Acute Diarrheal Diseases Research Articles

Leading causes of deaths in the mortality transition in Papua New Guinea: evidence from the Comprehensive Health and Epidemiological Surveillance System.

Changing causes of deaths in the mortality transition in Papua New Guinea (PNG) are poorly understood. This study analysed community-level data to identify leading causes of death in the population and variations across age groups and sexes, urban-rural sectors and provinces. Mortality surveillance data were collected from 2018-20 as part of the Comprehensive Health and Epidemiological Surveillance System (CHESS), using the World Health Organization 2016 verbal autopsy (VA) instrument. Data from 926 VA interviews were analysed, using the InterVA-5 cause of death analytical tool to assign specific causes of death among children (0-14 years), those of working age (15-64 years) and the elderly (65+ years). Nearly 50% of the total deaths were attributed to non-communicable diseases (NCDs), followed by infectious and parasitic diseases (35%), injuries and external causes (11%) and maternal and neonatal deaths (4%). Leading causes of death among children were acute respiratory tract infections (ARTIs) and diarrhoeal diseases, each contributing to 13% of total deaths. Among the working population, tuberculosis (TB) contributed to 12% of total deaths, followed by HIV/AIDS (11%). TB- and HIV/AIDS-attributed deaths were highest in the age group 25-34 years, at 20% and 18%, respectively. These diseases killed more females of working age (n = 79, 15%) than males (n = 52, 8%). Among the elderly, the leading causes of death were ARTIs (13%) followed by digestive neoplasms (10%) and acute cardiac diseases (9%). The variations in leading causes of death across the populations in PNG suggest diversity in mortality transition. This requires different strategies to address specific causes of death in particular populations.

Etiology of a diarrhoea epidemic among employees of a poultry farm in the city of N’zérékoré, Republic of Guinea

Objective: Acute diarrheal diseases are a primary and recurrent health concern among poultry workers. This study is designed is to determine the causative agent of an epidemic which broke out among the 510 employees of a poultry farm in the City of N'zérékoré. Methodology: Systematic survey was implored according to a list drawn up by the personal chef of the To detect germs commonly implicated in food-borne illnesses, a biological analysis of the stools with the Polymerase Chain Reaction was performed, followed by a direct examination of the stools and poultry feed. Statistical processing was achieved with the BiostatGV software. Results: 104 cases (20,4%) of Salmonella typhi DNA positivity were detected in these stool samples, including 50 cases (9.8%) positive in men versus 54 cases (10.59%) positive in women. the most affected are: (18-29) years old 6.5%, followed by that of (30-41) years old with 5.7%. 73 cases (14,3%) of DNA positivity of Campylobacter spp detected including 44 positive cases in men i.e., 8.6% against 29 positive cases in women, i.e., 5.69%. 32 positive cases (6,3%) of Tapeworm spp eggs detected, including 12 positive cases in men, i.e., 2.4% against 20 positive cases in women, i.e., 3,92%. Conclusion: Among the 510 farm employees, Salmonella typhi, Campylobacters spp, and Tapeworm spp were responsible for the acute diarrhea epidemic declared on 01 / July / 2022.

ASSOCIATION OF MATERNAL FACTORS TOWARDS ACUTE DIARRHOEAL EPISODES IN UNDER FIVE CHILDREN IN CHHINDWARA DISTRICT: A CROSS-SECTIONAL STUDY

Background: Diarrhea is widely documented as a major cause of childhood morbidity and mortality in countless developing countries, particularly in India. According to the World Health Organization (WHO) report, diarrheal diseases are still leading causes of mortality and morbidity in children below 5 years of age. Objective: The present study done to estimate the association amid maternal factors and prevalence of acute diarrheal illnesses in children below 5 years of age in Chhindwara district. Methods: This community-based and cross-sectional study conducted in the urban field practice area attached to Department of Community Medicine of Chhindwara Institute of Medical Sciences, Chhindwara, from January 2019 to December 2019 was aimed to estimate the connotation between maternal factors and prevalence of acute diarrheal diseases in children under 5 years of age in Indian locations. Study tools included a pre-structured questionnaire. Baseline information of education area was taken from the Urban Primary Health Centre in the catchment area of medical college, Chhindwara. Data were arrived in Microsoft Excel spreadsheet to perform analysis. Results: In our study, 310 mothers who used to take bath daily of which 58 (19.9%) had diarrheal episodes, whereas out of 18 mothers who do not take bath daily, 11 (61.1%) had diarrheal episodes. Further, 292 mothers of children who castoff to wash their hands daily earlier the meals of which 58 (15.8%) children had diarrheal events, whereas out of 7 (38.9%) mothers who did not wash their hands before meals, 27 (12%) children had diarrheal incidents. Conclusion: The present study indicated that maternal factors bear an important impact on morbidity caused by diarrhea.

