches"). Performance records from infected and control batches, paired by flow, were compared using non-parametric paired tests. Mortality, ADG and FCR were significantly different in PEDv-positive (infected) compared with PEDv-negative (control) batches, with a mean increase of mortality and FCR of 11% and 0.5, respectively, and a decrease of ADG of 0.16 lb/day. Our results demonstrate a poorer performance of growing pigs weaned after a PEDv outbreak compared with those weaned within the previous 14-120 days, suggesting that in addition to the mortality induced by PEDv in suckling pigs, the disease also impairs the performance of surviving pig. These findings help to quantify the impact of PEDv infection in the US and, ultimately, contribute to efforts to quantify the cost-effectiveness of disease prevention and control measures.

  8. Campylobacter jejuni and Campylobacter coli in Children With Acute Diarrhea in Health Centers of Hamadan, Iran

    Directory of Open Access Journals (Sweden)

    Rastyani

    2015-11-01

    Full Text Available Background Enteritis caused by Campylobacter is considered as the most common acute bacterial diarrhea around the world. In most cases, infection occurs as a result of consuming contaminated water or food, especially raw meat of fowls. Objectives The purpose of the present study was to determine the prevalence and antibiotic resistance of campylobacter species among pediatrics of Hamadan city, Iran. Patients and Methods A total of 120 stool samples from children less than 10 years old were examined from January 2013 to December 2014 in Hamadan, Iran. The samples were incubated in Campy-Thio enrichment medium for 1 - 2 hours and then cultured on a specific medium; after that, the suspected colonies were analyzed for Campylobacter spp. identification by conventional tests. The identified species by biochemical methods were confirmed by polymerase chain reaction (PCR. Antimicrobial susceptibility testing was performed by disk agar diffusion (DAD method. Results Twelve (10% Campylobacter spp. from 120 stool samples were isolated including C. coli and C. jejuni. In the antibiotic susceptibility test, the most frequent resistance was observed to ciprofloxacin 8 (88.8%, followed by 7 (77.7% resistant strains to tetracycline, 7 (77.7% to erythromycin, 6 (66.6% to clindamycin, 5 (55.5% to meropenem, 4 (44.4% to gentamicin, 3 (33.3% to nalidixicacid and only 1 (11.1% to chloramphenicol. Conclusions Campylobacter is responsible for some important clinical problems such as enteritis and is also associated with meningitis and hemolytic-uremic syndrome. It is imperative to monitor the prevalence and antibiotic resistance of Campylobacter spp. as well as other the zoonotic bacteria.

  9. Seroprevalence of bovine viral diarrhea virus in crossbred dairy cattle in Bangladesh

    Directory of Open Access Journals (Sweden)

    Mohammed Arif Uddin

    2017-08-01

    Full Text Available Aim: The study was conducted to determine the seroprevalence of bovine viral diarrhea virus (BVDV and hematological features in crossbred dairy cattle in Chittagong, Bangladesh. Materials and Methods: The antibody against BVDV in crossbred dairy cattle serum was detected by indirect enzyme-linked immunosorbent assay. The association of different categorical variables in the prevalence of BVDV has been studied. Blood samples were collected and analyzed to know the hematological variations in the study population. Results: The overall seroprevalence of BVDV in the study area was 51.1% (95% confidence interval [CI], 40.5-61.5. Among different physiological stages of animals, the highest 57.1% (95% CI, 42.2-71.2 prevalence was in case of non-pregnant animals. Aborted cows were found to be significantly (p<0.05 more seropositive 77.8% (95% CI, 52.4-93.6 than the non-aborted cows (77.8%, 95% CI, 52.4-93.6, compared to 44.7%, 95% CI, 33.3-56.6, respectively. Cows having the history of retained placenta were found more positive than without the history of retained placenta (63.2%, 95% CI, 38.4-83.7, compared to 54.7%, 95% CI, 40.4-68.4, respectively. Among the animals of different age groups, BVDV seroprevalence was higher 61.3% (95% CI, 42.2-78.2 in animals of more than 3 years up to 5 years, whereas 32% was in case of 0-1-year-old. Significant variation found in different geographical areas of the study area. Hematological analyses have shown variation between the BVDV positive and negative animals. Conclusion: Seroprevalence of BVDV found to be high in the study area is also economically important and cause significant damage to the production industry. Therefore, it is necessary to conduct effective control measures to reduce the burden of BVDV.

  10. Reclaiming unused IPv4 addresses

    CERN Multimedia

    IT Department

    2016-01-01

    As many people might know, the number of IPv4 addresses is limited and almost all have been allocated (see here and here for more information).   Although CERN has been allocated some 340,000 addresses, the way these are allocated across the site is not as efficient as we would like. As we face an increasing demand for IPv4 addresses with the growth in virtual machines, the IT Department’s Communication Systems Group will be reorganising address allocation during 2016 to make more efficient use of the IPv4 address ranges that have been allocated to CERN. We aim, wherever possible, to avoid giving out fixed IP addresses, and have all devices connected to the campus network obtain an address dynamically each time they connect. As a first stage, starting in February, IP addresses that have not been used for more than 9 months will be reclaimed. No information about the devices concerned will be deleted from LANDB, but a new IP address will have to be requested if they are ever reconnected to t...

  11. Evaluation of Serum 3-Bromotyrosine Concentrations in Dogs with Steroid-Responsive Diarrhea and Food-Responsive Diarrhea.

    Science.gov (United States)

    Sattasathuchana, P; Allenspach, K; Lopes, R; Suchodolski, J S; Steiner, J M

    2017-07-01

    The clinical usefulness of serum 3-BrY concentrations for subclassifying dogs with food-responsive diarrhea (FRD) and steroid-responsive diarrhea (SRD) has not been studied. To compare serum 3-BrY concentrations in dogs with FRD, dogs with SRD, and healthy control dogs. 38 dogs with FRD, 14 dogs with SRD, and 46 healthy dogs. Prospective study. Measurement of 3-BrY concentration in serum samples was performed by gas chromatography/mass spectrometry. There was no association of peripheral eosinophilia in dogs with FRD, SRD, and healthy control dogs (P = 0.069). There was no significant correlation between peripheral eosinophil counts and serum 3-BrY concentrations (ρ = -0.15, P = 0.13). Serum 3-BrY concentrations in dogs with SRD (median [range] = 3.27, 0.9-26.23 μmol/L) were significantly higher than in dogs with FRD (median [range] = 0.99, 0.62-8.82 μmol/L; P = 0.007) or in healthy dogs (median [range] = 0.62, 0.62-1.79 μmol/L; P dogs with FRD were significantly higher than in healthy dogs (P = 0.025). There was no significant correlation between the canine chronic enteropathy clinical activity index and serum 3-BrY concentrations (ρ = 0.17, P = 0.23). Measurement of serum 3-BrY concentrations, but not the peripheral eosinophil count, is helpful for detecting dogs with SRD and FRD. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  12. Zinc supplementation reduced cost and duration of acute diarrhea in children.

    Science.gov (United States)

    Gregorio, Germana V; Dans, Leonila F; Cordero, Cynthia P; Panelo, Carlo A

    2007-06-01

    To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. Cost-effectiveness analysis among patients consulting the emergency room of a government institution. Cost of treatment and outcome of participants of a randomized trial of zinc+ORS vs. ORS alone for acute diarrhea were investigated. Included were subjects 2-59 months with diarrhea <7 days and no dehydration. The direct medical, nonmedical and indirect costs were obtained, using the societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Sixty patients were given zinc+ORS and 57 were given ORS alone. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ORS group . The ICER showed that with use of zinc, the society saves $ 2.4 per day of diarrhea <4 days and spends $ 0.03 per case of diarrhea averted <4 days from consult, although the confidence interval included the null value of zero. Use of zinc with ORS reduced the total cost and duration of acute diarrhea. The ICER suggests cost effectiveness of zinc supplementation but there is a need to further assess the role of zinc supplementation in a larger population.

  13. Can Giardia lamblia infection lower the risk of acute diarrhea among preschool children?

    Science.gov (United States)

    Muhsen, Khitam; Cohen, Dani; Levine, Myron M

    2014-04-01

    There are inconsistent findings concerning the role of Giardia lamblia in pediatric diarrhea. A prospective cohort study of the incidence of acute diarrhea among Israeli Arab preschool children offered the opportunity to examine the association between G. lamblia infection (at baseline) and subsequent diarrhea. Following baseline screening by light microscopy for the presence of Giardia in their stools, a cohort was assembled of 142 children who were followed between October 2003 and August 2004 for the incidence of diarrhea. Surveillance was performed through maternal interviews. At baseline, 21 children tested Giardia-positive. During the prospective surveillance, acute diarrhea occurred less often among Giardia-positive children (9.5%) than among children who were not infected with Giardia (26.5%). G. lamblia infection was associated with lower risk of acute diarrhea; adjusted odds ratio of 0.18 (95% confidence interval 0.04-0.93) (p = 0.041). This prospective study provides additional evidence that Giardia may lower the risk of subsequent acute diarrhea among preschool children.

  14. The role of probiotics in the prevention and treatment of childhood infectious diarrhea

    Directory of Open Access Journals (Sweden)

    Maria Maragkoudaki

    2013-10-01

    Full Text Available Probiotics are beneficial bacteria that colonize and replicate in the human intestinal tract providing a positive benefit to the host. Several clinical trials support the efficacy of certain probiotics in the prevention and treatment of various diarrheal illnesses. This paper reviews published clinical trials assessing the efficacy of various probiotic species and strains in preventing and treating acute diarrhea in children. The available evidence shows that few probiotic species (mostly Lactobacillus GG and Saccharomyces boulardii are efficacious in decreasing the duration and the severity of acute gastroenteritis, with the most prominent of the reported benefits, the reduction of the duration of diarrhea by approximately 1 day. With regard to the prevention of acute diarrhea in the community and the hospital, there is modest evidence that some probiotic species may be efficacious in preventing community acquired diarrhea (Bifidobacterium lactis, Lactobacillus reuteri, Lactobacillus GG, nosocomial acquired diarrhea (Lactobacillus GG and Clostridium difficile diarrhea (Lactobacillus GG and Saccharomyces boulardii. In conclusion, the available evidence suggests that probiotics are safe when used in healthy children and effective in reducing the duration of acute infectious diarrhea. Further studies are required to assess the efficacy of selected probiotic species and strains at different dosages for different clinical indications and patient groups.

  15. Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.

