Cases Of Acute Diarrhea Research Articles

Food safety in the Dominican Republic—The current situation and challenges in the public management system

AbstractThe Dominican Republic, like other economically developing countries, has begun to shift national focus away from food security to concentrate on improving food safety and nutrition. The government of the Dominican Republic has promoted and implemented measures aimed at eradicating poverty and malnutrition and reducing the diseases that are a direct consequence of nutritional deficiencies. However, between 2013 and 2018, the Dominican Republic reported approximately 23,000 cases of foodborne illness annually. Additionally, the number of annual cases of acute diarrhea has increased to approximately 80,000 cases per year with a mortality rate (per 100,000 inhabitants) between 5.98 and 6.94. While the etiological agents responsible for these cases are often not identified, foodborne pathogens including Shigella, E. coli, Klebsiella pneumoniae, Salmonella, and Campylobacter have been isolated from food exported from the Dominican Republic as well as locally consumed foods. This review describes the status of food safety in the Dominican Republic. The review focuses on what is known regarding the etiological agents involved in foodborne disease outbreaks in the country, the impact of foodborne disease, measures the Dominican Republic government has taken to ensure the safety of both exported foods and foods consumed locally, barriers to improving food safety, as well as current and emerging food safety challenges.

Delhi Belly during Deadly Summers: A Study of Acute Diarrhea Due to Vibrio cholerae Infection

Abstract Background: Cholera is an acute, watery diarrheal disease caused by Vibrio cholerae, and a major public health problem in developing nations with poor sanitary conditions. Summers of 2024 in Delhi witnessed extremes of temperature, and water scarcity, sparking rise in diarrhoeal illnesses. Aims and Objective: The primary objective of this study is to investigate aetiology of diarrheal diseases during summer using a rapid molecular method, ‘gastrointestinal syndromic panel testing by multiplex polymerase chain reaction (PCR)’ on stool specimen, with special attention to Vibrio Cholerae. Material and Methods: This study was carried out between April to June of 2024, at a tertiary care hospital of Delhi Cantonment. Stool samples were collected from cases of acute watery diarrhoea and processed in parallel for conventional culture and commercially available multiplex PCR, BioFire Film Array. Results: BioFire Gastro-intestinal (GI) panel identified a total of 55 pathogens in 35 stool samples (63.63%) with multiple organisms detected in 15 (42.85%) samples. Conventional microbiological culture revealed Vibrio cholerae O1 biotype El Tor serotype Ogawa as the causative agent in six cases, whereas BioFire GI panel detected Vibrio cholera in seven. Conclusion: Multiplex PCR assay on stool sample offers a shorter turnaround time and the ability to detect a wide array of pathogens. BioFire GI panel is recommended as a screening tool for prompt diagnosis of acute gastroenteritis in a setting of an outbreak.

Evaluation of rational drug use in primary healthcare centres of Probolinggo District, Indonesia

Background: The Indonesian government has been working on optimising drug use in primary healthcare centres (puskesmas) of the Probolinggo District Health Office (dinkes). Objective: This study aimed to evaluate the rationality of drug use (RDU) using indicators set by the Indonesian Ministry of Health. Method: A retrospective descriptive study was conducted using data from 33 Puskesmas in Probolinggo Dinkes during the year 2022. Data on patients diagnosed with Acute Respiratory Infection (ARI) non-pneumonia (n = 36,378), non-specific diarrhoea (n = 4,291), and myalgia injection cases (n = 9,641) were collected. Result: The study's findings showed that the percentage of antibiotics for ARI was 17.11%, meeting the standard. Of the 33 Puskesmas, 67% met the standard, while 33% did not. Meanwhile, the antibiotic used for non-specific diarrhoea was 9.58%, exceeding the tolerance limit, with 55% of Puskesmas meeting the standard and 45% not. The percentage for injectable drugs in myalgia cases was 0.43%, in line with the standard, with 82% of Puskesmas meeting the standard and 18% not. Conclusion: The study found that antibiotic usage for ARI and injections for myalgia met the standards, but for non-specific diarrhoea cases did not.

Impacts of climate change on diarrhoeal disease hospitalisations: How does the global warming targets of 1.5-2°C affect Dhaka, Bangladesh?

