Abstract
Enteric viruses are highly contagious and a major cause of waterborne gastroenteritis in children younger than five years of age in developing world. This study examined the prevalence of enteric virus infection in children with gastroenteritis to identify risk factors for co-infections. In total, 107 stool samples were collected from patients with acute gastroenteritis along with samples of their household drinking water and other possible contamination sources, such as food and hand. The presence of major gastroenteritis-causing enteric virus species (group A rotaviruses, enteroviruses, adenoviruses, and noroviruses of genogroup I) in stool and water samples was examined using quantitative polymerase chain reaction. Among the 107 stool samples tested, 103 (96%) samples contained at least one of the four tested enteric viruses, and the combination of group A rotaviruses and enteroviruses was the most common co-infection (52%, n = 54/103). At least one viral agent was detected in 16 (16%) of 103 drinking water samples. Identical enteric viruses were detected in both the stool and water samples taken from the same patients in 13% of cases (n = 13/103). Group A rotaviruses were most frequently found in children suffering from acute diarrhea. No socio-demographic and clinical factors were associated with the risk of co-infection compared with mono-infection. These less commonly diagnosed viral etiological agents in hospitals are highly prevalent in patients with acute gastroenteritis.
Highlights
Acute gastroenteritis is one of the leading causes of morbidity and mortality in developing countries such as Nepal [1,2,3,4,5,6]
Enteric viruses were detected in both stool samples and drinking water used by children with gastroenteritis
The rate of co-infection of two or more enteric viruses was found to be high in children with gastroenteritis, but their clinical presentation was not more severe than that of children with mono-infection with the same pathogens (p > 0.05)
Summary
Acute gastroenteritis is one of the leading causes of morbidity and mortality in developing countries such as Nepal [1,2,3,4,5,6]. Enteric viruses are a group of viruses that can cause acute watery diarrhea and are a major threat to human health worldwide [9]. They are usually prevalent in countries with issues of poor hygiene and sanitation [10]. More than 1.4 million children die as a consequence of waterborne gastroenteritis [11], with a high proportion of mortality caused due to the lack of timely intervention [12,13]. Despite gastroenteritis being preventable and treatable, a higher number of children suffer from the Healthcare 2019, 7, 9; doi:10.3390/healthcare7010009 www.mdpi.com/journal/healthcare
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