Temporal-Spatial Distribution of Vibrio cholerae in Cuba: July 1997-December 2019.

Vibrio cholerae is a microorganism that causes acute diarrheal diseases and cholera, one of the leading causes of global morbidity and mortality, especially in children under five years old. It is present in many regions and has been isolated from diverse sources such as water, soil and food. Surveillance of this microorganism in Cuba from 1985 through June 1997 showed circulation of non-epidemic non-O1/non-O139 serogroups, but surveillance continued to identify distribution of V. cholerae serotypes and serogroups in the different geographic regions of the country during the following years, due to the risk of introducing cholera-causing serogroups that provoked cholera epidemics in other countries of the region. Describe the temporal‒spatial distribution of serogroups and serotypes of V. cholerae in Cuba. A cross-sectional study was conducted that included isolates from passive surveillance of V. cholerae in 16 hygiene and epidemiology centers throughout Cuba from July 1997 through December 2019, submitted to the National Reference Laboratory for Acute Diarrheal Diseases of the Pedro Kourí Tropical Medicine Institute in Havana, Cuba. The timeline was subdivided into three five-year periods and one eight-year period. The centers submitting isolates were grouped into three geographical regions: western, central and eastern Cuba. A total of 1060 V. cholerae isolates were studied, from the 1438 samples sent from 15 Provincial Hygiene, Epidemiology and Microbiology Centers and the Municipal Hygiene, Epidemiology and Microbiology Center of the Isle of Youth Special Municipality. Genus, species and serotype of all specimens were studied and reviewed in the context of the outbreaks of acute diarrheal diseases reported in the country. All 1060 isolates were confirmed as V. cholerae. In the distribution by time period and region, the highest percentage occurred in the 2012‒2019 period, and the eastern region contributed the most isolates in all periods. Approximately 63.9% (677/1060) were from outbreaks, and in the 2012‒2019 period, the most epidemic-causing isolates came from the western region. Approximately 52.8% (560/1060) were identified as non-O1/non-O139 V. cholerae, and 47.2% (500/1060) as O1 V. cholerae; of these, 96.4% (482/500) corresponded to Ogawa serotype and 3.6% (18/500) to Inaba. Circulation of non-O1/non-O139 V. cholerae occurred throughout the entire period. The O1 serogroup began to circulate in 2012 and continued through 2016; however, since 2017, it has not been identified again. In the western region, there were smaller percentages of isolates of non-O1/non-O139 V. cholerae in all periods, except 2012‒2019. In that period, V. cholerae O1 was identified to a lesser degree in the central region. Vibrio cholerae circulated in all three Cuban regions during the years studied, with a higher percentage of isolates of the non-O1/non-O139 serogroup, which caused outbreaks or sporadic cases of diarrhea in the eastern region, with the exception of the 2012‒2019 period, when epidemic outbreaks of the O1 serogroup (which causes cholera) occurred in all three regions, with higher percentages in the western region.

Rise of cholera in Iraq: A rising concern

With over seven pandemics and four million reported cases, Cholera remains of the most prevalent acute watery diarrheal diseases in the world to date. As in other developing countries, Iraq once again combats Cholera – and its past encounter in 2015, where the death toll reached 1500, highlights the importance of quickly addressing the current outbreak. The war-torn state of the nation, malnourished public, lack of sanitation and hygiene, mass displacement and global warming all contribute to the prevalence of Cholera in Iraq. Along with the current efforts, additional strategies are recommended for managing cholera cases, such as awareness campaigns, monitoring the safety of water bodies, and food inspection.