    Science.gov (United States)

    Li, Hongling; Wang, Changcheng; Liu, Shuqing; Xu, Dongsheng; Zhang, Ju; Chen, Hongmei

    2014-01-01

    The causes and mechanisms of chronic diarrhea are complex. This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions. All cases were collected from January 2009 to June 2010. The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings. Those who had hyperthyroidism, diabetes, chronic pancreatitis, cirrhosis, atrophic gastritis, short bowel syndrome and connective tissue diseases had been excluded. The control group contained 40 healthy individuals without diarrhea. Endoscopy of the terminal ileum was applied in both groups, with the endoscope inserted into terminal ileum for more than 20 cm. The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days. Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups (P diarrhea, and terminal ileum lesions disappeared in 30 cases as determined by endoscopy. In the control group, endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases, and the follicles were small with the maximal diameter being 3 mm. There was no hyperemia, edema, erosion or ulcers. Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia, erosion, ulcers and lymphoid follicle hyperplasia. Therapeutic effect is good with metronidazole and probiotics.

  16. Celiac disease in children with diarrhea is more frequent than previously suspected.

    Science.gov (United States)

    Imanzadeh, Farid; Sayyari, Ali Akbar; Yaghoobi, Mohammad; Akbari, Mohammad Reza; Shafagh, Hamed; Farsar, Ahmad Reza

    2005-03-01

    Celiac disease (CD) may be missed or diagnosed late in children with chronic diarrhea. In this study the authors estimated the frequency of CD among pediatric patients with chronic diarrhea based on serologic and pathologic examinations. During a 6-year period, all patients with chronic diarrhea of more than 6 weeks referred to the authors' department were included. For each patient, an asymptomatic control was enrolled from among the patients referred to our clinic for other reasons. Serologic tests for CD including immunoglobulin A endomysial antibody and immunoglobulin A antigliadin antibody were performed in all patients and controls. If positive, duodenal biopsy was performed to confirm the diagnosis. Patients subsequently diagnosed as CD were placed on a gluten-free diet and reevaluated after 6 months. 825 cases of diarrhea and 825 controls were enrolled. CD was diagnosed in 54 (6.5%) of the diarrhea patients and seven (0.8%) of the controls. After 6 months of gluten-free diet, 48 (88.8%) patients had significant improvement in symptoms and of these 41 (76.1%) were totally asymptomatic. Forty-two patients allowed repeat endoscopy after 6 months of gluten-free diet and 40 (95.2%) showed improvement in histologic findings. CD is common among patients labeled as chronic diarrhea. In this subgroup, gluten-free diet may lead to a significant improvement in symptoms. Routine testing for CD may be indicated in all patients being evaluated for chronic diarrhea.

  17. Who are susceptible to pseudomembranous colitis among patients with presumed antibiotic-associated diarrhea?

    Science.gov (United States)

    Lee, Ki Sung; Shin, Woon Geon; Jang, Myoung Kuk; Kim, Hyoung Su; Kim, Hee Seon; Park, Chi Jun; Lee, Ja Young; Kim, Kyung Ho; Park, Joon Young; Lee, Jin Heon; Kim, Hak Yang; Cho, Sung Jin; Yoo, Jae Young

    2006-10-01

    Pseudomembranous colitis is a severe form of antibiotic-associated diarrhea. However, there have been no reports about the factors that make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. This study was designed to determine the clinical risk factors for pseudomembranous colitis among the patients with presumed antibiotic-associated diarrhea. This was a retrospective study of 150 consecutive patients admitted to our institution between January 2000 and December 2004 with a diagnosis of presumed antibiotic-associated diarrhea. All patients underwent sigmoidoscopy or colonoscopy because of diarrhea after administration of antibiotics. Pseudomembranous colitis was confirmed both endoscopically and histologically. Various clinical parameters were compared between the pseudomembranous colitis group and non-pseudomembranous colitis group. The mean age of patients was 61 years, and 60 percent (90/150) was female. Pseudomembranous colitis was diagnosed in 53 percent (80/150). On univariate analysis, older than aged 70 years (P = 0.014), antibiotic therapy for more than 15 days (P pseudomembranous colitis. On multivariate analysis, the important clinical risk factors were advanced age (older than aged 70 years; adjusted odds ratio, 2.7; 95 percent confidence interval, 1.208-6.131; P pseudomembranous colitis was 0.86. Advanced age and long hospital stay may make patients with presumed antibiotic-associated diarrhea susceptible to pseudomembranous colitis. Therefore, pseudomembranous colitis should be first suspected in cases with presumed antibiotic-associated diarrhea having such risk factors.

  18. Changes in Childhood Diarrhea Incidence in Nicaragua Following 3 Years of Universal Infant Rotavirus Immunization

    Science.gov (United States)

    Becker-Dreps, Sylvia; Paniagua, Margarita; Dominik, Rosalie; Cao, Hongyuan; Shah, Naman K.; Morgan, Douglas R.; Moreno, Gilberto; Espinoza, Félix

    2011-01-01

    Background While the pentavalent rotavirus vaccine was highly efficacious against rotavirus diarrhea in clinical trials, the vaccine’s effectiveness under field conditions in the developing world is unclear. In October, 2006, Nicaragua became the first developing nation to implement universal infant immunization with the pentavalent rotavirus vaccine. To assess the impact of the immunization program, we examined the incidence of diarrhea episodes between 2003 and 2009 among children in the state of León, Nicaragua. Methods We extracted data on diarrhea episodes from health ministry records. We used scaled Poisson regression models to estimate diarrhea incidence rate ratios (IRR) for the period following the program’s implementation to the period before implementation. Results Following implementation of the immunization program, diarrhea episodes among infants were reduced (IRR 0.85, 95% confidence interval [CI] 0.71–1.02) during the rotavirus season, but appear to have increased during other months. Conclusions While the immunization program appears effective in reducing diarrhea episodes during the rotavirus season, a large burden of diarrhea persists during the remainder of the year. PMID:20881511

  19. Nitazoxanide in Acute Rotavirus Diarrhea: A Randomized Control Trial from a Developing Country.

    Science.gov (United States)

    Mahapatro, Samarendra; Mahilary, Nijwm; Satapathy, Amit Kumar; Das, Rashmi Ranjan

    2017-01-01

    Background. Acute diarrhea is one of the leading causes of childhood mortality, with rotavirus being an important pathogen. Nitazoxanide, an antiparasitic agent, has been shown to inhibit rotavirus. Objective. This double-blind, randomized trial was designed to study the role of nitazoxanide in acute rotavirus diarrhea. Methods. Of 174 children (12 months to 5 years) with acute diarrhea, 50 rotavirus positive cases were randomized. The intervention group received syrup nitazoxanide twice daily (100 mg in 12-47 months, 200 mg in ≥4 yr) for 3 days along with standard treatment of diarrhea. Duration of diarrhea was the primary outcome measure. Results. The median duration (hrs) of diarrhea (54 versus 80; 95% CI: -26 [-13.2 to -38.8]) and hospitalization (68 versus 90; 95% CI: -22 [-12.98 to -31.02]) was significantly shorter in the nitazoxanide group. No significant difference was seen in the median duration (hrs) of fever or vomiting or the proportion of children requiring parenteral rehydration. There was no report of any adverse events. Conclusions. Oral nitazoxanide is effective and safe in the management of acute rotavirus diarrhea in Indian children (CTRI REF/2016/10/012507).

  20. Nitazoxanide in Acute Rotavirus Diarrhea: A Randomized Control Trial from a Developing Country

    Directory of Open Access Journals (Sweden)

    Samarendra Mahapatro

    2017-01-01

    Full Text Available Background. Acute diarrhea is one of the leading causes of childhood mortality, with rotavirus being an important pathogen. Nitazoxanide, an antiparasitic agent, has been shown to inhibit rotavirus. Objective. This double-blind, randomized trial was designed to study the role of nitazoxanide in acute rotavirus diarrhea. Methods. Of 174 children (12 months to 5 years with acute diarrhea, 50 rotavirus positive cases were randomized. The intervention group received syrup nitazoxanide twice daily (100 mg in 12–47 months, 200 mg in ≥4 yr for 3 days along with standard treatment of diarrhea. Duration of diarrhea was the primary outcome measure. Results. The median duration (hrs of diarrhea (54 versus 80; 95% CI: –26 [–13.2 to –38.8] and hospitalization (68 versus 90; 95% CI: –22 [–12.98 to –31.02] was significantly shorter in the nitazoxanide group. No significant difference was seen in the median duration (hrs of fever or vomiting or the proportion of children requiring parenteral rehydration. There was no report of any adverse events. Conclusions. Oral nitazoxanide is effective and safe in the management of acute rotavirus diarrhea in Indian children (CTRI REF/2016/10/012507.

  1. Rotavirus Diarrhea in Children Presenting to an Urban Hospital in Western Uttar Pradesh, India.

    Science.gov (United States)

    Teotia, Neeraj; Upadhyay, Amit; Agarwal, Sunny; Garg, Amit; Shah, Dheeraj

    2016-07-08

    To determine the proportion and clinical profile of rotavirus associated diarrhea in children aged 6 months to 5 years. Clinical details and stool samples were collected from 254 children aged between 6 months to 5 years presenting with acute diarrhea, irrespective of hydration status, to the outpatient department or emergency room of a hospital in Meerut, Uttar Pradesh, India. Rotavirus accounted for 26.3% (51 of 194) of diarrhea cases overall, and 41.2% (14 of 34) in hospitalized children. Rotavirus infection was associated with significantly longer duration [3.3 (1.4) d vs. 2.5 (1.1) d; P=0.004) of diarrhea, and more chances of dehydration (OR 1.85; 95% CI 1.19, 3.57) as compared to non-rotavirus diarrhea. Rotavirus is a common cause of acute diarrhea in under-five children, and is associated with a longer duration and more chances of dehydration than non-rotavirus diarrhea.

