Abstract
Diarrhoea remains a major cause of childhood morbidity and mortality worldwide. This study aimed to monitor the aetiology of acute diarrhoea in children in Shanghai. Paediatric outpatients with acute diarrhoea were enrolled in the study from Jan 2015 to Dec 2018. Faecal samples were collected for testing. Enteric bacteria were identified and typed by culture and serotyping, respectively. Enteric viruses were identified by real-time PCR. Enteric pathogens were identified in 1572 (58.4%) of the 2692 enrolled children with acute diarrhoea. Viruses were detected more frequently than bacteria (41.3% versus 25.0%). Nontyphoidal Salmonella spp. (NTS) was the most common (10.3%) bacteria isolated, followed by enteropathogenic Escherichia coli (EPEC) (6.5%), enteroaggregative Escherichia coli (EAEC) (6.2%), Campylobacter spp. (3.6%), enterotoxigenic Escherichia coli (ETEC) (1.1%), Shigella spp. (0.2%), and enterohemorrhagic Escherichia coli (EHEC) (0.1%). Rotavirus was the most common (16.0%) virus detected, followed by norovirus (15.5%), adenovirus (7.2%), sapovirus (3.0%) and astrovirus (2.7%). Rotavirus, norovirus and NTS were the major pathogens responsible for diarrhoea in Shanghainese children. Improving uptake of the rotavirus vaccine and strengthening foodborne-pathogen prevention will aid in reducing the burden of diarrhoeal disease in children in Shanghai.
Highlights
Diarrhoea is a major health problem in children and responsible for approximately 8.6% of paediatric deaths worldwide [1,2,3]
The inclusion criteria for case enrolment were as follows: (1) children aged
Enteropathogens were detected in 58.4% of children with acute diarrhoea in Shanghai; this result was significantly higher than the national average (44.6%) based on pooled data from 92 surveillance network laboratories [11]
Summary
Diarrhoea is a major health problem in children and responsible for approximately 8.6% of paediatric deaths worldwide [1,2,3]. Due to continuous improvements in sanitation, hygiene and water supply safety, the diarrhoea-related death rate in children aged less than 5 years in China has decreased remarkably from 4.9% in 2000 to 3.2% in 2015 [4, 5]. China is a developing country with unbalanced regional economic development and medical care systems. Developing areas often have inadequate sanitation facilities, a lack of awareness of personal hygiene and a shortage of well-trained health workers, which puts children in developing areas at greater risk of diarrhoea than those in developed areas [6].
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