Pathogen agents from the family Enterobacteriaceae that cause acute diarrheal diseases

The research was conducted in 2017 - 2021, the clinical samples (fecal masses) were collected from patients from the Public Health Medical Institution of AMT Buiucani. A total of 3752 samples were investigated. Two species of pathogenic bacteria from the Enterobacteriaceae family were identified: Shigella spp and Salmonella spp. A total of 28 positive strains (0.75%) were isolated, of which 9 strains (0.24%) belong to the Shigella species and 19 strains (0.51%) - Salmonella. The share of Salmonella strains is 2 times higher compared to Shigella. In 2017, the higher number of strains were isolated - 12, with a share of 1.02%, of which the dominant strain was Salmonella with 0.68%. Of the total number of strains isolated in 2017, both Shigella and Salmonella strains had the largest share.

Maternal Knowledge and Practices for Prevention of Acute Diarrheal Diseases in Children under 5 years of age

Background: Diarrhea is the second major cause of mortality in children worldwide. Timely interventions by caregivers who are mainly mothers, can contribute towards a favorable prognosis of this condition in children.
 Aim: The purpose of conducting this study was to assess maternal knowledge and the practices regarding prevention of diarrheal diseases in children under the age of 5 years.
 Setting: This study was carried out in three hospitals at Lahore, Pakistan.
 Methods: An analytical cross-sectional study was conducted from January to July 2020 and a convenience sampling technique was used for data collection. Data was collected from 158 mothers of children under 5 years of age by using a self-structured, pre-tested questionnaire. Chi square test was applied and p-value <0.05 was taken as significant.
 Results: A total of 158 mothers responded to the study questionnaire; mean age of the participants was 28.4+ 7.6 years, 22.8% were illiterate, 84.2% were housewives, and 37.4% had income more than 31000 rupees/month. The majority (43.1%) had ‘poor’ knowledge, 24% had’ poor’ attitudes and practices while 12% had better practices. Significant associations were observed between mother’s knowledge with education (p-value=0.004), income (p-value=0.001), frequency of diarrhea in a child (p-value=0.053) and practices with education (p-value =0.039).
 Conclusion: This study showed the direct relationship between mother's literacy level and family income with better knowledge and feeding practices of children regarding prevention of diarrhea. It has highlighted the role of mothers in the management of acute diarrheal diseases.

ANTIBACTERIAL ACTIVITY TEST OF MIANA (COLEUS ATROPURPUREUS L.) LEAF ETHANOL EXTRACT AGAINST STAPHYLOCOCCUS EPIDERMIDIS FNCC 0048 AND ESCHERICHIA COLI FNCC 0091

Infection is one of the health problems that is often experienced by the community, among others, infectious diseases that can be caused by Staphylococcus epidermidis and acute diarrheal diseases that can be caused by Escherichia coli bacteria. One of the plants that has antibacterial properties is Miana leaf (Coleus atropurpureus L.) because they contain active compositions containing essential oils, steroids, tannins, flavonoids, and alkaloids. This aims of this research were to study antibacterial activity and minimum concentration of ethanol extract of Miana leaf (Coleus atropurpureus L.) that gives antibacterial activity against Staphylococcus epidermidis and Escherichia coli. This type of research is an experimental research, using the method of well diffusion and diameter of the inhibition zone. The different concentrations of Miana leaf ethanol extract were used at 3%, 6%, and 9%. Tests were carried out to observe the presence or absence of inhibitory zones of Miana leaf (Coleus atropurpureus L.) extracts against Staphylococcus epidermidis and Escherichia coli after 24 hours of incubation. The analysis used is descriptive analysis. The results showed that the ethanol extracts of Miana leaf (Coleus atropurpureus L.) with concentrations of 3%, 6%, and 9% are able to inhibit the growth of Staphylococcus epidermidis. The minimum concentration of ethanol extract of Miana leaf which shows antibacterial activity against test bacteria is 3%.

A Comparative Study of ORS (Oral Rehydration Solution) with Probiotics versus ORS with Zinc as an Adjunct Therapy in Pediatric Acute Diarrhoeal Diseases