  2. Effect of rotavirus vaccine on diarrhea mortality in different socioeconomic regions of Mexico.

    Science.gov (United States)

    Gastañaduy, Paul A; Sánchez-Uribe, Edgar; Esparza-Aguilar, Marcelino; Desai, Rishi; Parashar, Umesh D; Patel, Manish; Richardson, Vesta

    2013-04-01

    In Mexico, declines in childhood diarrhea deaths have been documented during 2008-2010 after rotavirus vaccine introduction in 2007. Because of concerns about variation in rotavirus vaccine efficacy by socioeconomic status, we compared reductions in diarrhea mortality in the lesser developed southern region versus the more developed northern and central regions of Mexico. We obtained data from national vital statistics on diarrhea deaths among children aged diarrhea mortality before (2003-2006) and after (2009-2011) vaccine introduction. Regional vaccine coverage was estimated from administrative data, and socioeconomic status was assessed by using the Human Development Index. In northern, central, and southern Mexico, the 2007 Human Development Index was 0.84, 0.82, and 0.77, respectively, and by 2010 an estimated 99%, 84%, and 89% of children aged Diarrhea mortality among children .8). After introduction of rotavirus vaccination, marked and sustained declines in diarrhea deaths were seen among children in all regions of Mexico, including in the least developed southern region with the highest baseline diarrhea mortality. This finding indicates equitable vaccine delivery to children with varying risk of mortality and reaffirms the beneficial effects of rotavirus vaccination against fatal diarrheal disease.

  3. VSL#3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss.

    Science.gov (United States)

    Bowen, Joanne M; Stringer, Andrea M; Gibson, Rachel J; Yeoh, Ann S J; Hannam, Sarah; Keefe, Dorothy M K

    2007-09-01

    One of the most common toxicities of cancer treatment is diarrhea. Probiotics have been shown effective at preventing diarrhea in inflammatory bowel disease and may prove useful in the oncology setting. The primary aim of this study was to investigate the probiotic mixture, VSL#3, for amelioration of chemotherapy-induced diarrhea (CID). This experiment was carried out in a clinically relevant model of CID. VSL#3 was administered to female DA rats in one of three schedules. Irinotecan was used to induce mucositis and diarrhea, with rats monitored for seven days to record incidence of weight-loss and diarrhea. At study completion, intestines were collected to investigate histological and proliferative changes, apoptosis levels and mucin composition. VSL#3 reduced weight loss following irinotecan when administered before and after chemotherapy. Moderate and severe diarrhea was also prevented in these rats. This was associated with a significant increase in crypt proliferation combined with an inhibition of apoptosis in both the small and large intestines. VSL#3 also prevented irinotecan-induced increases in goblet cells within jejunal crypts. VSL#3 is effective at preventing severe diarrhea following chemotherapy with irinotecan and therefore has potential to be used clinically by cancer patients.

  4. An Assessment of Diarrhea Among Long-Distance Backpackers in the Sierra Nevada.

    Science.gov (United States)

    Meyer, Derek J; Costantino, Amber; Spano, Susanne

    2017-03-01

    Diarrhea is a common problem among long-distance backpackers, ranging in overall incidence from 11-56% as reported by previous studies on the Appalachian Trail and Long Trail. Differences in age, sex, and regularity of standard backcountry hygiene recommendations and practices have been shown to significantly affect the incidence of diarrhea. No study to date has investigated these trends among long-distance backpackers on the John Muir Trail (JMT) in the Sierra Nevada mountain range of California. Retrospective analysis of online survey data gathered from long-distance backpackers who attempted a JMT trek in 2014. Data were assessed for the significance of variables that might contribute to the incidence and severity of on-trail diarrhea. Of 737 valid responders, 16.4% reported experiencing diarrhea (82% with minimal/mild severity; 18% with significant severity). Regular hand sanitizer use was significantly correlated with more severe diarrhea (P < .05), but had no effect on incidence. Regular hand sanitizer users followed all other recommended hygiene practices as frequently as or better than those not using hand sanitizer regularly. Of all backpackers, 88% filtered or treated their drinking water regularly, with 18% of those reporting diarrhea of any severity. JMT backpackers have a comparatively lower incidence of diarrhea than backpackers on other major long-distance backpacking routes in the United States. Most JMT backpackers follow standard backcountry hygiene recommendations, including regular filtration or treatment of drinking water. No statistical significance was found between the incidence of diarrhea and compliance with standard hygiene recommendations. Regular hand sanitizer use was significantly correlated with more severe diarrhea but was not associated with incidence. There was no significant difference in compliance with standard backcountry hygiene practices between regular and infrequent hand sanitizer users. Copyright © 2017 Wilderness

  5. A Life’s Addresses

    DEFF Research Database (Denmark)

    Balle, Søren Hattesen

    to a number of different aspects of Koch’s own life such as marijuana, the Italian language, World War Two, etc. In this way, the book quite conventionally inscribes itself in the tradition of post-enlightenment apostrophic poetry as characterized by Culler, just as all its poems belong to the favourite...... relationship” (143). Apostrophe is called the figure of address in classical rhetoric, and it is precisely this meaning of the word which American poet Kenneth Koch puns upon in the title of his 2000 collection of poetry New Addresses. In fact, its fifty poems literally represent acts of poetic address......, are literally troped as and addressed in the manner of so many acquaintances, personal connections, relatives, friends, lovers, and family members in Koch’s life. My main claim is that Koch’s poetics in New Addresses is one that slightly dislocates the romantic dichotomy between the world of things...

  6. An uncommon cause of unexplained nonbloody diarrhea: When mind knows eyes may see

    Directory of Open Access Journals (Sweden)

    Hemanta Kumar Nayak

    2016-01-01

    Full Text Available Collagenous colitis (CC is characterized by chronic secretory diarrhea with the apparently normal gross appearance of the colonic mucosa. A biopsy is usually diagnostic. The symptoms of CC appear most commonly in the elderly. In CC, the major microscopic characteristic is a thickened collagen layer beneath the colonic mucosa. The reported case represents unexplained nonbloody diarrhea of a systemic lupus erythematosus patient, on extensive evaluation found to have CC. This case highlights the importance of considering a rare possibility of CC as a differential in a patient of unexplained nonbloody diarrhea.

  7. Emerging Insights into Antibiotic-Associated Diarrhea and Clostridium difficile Infection through the Lens of Microbial Ecology

    Directory of Open Access Journals (Sweden)

    Seth T. Walk

    2008-01-01

    Full Text Available Antibiotics are the main, and often only, clinical intervention for prophylactic and active treatment of bacterial infections in humans. Perhaps it is not surprising that these drugs also shift the composition of commensal bacteria inside our bodies, especially those within the gut microbial community (microbiota. How these dynamics ultimately affect the function of the gut microbiota, however, is not fully appreciated. Likewise, how antibiotic induced changes facilitate the outgrowth and pathogenicity of certain bacterial strains remains largely enigmatic. Here, we discuss the merits of a microbial ecology approach toward understanding a common side effect of antibiotic use, antibiotic-associated diarrhea (AAD, and the opportunistic bacterial infections that sometimes underlie it. As an example, we discuss how this approach is being used to address complex disease dynamics during Clostridium difficile infection.

  8. Economic costs associated with two testing strategies for screening feeder calves for persistent infection with bovine viral diarrhea virus.

    Science.gov (United States)

    Larson, Robert L; Miller, Robert B; Kleiboeker, Steve B; Miller, Margaret A; White, Brad J

    2005-01-15

    To develop partial budgets of the economic costs of 2 test strategies for screening cattle for persistent infection with bovine viral diarrhea virus (BVDV). Partial budget analysis. 938 calves arriving at 2 stocker operations. Calves were tested to determine prevalence of persistent BVDV infection. Test strategies that were evaluated included a single-test strategy consisting of immunohistochemical staining of skin biopsy specimens from all animals and a 2-test strategy consisting of polymerase chain reaction (PCR) assaying of pooled blood samples followed by immunohistochemical staining of skin biopsy specimens from animals in pools for which assay results were positive. Break-even costs (i.e., cost of persistent BVDV infection per animal necessary to justify whole-herd diagnostic testing) associated with each test strategy were calculated as a function of disease prevalence and test cost. Apparent prevalence of persistent BVDV infection was 0.32%. Sensitivity and specificity of the PCR assay for pooled samples were 100% and 89.7%, respectively. Regardless of the prevalence of persistent BVDV infection, the break-even cost for the 2-test strategy was lower than the break-even cost for the single-test strategy. However, the economic advantage was greatest when prevalence was low. Results suggest that using a 2-test strategy to screen cattle for persistent BVDV infection, whereby the first test involves PCR assaying of pooled samples and the second involves immunohistochemical testing only of those animals represented in pooled samples with positive assay results, will reduce the cost of screening incoming feedlot cattle, compared with immunohistochemical testing of all animals.

  9. Studying the prevalence of Campylobacter jejuni in adults with gastroenteritis from northwest of Iran

    Directory of Open Access Journals (Sweden)

    Ahmadreza Mobaien

    2016-12-01

    Full Text Available Objective: To investigate the prevalence of Campylobacter jejuni (C. jejuni in the patients with gastroenteritis. Methods: This descriptive and analytical study included all adult patients with acute diarrhea admitted to the University Hospital of Zanjan Province who were enrolled in a one-year period from 2013 to 2014. Stool samples were checked for white blood cells (WBC and lactoferrin, then samples with WBC ≤ 5 positive for lactoferrin were selected for amplification of mapA gene of C. jejuni by RT-PCR assay. Results: In this study, 864 patients (410 men and 454 women with acute diarrhea were enrolled, of which about 718 patients had WBC less than 5 and 146 patients had WBC more than 5 in the stool exam. All inflammatory diarrhea samples were tested for lactoferrin and 111 cases of the samples tested were positive for lactferrin. A total of 40 samples out of 111 were positive for C. jejuni by RT. Conclusions: The finding of this study showed that the prevalence of inflammatory diarrhea and diarrhea caused by Campylobacter in this study was high. This need for education and awareness in this area, as well as appropriate treatment is too important.

  10. Ethiop. J. Sci. & Technol. 9(1) 15-30, 2016 15 Prevalence of ...

    African Journals Online (AJOL)

    ABSTRACT. Diarrheal diseases cause about 3 million deaths annually, mainly to children under five years of age. This study determined the prevalence of diarrhea causing intestinal protozoans and the associated risk factors in diarrheic children aged below five years in Bahir Dar town, Ethiopia. From November 2011 to ...

  11. 27-35, 2015 27 Prevalence and antibiogram of Shigella and ...

    African Journals Online (AJOL)

    ABSTRACT. Diarrheal diseases remain the major cause of morbidity and mortality in children under five years of age. Salmonella and Shigella species are among the leading causes of diarrhea in children. The aim of this study was to determine the prevalence and antimicrobial profiles of Salmonella and Shigella spp. in ...

  12. The Knowledge Level: Presidential Address

    OpenAIRE

    Newell, Allen

    1981-01-01

    This is the first presidential address of AAAI, the American Association for Artificial Intelligence. In the grand scheme of history of artificial intelligence (AI), this is surely a minor event. The field this scientific society represents has been thriving for quite some time. No doubt the society itself will make solid contributions to the health of our field. But it is too much to expect a presidential address to have a major impact. So what is the role of the presidential address and wha...

  13. Enteric Pathogens and Coinfections in Foals with and without Diarrhea

    Directory of Open Access Journals (Sweden)

    Giovane Olivo

    2016-01-01

    Full Text Available Diarrhea is a major clinical problem affecting foals up to 3 months of age. The aim of this study was to identify enteric microorganisms involved in monoinfections and coinfections and the associated virulence factors in healthy and diarrheic foals. Diarrheic (D (n=56 and nondiarrheic (ND foals (n=60 up to three months of age were studied. Fecal samples were analyzed for identification of infectious agents (microbiological culturing, molecular techniques, and microscopic analyses. Escherichia coli fimH (30% versus 25%, Salmonella spp. (25% versus 7%, Strongyloides westeri (25% versus 25%, Clostridium perfringens type A (21% versus 10%, E. coli ag43 (20% versus 35%, Strongylus (11% versus 18%, and vapA-positive Rhodococcus equi (5% versus 2% were the most frequent enteric pathogens detected in D and ND foals, respectively. The frequency of toxin A-positive C. perfringens was significantly increased in the D (p=0.033 compared with the ND animals. R. equi strains harboring virulent plasmids were also identified (VapA 85-kb type I and VapA 87-kb type I in D and ND foals. Coinfections were observed in 46% of the D and 33% of the ND foals. Our results demonstrate the great diversity of enteric pathogens, virulence factors, and coinfections involved in enteric infections of foals.

  14. Immunoglobulin G response in patients with Campylobacter concisus diarrhea.

    Science.gov (United States)

    Nielsen, Hans Linde; Kaakoush, Nadeem O; Mitchell, Hazel M; Nielsen, Henrik

    2016-02-01

    Limited information is available on the systemic immunoglobulin response in patients infected with the emerging pathogen Campylobacter concisus. The aim of the present study was to detect anti-C. concisus antibodies in serum of 88 patients with C. concisus gastroenteritis. Specific IgG antibodies to C. concisus were measured in serum using an in-house enzyme-linked immunosorbent assay, and pooled donor serum was used as a control. The mean optical density was 0.135 (SEM: 0.020) for the 88 adult patients and 0.100 (SEM: 0.011) in controls. When using an optical density value equal to the mean +3 SEM for the control serum, 22 (25%) C. concisus-positive patients had increased IgG antibodies. Patients with high IgG levels more often reported headache, and they had a trend toward more mucus in stools, whereas IgG levels were unrelated to age, duration of diarrhea, number of stools per day, and weight loss. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Enteropathogenic bacteria isolated from specimens of patients with diarrhea

    Directory of Open Access Journals (Sweden)

    Salary M

    1997-09-01

    Full Text Available Acute infectious gastroenteritis is one of the most common infectious diseases of humans in the world. Diarrheal disease still ranks very high as a major cause of illness and death especially in developing nations. This study has been carried out to investigate enteropathogenic bacteria isolated from 2517 specimens of patients with diarrhea. The results obtained are as follow: Salmonella typhimurium: 6 cases 3.1 percent, Salmonella havana: 5 cases 2.6 percent, Shigella dysenteriae: 12 cases 6.2 percent, Shigella flexneri: 26 cases 13.5 percent, Shigella boydii: 8 cases 4.1 percent, Shigella sonnei: 24 cases 12.4 percent, Enteropathogenic E.coli: 11 cases 5.7 percent, Enteroinvasive E.coli: 2 cases 1 percent, Yersinia enterocolitica: - cases - percent, Vibrio cholera: - cases - percent, Aeromonas hydrophila: 6 cases 3.1 percent, Plesiomonas shigelloides: 1 cases 0.5 percent, Toxigenic C.difficile: 36 cases 18.7 percent, Enterotogenic c.perfringens: 6 cases 3.1 percent, Campylobacter jejuni: 50 cases 25.9 percent.

  16. Acute neurological involvement in diarrhea-associated hemolytic uremic syndrome.

    Science.gov (United States)

    Nathanson, Sylvie; Kwon, Thérésa; Elmaleh, Monique; Charbit, Marina; Launay, Emma Allain; Harambat, Jérôme; Brun, Muriel; Ranchin, Bruno; Bandin, Flavio; Cloarec, Sylvie; Bourdat-Michel, Guylhene; Piètrement, Christine; Champion, Gérard; Ulinski, Tim; Deschênes, Georges

    2010-07-01

    Neurologic involvement is the most threatening complication of diarrhea-associated hemolytic uremic syndrome (D+HUS). We report a retrospective multicenter series of 52 patients with severe initial neurologic involvement that occurred in the course of D+HUS. Verotoxigenic Escherichia coli infection was documented in 24. All except two patients had acute renal failure that required peritoneal dialysis, hemodialysis, or both techniques. A first group of eight patients remained with normal consciousness; five of them had protracted seizures. A second group of 23 patients had stuporous coma; five of these had protracted severe seizures, and 18 had a neurologic defect including pyramidal syndrome, hemiplegia or hemiparesia, and extrapyramidal syndrome. A third group of 21 patients had severe coma. Plasma exchanges were undertaken in 25 patients, 11 of whom were treated within 24 hours after the first neurologic sign; four died, two survived with severe sequelae, and five were alive without neurologic defect. Magnetic resonance imaging (MRI) for 29 patients showed that (1) every structure of the central nervous system was susceptible to involvement; (2) no correlation seemed to exist between special profile of localization on early MRI and the final prognosis; and (3) MRI did not exhibit any focal lesions in three patients. The overall prognosis of the series was marked by the death of nine patients and severe sequelae in 13. Neurologic involvement is associated with a severe renal disease but does not lead systematically to death or severe disability.

  17. [Etiological and molecular characteristics of diarrhea caused Proteus mirabilis].

    Science.gov (United States)

    Shi, Xiaolu; Hu, Qinghua; Lin, Yiman; Qiu, Yaqun; Li, Yinghui; Jiang, Min; Chen, Qiongcheng

    2014-06-01

    To analyze the etiological characteristics, virulence genes and plasmids that carrying diarrhea-causing Proteus mirabilis and to assess their relationship with drug resistance and pathogenicity. Proteus mirabilis coming from six different sources (food poisoning, external environment and healthy people) were analyzed biochemically, on related susceptibility and pulsed-field gel electrophoresis (PFGE). Virulence genes were detected by PCR. Plasmids were extracted and sequenced after gel electrophoresis purification. The biochemical characteristics of Proteus mirabilis from different sources seemed basically the same, and each of them showed having common virulence genes, as ureC, rsmA, hpmA and zapA. However, the PFGE patterns and susceptibility of these strains were different, so as the plasmids that they carried. Plasmid that presented in the sequenced strain showed that the 2 683 bp length plasmid encodes qnrD gene was associated with the quinolone resistance. Etiological characteristics and molecular characteristics of Proteus mirabilis gathered from different sources, were analyzed. Results indicated that traditional biochemical analysis and common virulence gene identification might be able to distinguish the strains with different sources. However, PFGE and plasmids analysis could distinguish the sources of strains and to identify those plasmids that commonly carried by the drug-resistant strains. These findings also provided theoretical basis for further study on the nature of resistance and pathogenicity in Proteus mirabilis.

  18. Recombinant porcine norovirus identified from piglet with diarrhea

    Directory of Open Access Journals (Sweden)

    Shen Quan

    2012-09-01

    Full Text Available Abstract Background Noroviruses (NoVs are members of the family Caliciviridae and are emerging enteric pathogens of humans and animals. Some porcine NoVs are genetically similar to human strains and are classified into GII, like most epidemic human NoVs. So far, PoNoV have been exclusively detected in fecal samples of adult pig without clinical signs. Results Result showed that 2 of the 12 evaluated fecal samples were positive for PoNoVs, one of which was positive for PoNoV alone, and the other was coinfected with porcine circovirus and PoNoV. Phylogenetic and recombination analysis showed that the PoNoV positive alone strain was a recombinant new genotype strain. Experimental infection of miniature pigs with fecal suspensions confirmed that this strain can cause gastroenteritis in piglets. Conclusion This is the first report that recombinant new genotype PoNoV exised in pig herd of China, which cause diarrhea in pigs in nature condition. This find raised questions about the putative epidemiologic role of PoNoV.

  19. Intractable diarrhea with tufting enteropathy: a favorable outcome is possible.

    Science.gov (United States)

    Lemale, Julie; Coulomb, Aurore; Dubern, Béatrice; Boudjemaa, Sabah; Viola, Sheila; Josset, Patrice; Tounian, Patrick; Girardet, Jean-Philippe

    2011-06-01

    Tufting enteropathy (TE) is a congenital abnormality of intestinal mucosa development characterized by severe intestinal failure requiring parenteral nutrition (PN) and, in some cases, small bowel transplantation. A few patients have had a more favorable outcome. The objective of this study was to evaluate possible correlations between histological lesion severity in duodenal biopsies and clinical outcomes in children with TE. We retrospectively reviewed the records of patients diagnosed with TE between 1993 and 2003 at our institution based on intractable neonatal-onset diarrhea with prolonged dependence on PN and duodenal biopsy findings of villous atrophy, epithelial dysplasia with enterocyte dedifferentiation and disorganization (tufting) of the surface epithelium, and crypt abnormalities. The histological lesions were assessed semiquantitatively and compared with the clinical outcomes including dependence on PN. Seven children, all from consanguineous parents, were studied for a median of 6.5 years. Three were permanently weaned off PN and experienced normal growth without nutritional assistance. Initial biopsies in all 3 children showed severe diffuse histological lesions. At weaning off PN, 2 of these 3 patients had persistent, although less diffuse, histological lesions. Progressive weaning off PN is possible in some children with TE. In our experience, this favorable outcome was not predicted by histological lesion severity, although the lesions improved in some patients. New biomarkers for identifying the histological lesions and predicting the outcome would be useful.

  20. [Abdominal spasms, meteorism, diarrhea: fructose intolerance, lactose intolerance or IBS?].

    Science.gov (United States)

    Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart

    2012-12-01

    Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p < 0,02) and in children 90 versus 62 % (p < 0,001)) and is in polyintolerances most frequently correlated to histamine intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.