Abstract Background: Diarrhea is characterized by abnormally loose or watery stools. Diarrhea causes the body to lose a lot more fluid than normal, infants and toddlers can become dehydrated more quickly than older children when they have diarrhea and vomiting. If dehydration becomes severe it can be dangerous particularly in young babies. We in the current study tried to evaluate the effect of ORS with probiotics and ORS with zinc supplementation as an adjunct therapy to diarrheal disease. Methods: Based on the inclusion and exclusion criteria n=100 successive cases were identified and included in the study. They were randomly allotted in two groups. Group A (N=50) was given a probiotic sachet consisting of Saccharomyces 2.5 billion spores and Lactic acid bacillus 100 million spores. The powder in the sachet was dissolved in 20 ml of lukewarm water and given to the child twice daily. Group B (n=50) were given 20mg Zinc sulfate tablet once daily along with the usual treatment of fluid replacement. Results : The mean age was 2.76 years in-group-A and 2.92 years in Group-B. In this study, the mean weight was 10.12 kg of the patients belonging to group-A and the mean weight was 10.16 kg of the patients belonging to group B. The Mean duration of diarrhea to subside after intervention in group A was 75.3 hours and the mean duration of diarrhea after intervention in group B was 56.08 hours. The average time for recovery in patients of group A was 4.5 days and in group B the meantime for recovery was 3.9 days. Conclusion: There was a significant improvement in the patients treated with the zinc group when compared with the probiotic group in terms of time taken for resolving diarrhea. There was a little difference in the effect of probiotics and zinc in patients in terms of stool frequency and stool consistency. However, the efficacy of zinc was greater compared to probiotics.

Impact of COVID Pandemic on the Use of Services in a Peripheral Health Center in Southern Benin

<i>Background:</i> COVID-19 pandemic has had negative impacts on health systems of most countries. <i>Methods:</i> we conducted a descriptive and analytical cross-sectional study in a peripheral health center in southern Benin. The morbidity indicators and the functioning of the services were collected and analyzed 10 months before COVID and 10 months during COVID by a linear regression model. <i>Results: </i>The onset of the COVID pandemic led to a non-significant drop in the number of consultations among children aged 12 to 35 months [-8,100; 0.297], and borderline negative effects on malaria [-44.20; 0.098], and significant for acute respiratory infections [-34.200; 0.039] and diarrheal diseases [-4.100; 0.036]. <i>Conclusion: </i>Even in a rural outlying health center, the outbreak of the COVID-19 pandemic had an impact on the health system. This repercussion led to a drop in consultations on morbidity indicators such as malaria, acute respiratory infections and diarrheal diseases. This reflects both the fear of the populations to come to the health center in during pandemic period but also the reduction in the functioning of the center due to the outbreak. Strengthening measures are needed to ensure quality care for the population, Such as the increase in the number of health care workers, the increase in the security and protection arrangements for health workers and users of health centers.

A study of rotavirus infection in acute diarrhoea in children less than 5 years of age

: Diarrhoeal diseases account for an estimated 1.5 million deaths globally every year making it the second leading cause of childhood mortality. In India 1 out of every 250 children die of rotavirus diarrhea each year.: To find out the incidence of rotavirus infection in acute diarrhoeal cases in children under 5 years of age.: A prospective study was conducted on 100 non repetetive stool samples of Children under 5 years of age, presenting with acute diarrhea and hospitalized in the pediatric ward, during December 2015 to November 2016. Stool samples were processed according to premier rotaclone enzyme immunoassay protocol for the detection of rotavirus antigen, adhering to standard laboratory precautions.: The incidence of acute diarrhoeal diseases was 5.86% in our setting. was detected in 29% cases by ELISA method.The antigen detection by EIA is a reliable test, as it is quantitative and also has high sensitivity and specificity. Hence, can be routinely employed to prevent major morbidity and mortality among children, especially less than 5 years of age.

Post Flood Study on the Incidence of Leptospirosis in Alappuzha District of Kerala, India

Alappuzha district was severely affected by floods due to the intense rainfall in August 2018. A three member team with the assistance of local health workers was entrusted to assess the post flood situation and to assist the local health department to extend expertise mainly to control infectious diseases and propose suggestions regarding hygiene and sanitary measures to be taken for health and wellbeing of the community. Among the infectious diseases, Leptospirosis poses a significant public health issue in the flood affected areas of Alappuzha district. Majority of households had taken chemoprophylaxis for Leptospirosis as per standard protocol as also temporary rehabilitation camps in the flood affected areas. There was no episode of Acute Diarrheal Diseases (ADD), found in clusters in any of the areas. The number of dengue fever cases reported in post flood period was less when compared to previous year. Risk assessment is essential in post-disaster situations mainly concerned with the rapid implementation of control measures through refurbishment and improvement of health care delivery. The findings presented relate to an assessment carried out in Alappuzha district in September 2018 that included epidemiological situation analysis, appraisal of laboratory facilities for microbiology investigations, evaluation of health facilities and infrastructure available at Local Self Governments (LSGs).

Occurrence, Risk Factors, and Antimicrobial Susceptibility Test of Thermophilic Campylobacter Species of Bovine Carcass at Municipal Abattoir and Butcher Shops of Jimma Town, Southwest Ethiopia.

BackgroundAlthough Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) cause acute diarrheal diseases in people all over the world, they are most commonly seen in other mammalian species and are a seemingly healthy carrier condition. Humans in Ethiopia, on the other hand, are largely unaware of the existence of Campylobacter in food animals as potential sources of infection.ObjectiveTo determine the occurrence, risk factors, and antimicrobial susceptibility pattern of thermophilic Campylobacter species in bovine raw meat from the abattoir and butcher shops.MethodsSwab samples were collected from 177 cattle carcasses (from abattoir 93 and butcher shops 84) and cultured using standard methods. An antimicrobial susceptibility test was performed using the disk diffusion method towards eleven antimicrobial agents.ResultsThe overall prevalence of thermophilic Campylobacter species was 14 (7.9%). From these, 11 (78.6%) were identified to be C. jejuni and 3 (21.4%) were C. coli. Lack of handwashing before meat processing and after visiting the toilet, meat contact with floors, walls, or soiling during preparation, and lack of training were the most important factors independently associated with (p<0.05) the prevalence of Campylobacter species contamination. The highest level of antimicrobial resistance of the Campylobacter isolates was recorded to ampicillin (10μg) (100%), followed by amoxicillin (30μg) (78.6%) and sulphamethoxazole-trimethoprim (57.1%) while the least resisted antimicrobials were streptomycin (25μg), erythromycin (15μg), oxytetracycline (30μg) (each 28.6%), kanamycin (30μg) 14.3%, chloramphenicol (30μg) and gentamycin (10μg) (each 7.1%).ConclusionDespite the low prevalence of thermophilic Campylobacter in the current investigation, it may pose a significant public health threat. As a result, it is vital to give retailers and customers extensive education, training, and knowledge about the correct handling and cooking of animal-derived goods. Furthermore, antimicrobials should be used with caution in both veterinary and human treatment regimens as well as a wider examination of antimicrobial resistance patterns for the use of well-targeted antimicrobials.

The Struggle Against Acute Enteric Infections Among Children in Soviet Russia (1930-1940)

The results of a historical and medical study reflecting the issues of combating dysentery and other acute enteric infections among the children in Soviet Russia during the 1930-1940 period are presented in this article. Analysis of medical reports, orders, circular letters of the People’s Commissariat of Health Сare of the USSR and other documents from published and unpublished archival materials, and scientific publications of Soviet scientists indicate that the situation with dysentery and other acute intestinal infections among children (especially of early age) was complicated and characterized by significant prevalence of this pathology in the 1930s. This study has shown that it was possible to reduce children morbidity and mortality due to the implementation of extensive sanitary, hygienic and anti-epidemic measures on the government level, the implementation of specialized dietary products for kids and new methods of therapy (sulfanilamides, dysenteric bacteriophage, antidisenteric serum) in Moscow and other regions (for example in Gorky and Kirov regions). The experience of organizing the pediatricians, epidemiologists, health care organizers work against acute enteric infections among children in Soviet Russia in the 1930s can currently be used in various countries and regions where acute diarrheal diseases are significant cause of children mortality.

Assessment of the Degree and Types of Dehydration in Libyan Children Suffering from Acute Diarrheal Diseases in Gharyan City

Assessment of the Degree and Types of Dehydration in Libyan Children Suffering from Acute Diarrheal Diseases in Gharyan City

Riesgo de infecciones, enfermedades crónicas y trastornos de salud mental con posteridad a inundaciones por el Fenómeno del Niño Costero en poblaciones desplazadas, Piura, 2017