  1. Bovine viral diarrhea (BVD: A review emphasizing on Iran perspective

    Directory of Open Access Journals (Sweden)

    Mohammad Khezri

    2015-09-01

    Full Text Available Bovine viral diarrhea (BVD is one of the most important diseases of cattle responsible for major economic losses in dairy industries of Iran. So far, no nationwide program has been taken in Iran to control and eradicate the disease. Moreover, until now, no vaccination program has been practiced against BVD in Iran, although the disease is prevailing in the country. For effective controlling of BVD, it is necessary to cull the affected animals, and new entry of BVD in the farm should be prevented. Focusing on biosecurity in systematic control programs of BVD can also reduce the risks of introduction and spread of other epizootic and zoonotic diseases, thereby improving both cattle health and welfare in general. In this review paper, an overview on BVD emphasizing on Iran perspective has been discussed focusing on clinical manifestations of BVD, routes of transmission of BVD virus (BVDV, its diagnostic methods and possible prevention strategies. [J Adv Vet Anim Res 2015; 2(3.000: 240-251

  2. Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD

    Directory of Open Access Journals (Sweden)

    Hübner, Claudia

    2015-10-01

    Full Text Available Aim: -associated diarrhea (CDAD causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98, pharmaceuticals (€ 22.88 and laboratory (€ 17.44 are quite low.Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.

  3. Factors associated with food workers working while experiencing vomiting or diarrhea

    National Research Council Canada - National Science Library

    Sumner, Steven; Brown, Laura Green; Frick, Roberta; Stone, Carmily; Carpenter, L Rand; Bushnell, Lisa; Nicholas, Dave; Mack, James; Blade, Henry; Tobin-D'Angelo, Melissa; Everstine, Karen

    2011-01-01

    This study sought to determine the frequency with which food workers said they had worked while experiencing vomiting or diarrhea, and to identify restaurant and worker characteristics associated with this behavior...

  4. The cost utility and budget impact of adjuvant racecadotril for acute diarrhea in children in Thailand

    National Research Council Canada - National Science Library

    Rautenberg TA; Zerwes U

    2017-01-01

    ...; 3Assessment in Medicine GmbH, Lörrach, Germany Objective: To evaluate the cost utility and the budget impact of adjuvant racecadotril for the treatment of acute diarrhea in children in Thailand. Methods...

  5. RISK FACTORS AND PECULIARITIES OF NUTRITION OF INFANTS WITH CHRONIC DIARRHEA

    Directory of Open Access Journals (Sweden)

    T.S. Lazareva

    2008-01-01

    Full Text Available Results of observation of children from 2,5 months to 4 years old, treated in hospital with diagnosis chronic diarrhea are analyzed in this article. Diarrhea debuted in first year of living in most cases. The reason of onset of diarrhea often was alimentary factor. Hereditary predisposition, pathologic pregnancy, and diseases in women at the time of pregnancy played an important role in development of disease. Nutrition of children in early age was characterized by low duration of breast feeding and early conversion of children to the mixed and artificial feeding. Main food stuffs in children's nutrition on mixed and artificial feeding was adapted milk formulas, and rarely non adapted milk food (cow's and goat's milk, kefir. Only 30% of mothers had a definite knowledge of proper child's feeding and advantages of breast feeding. This fact indicates necessity of more active educational work by medical staff.Key words: children, chronic diarrhea, nutrition.

  6. [Study of traditional Chinese medicine syndrome features of AIDS-related chronic diarrhea].

    Science.gov (United States)

    Ni, Liang; Wang, Rong-Bing; Yang, Xiao-Ping; Gao, Hui; Tan, Xing-Hua; Wang, Cui-Fang; Li, Feng

    2013-08-01

    To study the AIDS-related chronic diarrhea in traditional Chinese medicine (TCM) clinical manifestations and syndrome factors, explore the characteristics of syndrome. A multicenter, prospective collection of 311 cases of AIDS patients with chronic diarrhea, study the characteristics of TCM syndrome by using the method of descriptive statistics and exploratory factor analysis. The common clinical manifestation of TCM: fatigue (229 cases, 73.63%), bowel (229 cases, 68.81%), diarrhea (194 cases, 62.38%), thin fur (201 cases, 64.63%), pink tongue (166 cases, 53.38%), greasy fur, thready pulse (126 cases, 40.51%), sink vein (64 cases, 20.58%), slippery pulse. 17 common factors were extracted, common disease syndrome factor as the spleen, stomach, liver, gallbladder and colon syndrome factors of disease, Qi, Yang deficiency, Qi stagnation, dampness and heat evil. AIDS-related chronic diarrhea symptoms involving multiple organs, the disease belongs to deficiency and excess.

  7. A rare cause of congenital diarrhea in a Turkish newborn: tufting enteropathy.

    Science.gov (United States)

    Kahvecioğlu, Dilek; Yıldız, Duran; Kılıç, Atilla; İnce-Alkan, Banu; Erdeve, Ömer; Kuloğlu, Zarife; Atasay, Begüm; Ensari, Arzu; Yılmaz, Resul; Arsan, Saadet

    2014-01-01

    Tufting enteropathy is an autosomal recessive congenital enteropathy presenting with early-onset severe intractable diarrhea. It presents with watery diarrhea that develops in the first days after birth and persists despite bowel rest. Growth is impaired, and most patients require total parenteral nutrition. The histological characteristic of tufting enteropathy is the presence of epithelial tufts. We hereby present a patient who was referred to our neonatal intensive care unit because of chronic diarrhea and diagnosed with tufting enteropathy according to histological examination. To the best of our knowledge, the newborn case presented here is the first one reported from Turkey. As TE is a very rare disease, it should be considered in patients with continuing diarrhea beginning in the first days of life.

  8. Management of chronic diarrhea in HIV-infected patients: current treatment options, challenges and future directions

    Directory of Open Access Journals (Sweden)

    Lidia Elfstrand

    2010-11-01

    Full Text Available Lidia Elfstrand, Claes-Henrik FlorénDepartment of Medicine, Division of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenAbstract: Diarrhea is a common clinical manifestation of HIV infection regardless of whether the patients have AIDS. HIV and malnutrition tend to occur in the same populations, the underprivileged and resource-poor. Malnutrition increases severity and mortality of infection. Occurrence of chronic diarrhea in HIV-infected patients, gut status and pathogenic agents, nutritional status and the crucial role of nutrition are reviewed. Bovine colostrum-based food can be useful for managing chronic diarrhea in HIV-infected patients, enhancing both nutritional and immunological status.Keywords: HIV, diarrhea, nutrition, bovine colostrum, CD4+ 

  9. An outbreak of Clostridium difficile-associated diarrhea in piglets in Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Otávio Silveira Silva

    2014-02-01

    Full Text Available In spite of the substantial role of Clostridium difficile in causing diarrhea in piglets, there have been few reports of the disease caused by this bacterium in Rio Grande do Sul, Brazil. In this paper, we describe an outbreak of C. difficile-associated diarrhea in a pig farm in Brazil. The diarrhea rate increased in piglets 1-to-7 days old from an average of 2% to approximately 20%. Necropsied piglets showed mesocolon edema, and in a histological evaluation, severe necrotizing neutrophilic colitis was observed. The intestinal contents were positive for the A/B toxins of C. difficile and negative for other tested enteropathogens. The association between the clinical signs, post mortem findings and laboratory exams confirmed the diagnosis of C. difficile-associated diarrhea. The present report confirms C. difficile as a pathogen in swine in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease in swine.

  10. Rotavirus vaccines and health care utilization for diarrhea in the United States (2007-2011).

    Science.gov (United States)

    Leshem, Eyal; Moritz, Rebecca E; Curns, Aaron T; Zhou, Fangjun; Tate, Jacqueline E; Lopman, Benjamin A; Parashar, Umesh D

    2014-07-01

    To examine reductions in diarrhea-associated health care utilization after rotavirus vaccine implementation and to assess direct and indirect effectiveness of vaccination. Retrospective cohort analysis of claims data of commercially insured US children aged diarrhea-associated health care utilization in prevaccine (2001-2006) versus postvaccine introduction (2007-2011) years, compared rates of diarrhea-associated health care utilization in vaccinated versus unvaccinated children and compared rates in unvaccinated children in postvaccine versus prevaccine years. Among children aged diarrhea health care utilization in US children. Both rotavirus vaccines conferred high protection against rotavirus hospitalizations; RV5 conferred durable protection through the fourth year of life. Vaccination also conferred indirect benefits to unvaccinated children. Copyright © 2014 by the American Academy of Pediatrics.

  11. Use of an Oral Elemental Diet in Infants with Severe Intractable Diarrhea

    Science.gov (United States)

    Sherman, Joseph O.; And Others

    1975-01-01

    Evaluated was the use of an oral elemental diet consisting of crystalline amino acids, glucose, electrolytes, and vitamins to control severe intractable diarrhea in 27 infants (1-day to 9-months of age). (DB)

  12. Treatment of pediatric diarrhea: a simulated client study at private pharmacies of Ujjain, Madhya Pradesh, India

    National Research Council Canada - National Science Library

    Diwan, Vishal; Sabde, Yogesh D; Byström, Emma; De Costa, Ayesha

    2015-01-01

    .... The present study used simulated client methodology to assess the actual dispensing practices for patients with pediatric diarrhea at private pharmacies in an urban setting of an Indian province...

  13. New diagnostic biomarker in acute diarrhea due to bacterial infection in children

    Directory of Open Access Journals (Sweden)

    Hassan M. Al-Asy

    2017-06-01

    Conclusions: Both serum PCT and sTREM-1 are valuable in the early diagnosis of acute bacterial infection-induced diarrhea in children, and there was markedly higher diagnostic discriminatory power for sTREM-1.

  14. FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea

    National Research Council Canada - National Science Library

    Antonio Piralla; Giovanna Lunghi; Gianluigi Ardissino; Alessia Girello; Marta Premoli; Erika Bava; Milena Arghittu; Maria Rosaria Colombo; Alessandra Cognetto; Patrizia Bono; Giulia Campanini; Piero Marone; Fausto Baldanti

    2017-01-01

    .... In the present bicentric study, the diagnostic value of FilmArray™ GI panels was assessed in unformed stool samples of patients with acute gastroenteritis and in a series of samples collected from pediatric patients with heamorragic diarrhea...