Introduction:&nbsp;In Peru, the presence of the Coastal Child Phenomenon produces floods and the appearance of diseases cyclically.&nbsp;Objective:&nbsp;To determine the risk factors for the presence of diseases in displaced populations in Piura due to the Nino Costero.&nbsp;Methods:&nbsp;Quantitative, longitudinal, analytical investigation of cases and controls with 544 families that were selected through a two-stage random sampling considering the proportion of families per block, area and cluster. For data collection, various diagnostic and monitoring instruments were used, such as that of the International Organization for Migration (IOM), the health care base and the application of an instrument for mental health.&nbsp;Results:&nbsp;The analysis of the variation of care in two time periods at 3 and 9 months shows that there are statistically significant changes in these periods that include skin infections, urinary tract infection, joint pain, diabetes mellitus and family violence. 26.46% presented some psychological disorder associated with coexistence in shelters. The bivariate analysis showed that families with less than 80% of safe water management and safe water storage were at risk of presenting acute diarrheal diseases with OR = 6.15 (95% CI 5.97-6.95) and OR = 2.08 (95% CI 1.06- 2.97) respectively.&nbsp;Conclusions:&nbsp;The epidemiological profiles show the presence of psychological effects and the transition of communicable diseases at the beginning of the disaster and that over time, non-communicable diseases and violence appear in the shelters associated with the previous health profiles of the displaced population.

Comparative assessment of clinical-paraclinical manifestations of rotavirus infection versus genotypical variety in infants

Introduction. RVI (rotavirus infection) is the most common cause of dehydration in infants and young children. The implementation of the sentinel surveillance of RVI in infants from 2008 in the Republic of Moldova demonstrated the high rate of this infection (40.0%), being an argument in recommending the antirotaviral immunization in children within the National Immunization Program.&#x0D; Material and methods. The study enrolled 193 children with acute diarrheal disease, included in the sentinel supervision (2012-2016) and treated in the Unit for Acute Diarrheal Diseases at Children’s Clinical Hospital no. 1. The biological material was examined by serological enzyme-linked immunosorbent assay (ELISA) and genotyping, revealed by polymerase chain reaction (PCR). &#x0D; Results. The rotavirus infection was confirmed in 193 infants, of which 121 children were not vaccinated against RVI, and 72 were immunized. Depending on the genotypes encountered before and after vaccination, it was found that G9P [8], G3P[8], G4P[8] were detected before vaccination, although postvaccine prevailed G2P[4], G4P[8]. In addition, the incidence of RVI is decreasing and the disease evolution is much better.&#x0D; Conclusions. This article reflects the evolution of the genotypic properties of rotaviruses and the clinical-paraclinical particularities of RVI in infants, highlighting the importance of the implementation of antiretroviral immunization in children within the National Immunization Program in the Republic of Moldova.

Trends in pattern of communicable diseases during COVID-19 lockdown in Kerala.

Dear Editor, Kerala is witnessing an increase in instances of vector-borne diseases and water-borne infections in recent times. [1] The state witnessed Nipah virus outbreak during 2018 and 2019. [2] COVID-19 pandemic surfaced in Kerala on 30 January 2020 and the cases increased during the month of March. [3] We performed a retrospective analysis of communicable disease reported in Kerala with the data retrieved from the website archive of Integrated Disease Surveillance Programme and tuberculosis notification website. [45] The incidence of various communicable diseases were compared during the study period (month of March, April and May 2020 where cases of COVID-19 were reported and containment strategies were implemented) with similar months for last four years (2016 to 2019) as per availability of the data. There was a decrease in the incidence of chickenpox cases by 22.3%, 21.5% and 66.3%, respectively, during the month of March, April and May 2020 in comparison with similar months of 2019. Tuberculosis cases decreased by 19.4%, 35.77% and 19.41% during the study period in comparison with similar months in 2019 [Table 1]. The incidence of H1N1, hepatitis A and typhoid cases decreased during the study period in comparison with similar months of 2019. There was a trend of increase in incidence of ADD cases during the month of May, but during 2020 the percentage increase was lowest among the last 4 years. Malaria and Chikungunya cases reported low but the incidence of dengue cases was slightly more in study period in comparison with similar period in 2019 [Table 1].Table 1: Incidence of communicable diseases in Kerala during the month of March, April and May 2016-2020.The containment strategies against COVID-19 in Kerala prevent the interaction between the agent and host in a favourable environment which helps to contain communicable diseases [Figure 1]. Overcrowding which was prevented by lockdown measures, life style and behavioural changes like social distancing, respiratory hygiene/cough etiquette helped to decrease other respiratory infections like tuberculosis, chickenpox and H1N1 along with COVID-19.Figure 1: Epidemiological triad showing the factors prevented the interaction between agent, host and environmentLockdown measures confined individuals at home which removed the possibility of food and water intake from contaminated environment and routine hand washing practices curtailed the intestinal diseases like hepatitis A, typhoid and acute diarrheal diseases. It was also noticed a decrease in malaria and chikungunya cases which may be due to the environmental sanitation measures underwent during the pandemic [Table 1]. The response of health system to the pandemic, its containment strategies which was implemented through community participation and intersectorial coordination along with lifestyle and behavioral modification of people helped in control of other communicable diseases in the state. There may be some other reasons also for the decrease in the incidence of communicable diseases as people might have ignored slight manifestations of the disease because of the fear to go to hospitals. Health system is overwhelmed with COVID-19 cases which may result in less testing and under reporting of other communicable diseases. Control of infectious diseases is a difficult challenge for our public health systems; however, we believe that covid-19 response and strengthened containment strategies had an impact on the incidence of communicable diseases which need to be carried over. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Acknowledgement The authors thank Dr. Binod Kumar Patro, Additional Professor, AIIMS, Bhubaneswar for his guidance and review of the article.