  15. Gastro 2013 APDW/WCOG Shanghai working party report: chronic diarrhea: definition, classification, diagnosis.

    Science.gov (United States)

    Schiller, Lawrence R; Pardi, Darrell S; Spiller, Robin; Semrad, Carol E; Surawicz, Christina M; Giannella, Ralph A; Krejs, Guenter J; Farthing, Michael J G; Sellin, Joseph H

    2014-01-01

    Diarrhea is best defined as passage of loose stools often with more frequent bowel movements. For clinical purposes, the Bristol Stool Form Scale works well to distinguish stool form and to identify loose stools. Laboratory testing of stool consistency has lagged behind. Acute diarrhea is likely to be due to infection and to be self-limited. As diarrhea becomes chronic, it is less likely to be due to infection; duration of 1 month seems to work well as a cut-off for chronic diarrhea, but detailed scientific knowledge is missing about the utility of this definition. In addition to duration of diarrhea, classifications by presenting scenario, by pathophysiology, and by stool characteristics (e.g. watery, fatty, or inflammatory) may help the canny clinician refine the differential diagnosis of chronic diarrhea. In this regard, a careful history remains the essential part of the evaluation of a patient with diarrhea. Imaging the intestine with endoscopy and radiographic techniques is useful, and biopsy of the small intestine and colon for histological assessment provides key diagnostic information. Endomicroscopy and molecular pathology are only now being explored for the diagnosis of chronic diarrhea. Interest in the microbiome of the gut is increasing; aside from a handful of well-described infections because of pathogens, little is known about alterations in the microbiome in chronic diarrhea. Serological tests have well-defined roles in the diagnosis of celiac disease but have less clearly defined application in autoimmune enteropathies and inflammatory bowel disease. Measurement of peptide hormones is of value in the diagnosis and management of endocrine tumors causing diarrhea, but these are so rare that these tests are of little value in screening because there will be many more false-positives than true-positive results. Chemical analysis of stools is of use in classifying chronic diarrhea and may limit the differential diagnosis that must be considered, but

  16. Novel Human Bufavirus Genotype 3 in Children with Severe Diarrhea, Bhutan

    Science.gov (United States)

    Yahiro, Takaaki; Wangchuk, Sonam; Tshering, Kinlay; Bandhari, Purushotam; Zangmo, Sangay; Dorji, Tshering; Tshering, Karchung; Matsumoto, Takashi; Nishizono, Akira; Söderlund-Venermo, Maria

    2014-01-01

    We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs. PMID:24856373

  17. Self-reported description of diarrhea among military populations in operations Iraqi Freedom and Enduring Freedom.

    Science.gov (United States)

    Putnam, Shannon D; Sanders, John W; Frenck, Robert W; Monteville, Marshall; Riddle, Mark S; Rockabrand, David M; Sharp, Trueman W; Frankart, Carla; Tribble, David R

    2006-01-01

    Infectious diarrhea is among the most common medical problems associated with military deployments and has been reported as a frequent problem for troops currently deployed to Iraq and Afghanistan. Lacking is information describing clinical presentation, risk behaviors, and treatment of travelers' diarrhea in this population. An anonymous cross-sectional survey was conducted among 15,459 US military personnel deployed to Southwest Asia during 2003 to 2004. Overall, diarrhea was commonly reported (76.8% in Iraq and 54.4% in Afghanistan) and was frequently severe (more than six stools/d) (20.8% in Iraq and 14.0% in Afghanistan) or associated with fever (25.8%), vomiting (18% with diarrhea and 16.5% without), persistent symptoms (>14 d, 9.8%), or chronic symptoms (>30 d, 3.3%). Diarrhea was associated with time spent off military compounds and eating local food. Over 80% of respondents sought care for their symptoms, usually at the lowest echelon of care (field medic), and were most often treated with either loperamide or an antibiotic. Self-treatment with loperamide or Pepto-Bismol was also common and successful with only 9% of self-treated individuals reporting seeking further medical care. Infectious diarrhea is a common problem for US military personnel, and associated fevers and vomiting are more common than in past conflicts in the region. As with past studies, time spent off base and local food consumption, both more common in Iraq than Afghanistan, continue to be the most important risk factors for acquiring diarrhea. The majority of soldiers reported seeking care for diarrhea, but appropriate treatment, including self-treatment with over-the-counter medicines, was generally successful. Further studies should be conducted to evaluate appropriate treatment algorithms, including the use of self-treatment, for deployed military personnel.

  18. Lack of Evidence of Enterotoxin Involvement in Pathogenesis of Campylobacter Diarrhea

    Science.gov (United States)

    1992-01-01

    production in Campylobacter strains, we TABLE 5. C. jejuni ELISA determination for serum samples of patients with sporadic diarrhea in Thailand Mean OD t...p AD-A271 890 1 April 1993 Reprint Lack of Evidence of Enterotoxin Involvement in Pathogenesis of Campylobacter Diarrhea Army Project Order 90PP0820...Order: Studies of the Outer Membrane Proteins of Campylobacter Jejuni for Vaccine Development Approved for public release; distribution unlimited

  19. The cost utility and budget impact of adjuvant racecadotril for acute diarrhea in children in Thailand.

    Science.gov (United States)

    Rautenberg, Tamlyn Anne; Zerwes, Ute

    2017-01-01

    To evaluate the cost utility and the budget impact of adjuvant racecadotril for the treatment of acute diarrhea in children in Thailand. A cost utility model has been adapted to the context of Thailand to evaluate racecadotril plus oral rehydration solution (R+ORS) versus oral rehydration solution (ORS) alone for acute diarrhea in children racecadotril versus ORS alone is potentially cost-effective for children in Thailand and uptake could translate into savings for the Thailand public health care system.

  20. Community Diarrhea Incidence Before and After Rotavirus Vaccine Introduction in Nicaragua

    OpenAIRE

    Becker-Dreps, Sylvia; Meléndez, Marlon; Liu, Lan; Enrique Zambrana, Luis; Paniagua, Margarita; Weber, David J.; Hudgens, Michael G.; Cáceres, Mercedes; Källeståll, Carina; Morgan, Douglas R.; Espinoza, Félix; Peña, Rodolfo

    2013-01-01

    We estimated the incidence of watery diarrhea in the community before and after introduction of the pentavalent rotavirus vaccine in León, Nicaragua. A random sample of households was selected before and after rotavirus vaccine introduction. All children < 5 years of age in selected households were eligible for inclusion. Children were followed every 2 weeks for watery diarrhea episodes. The incidence rate was estimated as numbers of episodes per 100 child-years of exposure time. A mixed effe...

  1. The Role of Probiotics in the Prevention and Treatment of Diarrhea in Children

    Directory of Open Access Journals (Sweden)

    M Razi

    2014-04-01

    Full Text Available Introduction: Diarrhea remains a major cause of death in children under 5 years are considered. However, following the overuse of antibiotics and the arbitrary use of broad-spectrum antibiotic, as well as diarrhea associated with antibiotic use is increasing. This study aimed to determine the role of probiotics in the prevention and treatments of diarrhea in children have been conducted.   Materials and Methods: Search on the subject of electronic journals and databases such as Web sites SID, Iran Medex, Pubmed and Google scholr from 2010 to 2014 was conducted.   Results: Food and Agriculture Organization of the United Nations as probiotic " microorganisms that have beneficial health effect on the host has sufficient volume " can be defined. Probiotics on the intestinal microbial balance improves. The most important function of probiotics , development , maturation and regulation of the secretory immune system - is mucous . Other proposed mechanisms include probiotics strengthen the immune system by strengthening tight junctions , stimulation of cytokinin production and the production of secondary materials as protective nutrients ( short chain fatty acids, arginine for visceral action , is .Thibault and their colleagues in their study on 90 children were living in orphanages, kindergartens in France showed that days of diarrhea and daily probability of diarrhea in the probiotic group consumed significantly reduced compared with the control group.   Conclusions: According to studies, due to the wide acceptance and lack of side effects of probiotics, probiotic products are increasingly the trend is rising, so it is recommended due to the high incidence of diarrhea among children in the prevention and used to treat diarrhea.   Keywords: Child, Diarrhea, Probiotics.

  2. Management of chronic diarrhea in HIV-infected patients: current treatment options, challenges and future directions

    OpenAIRE

    Elfstrand, Lidia; Flor?n, Claes-Henrik

    2010-01-01

    Lidia Elfstrand, Claes-Henrik FlorénDepartment of Medicine, Division of Clinical Sciences, Skåne University Hospital, Lund University, Lund, SwedenAbstract: Diarrhea is a common clinical manifestation of HIV infection regardless of whether the patients have AIDS. HIV and malnutrition tend to occur in the same populations, the underprivileged and resource-poor. Malnutrition increases severity and mortality of infection. Occurrence of chronic diarrhea in HIV-infected patien...

  3. [Effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea].

    Science.gov (United States)

    Huang, Zu-xiong; Ye, Li-yan; Zheng, Zhi-yong; Chen, Xin-min; Ren, Rong-na; Tong, Guo-yuan

    2005-05-01

    To investigate the nutrient effect of glutamine on small intestinal repair in weanling rats after chronic diarrhea. Forty 21-day-old wistar rats were randomly divided into five groups (8 in each). Animal model of chronic diarrhea was induced by a lactose enriched diet in the weanling Wistar rat, normal control group was fed with a standard semipurified diet, and after 14 days the rats in both groups were killed to test the establishment of the model. After the establishment of the model, the other groups were fed with the standard semipurified diet to recover for 7 days, and were randomly divided into three groups: non-intervention group, glutamine (Gln)-intervention group and control group. Glutamine concentrations in blood was detected by high-performance liquid chromatography (HPLC). Morphological changes including villus height and villus surface area of the jejunum were measured under a light microscope and electron microscope, expression of proliferating cell nuclear antigen (PCNA) as an index of cell proliferation was observed using immunohistochemical staining and image analysis. The diarrhea rate in model group was 100 percent, average diarrhea index was 1.16 +/- 0.06, but both diarrhea rate and average diarrhea index in control group were 0 (P 0.05). And compared with non-intervened group, except for body weight (P > 0.05), plasma glutamine, villus height, villus surface area and expression of PCNA were all significantly increased in Gln-intervened group. Chronic diarrhea can induce malnutrition and reduce the villus height, villus surface area, expression of PCNA and plasm glutamine concentration. Oral glutamine could improve the proliferation of crypt cell and promote repair of intestinal mucosa after chronic diarrhea.

  4. Management of children with prolonged diarrhea [version 1; referees: 3 approved

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    Antonietta Giannattasio

    2016-02-01

    Full Text Available Prolonged diarrhea is usually defined as acute-onset diarrhea lasting 7 days or more, but less than 14 days. Its trend has been declining in recent years because of improvement in the management of acute diarrhea, which represents the ideal strategy to prevent prolonged diarrhea. The pathogenesis of prolonged diarrhea is multifactorial and essentially based on persistent mucosal damage due to specific infections or sequential infections with different pathogens, host-related factors including micronutrient and/or vitamin deficiency, undernutrition and immunodeficiency, high mucosal permeability due to previous infectious processes and nutrient deficiency with consequential malabsorption, and microbiota disruption. Infections seem to play a major role in causing prolonged diarrhea in both developing and developed areas. However, single etiologic pathogens have not been identified, and the pattern of agents varies according to settings, host risk factors, and previous use of antibiotics and other drugs. The management of prolonged diarrhea is complex. Because of the wide etiologic spectrum, diagnostic algorithms should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Often, expensive laboratory evaluations are of little benefit in guiding therapy, and an empirical approach may be effective in the majority of cases. The presence or absence of weight loss is crucial for driving the initial management of prolonged diarrhea. If there is no weight loss, generally there is no need for further evaluation. If weight loss is present, empiric anti-infectious therapy or elimination diet may be considered once specific etiologies have been excluded.

  5. Incidence of diarrhea in children living in urban slums in Salvador, Brazil

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    Maria Clotildes N. de Melo

    Full Text Available Diarrhea remains a major health issue in developing countries, with high morbidity and mortality rates. Determining the incidence of acute diarrhea in children and its associated factors is crucial to the planning of preventive approaches. The objective of this study was to determine the incidence of diarrhea and to assess some relevant associated factors to it in children younger than 40 months living in two slums of Salvador, Brazil. This is the first prospective cohort, community-based study that was performed in two periurban slums of Salvador, Brazil. Eighty-four children younger than 40 months were randomly selected and visited every other day for one year. The chi-square test was used to evaluate the occurrence of diarrhea and its associated factors. During the surveillance period, 232 diarrhea episodes were identified, resulting in an incidence rate of 2.8 episodes/child/year. In average (mean value of 84 children,each child suffered 11.1 days of diarrhea per year, yielding an average duration of 3.9 days per episode. The highest incidence rates were found among children under one year old. Early weaning, male sex, malnutrition, having a mother younger than 25 years or who considered her child malnourished, missed immunizations and previous pneumonia were associated factors for suffering diarrheal episodes. The rates of incidence and duration of diarrhea that we found are in accordance to those reported by others. Additionally, our results reinforce the importance of environmental and health-related associated factors to the onset of diarrhea.

  6. Congenital Chloride Diarrhea: Diagnosis by Easy-Accessible Chloride Measurement in Feces

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    van Gils, C.; M.-C. Eckhardt; Nielsen, P E; Nybo, M.

    2016-01-01

    Background. Congenital chloride diarrhea (CCD) is an autosomal recessive disorder caused by mutations in the genes encoding the intestinal Cl?/HCO3 ? exchanger and is clinically characterized by watery, profound diarrhea, electrolyte disturbances, and metabolic alkalosis. The CCD diagnosis is based on the clinical symptoms and measurement of high chloride concentration in feces (>90?mmol/L) and is confirmed by DNA testing. Untreated CCD is lethal, while long-term clinical outcome improves whe...

  7. A case of protracted diarrhea in a newborn: a diagnostic challenge

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    Catarina Mendes

    2014-12-01

    Full Text Available Congenital diarrhea comprises a broad range of pathologies and often requires a thor- ough workup and immediate treatment. Although rare, microvillous inclusion disease (MVID should be included in differential diagnosis of this presentation in the neonate. We report the case of a 36-week newborn who developed signs of severe dehydration and lethargy, requiring fluid resuscitation and total parenteral nutrition. MVID was diagnosed by recognition of profuse secretory diarrhea after an exhaustive etiological investigation, confirmed by DNA analysis.

  8. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting.

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    Dinleyici, Ener Cagri; Dalgic, Nazan; Guven, Sirin; Metin, Ozge; Yasa, Olcay; Kurugol, Zafer; Turel, Ozden; Tanir, Gonul; Yazar, Ahmet Sami; Arica, Vefik; Sancar, Mesut; Karbuz, Adem; Eren, Makbule; Ozen, Metehan; Kara, Ates; Vandenplas, Yvan

    2015-01-01

    Two randomized controlled clinical trials have shown that Lactobacillus (L) reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea. This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1×10(8)CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS) and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours). The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded. The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15h, 60.4±24.5h [95% CI: 51.0-69.7h] vs. 74.3±15.3h [95% CI: 68.7-79.9h], pdiarrhea was lower in the L. reuteri group (13/29; 44.8%) after 48h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79, pdiarrhea. No adverse effects related to L. reuteri were noted. L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Commercially available probiotic drinks containing Lactobacillus casei DN-114001 reduce antibiotic-associated diarrhea.

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    Dietrich, Christoph G; Kottmann, Tanja; Alavi, Manuela

    2014-11-14

    To investigate the effect of Lactobacillus-containing commercially available probiotic formulations in Germany during antibiotic treatment with an analysis of cost-efficiency. In an observational study, we analyzed the frequency of bowel movements from 258 patients with infections in a primary care hospital in western Germany; 107 of the patients were offered a probiotic drink containing at least 10 billion cultures of Lactobacillus casei DN 114001 b.i.d. The economic analysis was based on the costs of patient isolation vs preventive intake of probiotics. In a second pilot study, two commercially available probiotic drinks with different Lactobacillus casei strains were directly compared in 60 patients in a randomized controlled fashion. In the first study, the incidence of antibiotic-associated diarrhea (AAD) was significantly reduced in the intervention group (6.5% vs 28.4%), and the duration of AAD in days was significantly shorter (1.7 ± 1.1 vs 3.1 ± 2.1). Higher age and creatinine and lower albumin were identified as risk factors for AAD. Ampicillin was the antibiotic with the highest rate of AAD (50%) and with the greatest AAD reduction in the probiotic group (4.2%, relative risk reduction 92%). The economic analysis showed a cost advantage of nearly 60000 €/year in a department of this size. The second study confirmed the preventive effect of the drink with Lactobacillus casei DN114001; however, there were no advantages found for the other tested probiotic drink containing Lactobacillus casei Shirota. In contrast to a drink containing Lactobacillus casei Shirota, a commercially available probiotic drink containing Lactobacillus casei DN 114001 cost-efficiently reduces the prevalence of AAD during antibiotic treatment.

  10. Invasion of HEp-2 cells by Shigella spp. isolated from acute pediatric diarrhea

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    Omidi, Sajjad

    2017-09-01

    Full Text Available Aim: infection is an important global health problem in developing countries where hygiene is poor and hence shigellosis is a main cause of diarrhoea-associated mortality and morbidity, particularly in children under the age of five. The bacterial entry into colon and rectal epithelial cells has been named ‘bacterium-directed phagocytosis’. This term highlights that the bacteria actively stimulate their own uptake into non-professional phagocytes. The aim of this study was to demonstrate the invasion of HEp-2 cells by spp. isolated from acute pediatric diarrhea in Tehran, Iran.Methods: Three-hundred and ten non-duplicative diarrheal stool samples were collected from the children admitted to Children’s Medical Center in Tehran, Iran. Samples were cultured and suspected colonies were identified by routine microbiological and biochemical tests. The invasion of the two isolated spp. to HEp-2 cells was studied.Results: Of 310 stool samples, 16 (5.2% spp. were isolated, including seven (43.7% and nine (56.3% . Four (44.4% and seven (42.8% showed invasive phenotype to HEp-2.Conclusion: and are reported as the most prevalent spp. in nature which infect humans. Invasion of various cell lines gives the chance of survival to spp. This ability causes more virulent infections in the host. Despite costly and time consuming cell culture techniques, the current method described in this paper is reliable for detecting invasive behavior of spp. Results have also shown that not all the spp. are able to invade intestinal epithelial cells.

  11. Uncertainties associated with quantifying climate change impacts on human health: a case study for diarrhea.

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    Kolstad, Erik W; Johansson, Kjell Arne

    2011-03-01

    Climate change is expected to have large impacts on health at low latitudes where droughts and malnutrition, diarrhea, and malaria are projected to increase. The main objective of this study was to indicate a method to assess a range of plausible health impacts of climate change while handling uncertainties in a unambiguous manner. We illustrate this method by quantifying the impacts of projected regional warming on diarrhea in this century. We combined a range of linear regression coefficients to compute projections of future climate change-induced increases in diarrhea using the results from five empirical studies and a 19-member climate model ensemble for which future greenhouse gas emissions were prescribed. Six geographical regions were analyzed. The model ensemble projected temperature increases of up to 4°C over land in the tropics and subtropics by the end of this century. The associated mean projected increases of relative risk of diarrhea in the six study regions were 8-11% (with SDs of 3-5%) by 2010-2039 and 22-29% (SDs of 9-12%) by 2070-2099. Even our most conservative estimates indicate substantial impacts from climate change on the incidence of diarrhea. Nevertheless, our main conclusion is that large uncertainties are associated with future projections of diarrhea and climate change. We believe that these uncertainties can be attributed primarily to the sparsity of empirical climate-health data. Our results therefore highlight the need for empirical data in the cross section between climate and human health.

  12. Cost of Hospitalization for Foodborne Diarrhea: A Case Study from Vietnam.

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    Hoang, Van Minh; Tran, Tuan Anh; Ha, Anh Duc; Nguyen, Viet Hung

    2015-11-01

    Vietnam is undergoing a rapid social and economic developments resulting in speedy urbanization, changes in methods for animal production, food marketing systems, and food consumption habits. These changes will have major impacts on human exposures to food poisoning. The present case study aimed to estimate hospitalization costs of foodborne diarrhea cases in selected health facilities in Vietnam. This is a facility-based cost-of-illness study conducted in seven health facilities in Northern Vietnam. All suspect cases of foodborne diarrhea, as diagnosed by doctors, who admitted to the studied health facilities during June-August, 2013 were selected. Costs associated with hospitalization for foodborne diseases were estimated from societal perspective using retrospective approach. We included direct and indirect costs of hospitalization of foodborne diarrhea cases. During the study period, 87 foodborne diarrhea cases were included. On average, the costs per treatment episode and per hospitalization day for foodborne diarrhea case were US$ 106.9 and US$ 33.6 respectively. Indirect cost (costs of times to patient, their relatives due to the patient's illness) made up the largest share (51.3%). Direct medical costs accounted for 33.8%; direct non-medical costs (patient and their relatives) represented 14.9%. Cost levels and compositions varied by level of health facilities. More attentions should be paid on prevention, control of foodborne diarrhea cases in Vietnam. Ensuring safety of food depends on efforts of everyone involved in food chain continuum, from production, processing, and transport to consumption.