Retrospective analysis of EMR database to assess the effectiveness of Saccharomyces boulardii CNCM I-745 in children with acute diarrhoea during routine clinical practice.

This study aimed to assess the efficacy of Saccharomyces boulardii, a yeast probiotic, in the management of acute diarrhoeal disorders in the paediatric population in outpatient settings. It was a multicentre retrospective analysis of medical records of children who were treated for acute diarrhoea by routine treatment (oral rehydration solution and zinc) with or without S. boulardii. Overall, 160 children presenting with acute diarrhoea at seven different outpatient paediatric settings were included in the study. Children were divided into two categories based on their treatment with S. boulardii (SB group) or without S. boulardii (Non-SB group). Baseline demographic, anthropometric and clinical variables were compared between the two groups. The median duration of diarrhoea post-treatment was significantly shorter in the S. boulardii group (3 days) than in the non-SB group (4 days). A significant reduction in the frequency of stools was observed post-treatment in the S. boulardii group (1.7 versus 2.5 in the non-SB group). There was a significant weight gain in the S. boulardii group post-treatment (300 g) in comparison with the non-SB group (mean loss of 400 g). This study established the positive role of S. boulardii in the management of acute diarrhoeal diseases in children. Moreover, the S. boulardii probiotic was seen to be effective in diarrhoeal diseases in children with dehydration.

Evaluation of Antibiotic Utilization Pattern During Acute Diarrheal Disease at Chefa-Robit Health Center, Kemissie, North East Amhara, Ethiopia.

BackgroundDespite the fact that the majority of the acute diarrheal diseases are viral in origin and self-limited, routine and injudicious antibiotic treatment is a common practice globally and more prevalent in Africa. Indeed, the irrational use of antibiotics has a detrimental effect on the issue of antibiotics resistance and associated healthcare costs. Accordingly, a health center-based cross-sectional study is mandatory and was conducted due to the common malpractice of antibiotics use.ObjectiveThe aim of this study was to evaluate the antibiotic use pattern in the treatment of acute diarrheal disease in Chefa-robit health center, Kemissie, Northeastern Ethiopia.Methods and MaterialsA retrospective cross-sectional study was conducted to evaluate the antibiotic utilization pattern for the treatment of acute diarrheal disease. Data was collected from 230 patients’ record cards treated for acute diarrheal disease from January 2018 to December 2018 using structured questionnaires. The finding is presented using frequency distribution and percentages in tables as well as figures.ResultsAmong the 230 patients, 49.60% were males and the rest were females. From the total, 172 of them were with watery type of diarrhea and 132 of them were prescribed antibiotics inappropriately out of which 77 were under 5 years. In addition, 27 patients were diagnosed with mucoid diarrhea and only eight of them were treated with antibiotics whereas 31 patients were with bloody type of diarrhea and 10 of them were not treated with antibiotics. Of the 230 cases, 161 (70%) patients received different types of antibiotics, and co-trimoxazole, amoxicillin and ciprofloxacin were the most prescribed antibiotics.ConclusionThe study revealed that there is a high level of inappropriate antibiotics use which may fuel the increased antimicrobial resistance and associated costs nationally as well as globally.