  13. Spatial variation and hot-spots of district level diarrhea incidences in Ghana: 2010–2014

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    Frank Badu Osei

    2017-07-01

    Full Text Available Abstract Background Diarrhea is a public health menace, especially in developing countries. Knowledge of the biological and anthropogenic characteristics is abundant. However, little is known about its spatial patterns especially in developing countries like Ghana. This study aims to map and explore the spatial variation and hot-spots of district level diarrhea incidences in Ghana. Methods Data on district level incidences of diarrhea from 2010 to 2014 were compiled together with population data. We mapped the relative risks using empirical Bayesian smoothing. The spatial scan statistics was used to detect and map spatial and space-time clusters. Logistic regression was used to explore the relationship between space-time clustering and urbanization strata, i.e. rural, peri-urban, and urban districts. Results We observed substantial variation in the spatial distribution of the relative risk. There was evidence of significant spatial clusters with most of the excess incidences being long-term with only a few being emerging clusters. Space-time clustering was found to be more likely to occur in peri-urban districts than in rural and urban districts. Conclusion This study has revealed that the excess incidences of diarrhea is spatially clustered with peri-urban districts showing the greatest risk of space-time clustering. More attention should therefore be paid to diarrhea in peri-urban districts. These findings also prompt public health officials to integrate disease mapping and cluster analyses in developing location specific interventions for reducing diarrhea.

  14. Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

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    Gustavo Varela

    2015-01-01

    Full Text Available Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC, viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC. Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

  15. Selenium status and fungi in the protein-losing enteropathy of persistent diarrhea.

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    Dwipoerwantoro, Pramita G; Lukito, Widjaja; Aulia, Diana; Arnaud, Josiane; Roussel, Anne-Marie

    2017-06-01

    A vicious cycle of infection, malabsorption, and malnutrition has been implicated in the perpetuation of diarrheal disease. This study examined whether persistent diarrhea is associated with changes in selenium status and stool alpha-1 antitrypsin (AAT) concentration. This cross-sectional study included 30 children aged 1-12 years with persistent diarrhea who were hospitalized in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, and 30 apparently healthy children who were matched by age and sex and lived in a rural area of Jakarta. Clinical examinations, blood routine tests, erythrocyte glutathione peroxidase (GPX) activity and plasma selenium levels as well as AAT in fresh stool samples were performed in all the subjects. Of 30 children with persistent diarrhea, 17 had moderate malnutrition and 13 had severe malnutrition. The mean plasma selenium was significantly lower in children with persistent diarrhea than in children without diarrhea (86.0 μg/L [95% CI: 76.1-95.9] vs 110 μg/L [95% CI: 104-116, pSelenium correlated with AAT (p=0.05). Fecal fungi were persistently present. Although selenium status in both groups was optimal for the obtained plasma GPX activity, children with persistent diarrhea exhibited lower plasma selenium levels. This study suggests that the decrease in the plasma selenium level may be the consequence of protein loss and that fungi may be involved.

  16. Is microscopic colitis a missed diagnosis in diarrhea-predominant Irritable Bowel Syndrome?

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    Hamid Tavakoli

    2008-08-01

    Full Text Available

    • BACKGROUND: There are controversies about the importance of biopsies of normal colon mucosa in the investigation of patients with diarrhea predominant irritable bowel syndrome (IBS. On the other hand, microscopic colitis may bemissed based on normal colonoscopy and laboratory examination in this group of patients
    • METHODS: The study took place in Alzahra and Noor hospitals and Poursina Hakim Research Institute, from 2002 to 2004. Eligible patients were those suffering from diarrhea for at least 4 weeks. A total of 138 patients were included in the study after meeting Rome criteria (II with normal CBC, ESR, stool examination and no endoscopic abnormality.
    • RESULTS: The histologic findings in 138 patients with diarrhea predominant IBS with mean age of 34.7 years (female 55.1% and male 44.9% were as follows: 10 patients (7.2% had collagenous colitis and 3 patients (2.2% were compatible with lymphocytic colitis. No significant diagnostic histologic findings were seen in the rest of patients. Collagenouscolitis was detected in 13% of right colon biopsies and in 10% of sigmoid and transverse colon biopsies. Nocturnal diarrhea was found in 30% of collagenous colitis patients.
    • CONCLUSIONS: Total colonoscopy and multiple biopsies in diarrhea predominant IBS patients are necessary for earlydiagnosis of microscopic colitis.
    • KEY WORDS: Irritable bowel syndrome, microscopic colitis, colonoscopy, biopsy, diarrhea.

  17. Relationship of Renal Function Tests and Electrolyte Levels with Severity of Dehydration in Acute Diarrhea.

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    Gauchan, E; Malla, K K

    2015-01-01

    Acute diarrheal illness constitutes a major cause of morbidity and mortality in children in developing countries. Most of the complications of diarrhea occur due to excessive fluid and electrolyte loss; adverse complications are seen more with increasing severity of dehydration. This study was conducted to identify the relation of renal function and electrolyte abnormalities in children with varying severity of dehydration. This study was carried out in Manipal Teaching Hospital, Pokhara, Nepal over duration of one year. The aims were to find out the association of renal function and electrolyte disturbances with type of diarrhea, severity of dehydration and their relation to outcome. All children more than one month and less than 15 years with acute diarrhea were included in the study. Data were entered and analyzed by SPSS version 19. Statistical analysis applied was Chi-square test. A p-value of Dehydration was associated more with Acute Watery Diarrhea than with Invasive Diarrhea. Renal function and electrolyte abnormalities were seen more in Acute Watery Diarrhea with increasing levels of blood urea, serum creatinine and abnormal levels of serum sodium seen with increased severity of dehydration. Abnormalities in renal function and electrolytes correlated significantly with severity of dehydration. The outcome of patients correlated with severity of dehydration with mortality occurring in 18.1% of patients with Severe dehydration, 0.8% of Some dehydration with no mortality in the No dehydration group.

  18. Assessment of the maternal self-efficacy for child diarrhea prevention

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    Taís Capistrano Lopes

    2014-01-01

    Full Text Available This study aims at assessing self-efficacy for preventing child diarrhea among mothers of children living in Quixadá, Ceará, Brazil. A descriptive, quantitative study was conducted in three Basic Health Units of Quixadá, CE, Brazil from March to May2012.We interviewed 150 mothers of children under five years, using the socio demographic form and the Maternal Self-Efficacy Scale for Child Diarrhea Prevention. 51.3% of children had had diarrhea, 89% of the mothers had low self-efficacy for preventing child diarrhea. Items that showed greater disagreement were “I am able to avoid my son putting dirty objects in his mouth" (10.2%, ’I am able to wash fruits and vegetables with sodium hypochlorite or bleach" (25.3%and "I am able not to give my child left over meals‘ (25.3%. The majority (89.0% of the mothers had low self-efficacy for preventing child diarrhea. Thus, maternal self-efficacy should be considered for the prevention of child diarrhea.

  19. Probiotics use in childhood acute diarrhea: a web-based survey.

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    Weizman, Zvi

    2011-01-01

    To evaluate practices and barriers for the use of probiotics in acute diarrhea among pediatric gastroenterologists. Probiotics have shown significant therapeutic potential in acute infectious diarrhea. However, literature data regarding practice patterns in childhood are limited. A web-based 9-item survey among 1854 pediatric gastroenterologists worldwide. Only 634 (34%) responded. Forty-one were excluded owing to incomplete data. Finally 593, USA (n=407) and non-USA (n=186) participants, showed: limited use in acute diarrhea (28% and 32% prospectively), prescription of a 1 strain product only by 31% and 24%, respectively, and limited utilization in ambulatory settings (43% and 51%, respectively) and in prevention of diarrhea (2.6% and 3.4%, respectively). Most participants felt there is lack of useful clinical guidelines (91% and 84%, respectively), and found this therapy effective or very effective (54% and 62%, respectively). Dosing and duration were extremely variable, the youngest age treated ranged from 2 months to 2 years of age, and adverse effects were extremely rare. These characteristics were shared by USA and by non-USA participants, with no significant differences between groups (P>0.05). Many pediatric gastroenterologists worldwide do not use probiotics for acute diarrhea owing to lack of appropriate guidelines and/or poorly designed products. Therefore, worldwide health authorities should provide pharmaceutical and clinical guidelines for the appropriate use of probiotics in acute diarrhea of childhood.

  20. Effective treatment of common variable immunodeficiency associated diarrhea Diarrea asociada a inmunodeficiencia común variable tratada con budesonida

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    H. Córdova Guevara

    2009-03-01

    Full Text Available Common variable immunodeficiency disorder (CVID, the commonest symptomatic primary antibody deficiency syndrome, is characterised by recurrent bacterial infections, particularly of the upper and lower airways; it is also associated with an increased incidence of autoimmune and neoplastic disorders. CVID has a high prevalence of infectious, inflammatory and neoplastic gastrointestinal diseases. Up to 60% of the patients with non-treated CVID develop diarrhea and 10% associated idiopathic malabsorption with weight loss. The case of a 50-year-old woman with CVID-associated diarrhea, abdominal pain and bloating of one year's duration is reported. An exhaustive evaluation made for secondary causes of her symptoms was unrevealing; she was treated with loperamide and diet, without improvement. She later followed a course of oral budesonide for 3 months; her clinical symptoms disappeared and her quality of life improved. In conclusion, we report the case of a patient with CVID-related chronic diarrhea who responded well to oral budesonide treatment. This outcome provides the gastroenterologist with a new therapeutic option in this difficult group of patients.La inmunodeficiencia común variable (IDCV es la deficiencia primaria de anticuerpos sintomática más frecuente y está caracterizada por infecciones bacterianas recurrentes, especialmente de las vías aéreas superiores e inferiores, y también asociada a incremento de enfermedades autoinmunes y neoplasias. Presenta alta prevalencia de enfermedades gastrointestinales infecciosas, inflamatorias y neoplásicas. Hasta el 60% de los pacientes con IDCV no tratados desarrollan diarrea y el 10% desarrollan malabsorción idiopática asociado a pérdida de peso. Presentamos el caso de una mujer de 50 años con IDCV que presenta diarrea crónica, con dolor y distensión abdominal desde hace 1 año. Realizándose múltiples exploraciones y descartando causas secundarias de diarrea crónica, se inicia