Dhaka is one of the world's densely populated cities and faces significant public health challenges including high burden of diarrhoeal diseases. Climate change is intensifying existing environmental problems including urban heat island effect and poor water quality. While numerous epidemiological studies have linked meteorological factors to diarrhoeal diseases in Bangladesh, assessment of the impacts of future climate change on diarrhoeal diseases is scarce. We provide the assessment of climate change impacts on diarrhoeal disease in Dhaka and project future health risks under climate change scenarios. About 3 million acute diarrhoea cases presenting to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b) during 1981-2010 were linked to daily temperature, rainfall and humidity and association investigated using time series adapted negative binomial regression models employing constrained distributed lag linear models. The findings were applied to climate projections to estimate future risks of diarrhoea under various global warming scenarios. There was a significantly raised risk of diarrhoea hospitalisation in all ages with daily mean temperature (RR: 3.4, 95% CI: 3.0-3.7) after controlling for the confounding effects of heavy rainfall, humidity, autocorrelations, day of the week effect, long-term time, and seasonal trends. Using the incidence rate ratio (IRR) of 1.034, temperature increases based on the global warming targets of 1.5-2°C could result in an increase of diarrhoea hospitalisations by 4.5-7.4% in all age groups by the 2100s. These effects were more pronounced among <5 children where the predicted temperature increases could raise diarrhoea hospitalisation by 5.7% - 9.4%. Diarrhoea hospitalisation will increase significantly in Dhaka even if the global warming targets adopted by the Paris Agreement is reached. This underscores the importance of preparing the city for management and prevention of diarrhoeal diseases.

Sequence types of enteroaggregative Escherichia coli strains recovered from human, animal, and environmental sources: India

In the current study, we report whole genome sequencing (WGS) data on EAEC strains from India to identify lineages and different sequence types (STs) in our geographical regions across North India. We performed WGS comparative genomics characterization to examine the diversity of 122 EAEC strains collected from a large geographic area from clinical (Human sources) and non-clinical sources (animal and environmental sources). M-PCR for 21 virulence genes was performed. A triplex PCR detected phylogenetic groups A, B1, B2, and D was done. All strains were genome-sequenced, and bioinformatics analysis was performed. EAEC isolates belonged to 29 sequence types, further clustered into 11 clonal complexes, among which CC38 was the largest, containing 38 isolates mainly belonging to two ST types (ST38 and ST315). CC10 was the most diverse group, comprising 8 STs (ST43, ST2706, ST1286, ST 10, ST167, ST34, ST227, and ST4305). The most frequently detected virulence gene among the 96 clinical EAEC isolates was astA (87.5%), followed by ORF3 (62.5%), and aap (54.1 %). ST131, known for multidrug resistance and causing various diseases, was detected in acute diarrhea cases and animal sources, underscoring its clinical significance. These findings indicate the high diversity of EAEC and different sources of unique ST types of EAEC. The study reinforces the One Health approach, highlighting the interconnection between human health, animal reservoirs, and environmental sources in EAEC transmission dynamics. The identification of EAEC strains in animals suggests the zoonotic potential of these pathogens, necessitating comprehensive surveillance and control measures. The study emphasizes the need for continued surveillance and a One Health approach to address the complex transmission dynamics of EAEC.

Socioeconomic inequality in child health outcomes in India: analyzing trends between 1993 and 2021

BackgroundThe health of India’s children has improved over the past thirty years. Rates of morbidity and anthropometric failure have decreased. What remains unknown, however, is how those patterns have changed when examined by socioeconomic status. We examine changes in 11 indicators of child health by household wealth and maternal education between 1993 and 2021 to fill this critical gap in knowledge. Doing so could lead to policies that better target the most vulnerable children.MethodsWe used data from five rounds of India’s National Family Health Survey conducted in 1993, 1999, 2006, 2016, and 2021 for this repeated cross-sectional analysis. We studied mother-reported cases of acute respiratory illness and diarrhea, hemoglobin measurements for anemia, and height and weight measurements for anthropometric failure. We examined how the prevalence rates of each outcome changed between 1993 and 2021 by household wealth and maternal education. We repeated this analysis for urban and rural communities. ResultsThe socioeconomic gradient in 11 indicators of child health flattened between 1993 and 2021. This was in large part due to large reductions in the prevalence among children in the lowest socioeconomic groups. For most outcomes, the largest reductions occurred before 2016. Yet as of 2021, except for mild anemia, outcome prevalence remained the highest among children in the lowest socioeconomic groups. Furthermore, we show that increases in the prevalence of stunting and wasting between 2016 and 2021 are largely driven by increases in the severe forms of these outcomes among children in the highest socioeconomic groups. This finding underscores the importance of examining child health outcomes by severity.ConclusionsDespite substantial reductions in the socioeconomic gradient in 11 indicators of child health between 1993 and 2021, outcome prevalence remained the highest among children in the lowest socioeconomic groups in most cases. Thus, our findings emphasize the need for a continued focus on India’s most vulnerable children.

Acute Diarrhoea in Children Aged Up to 2 Years Age Group: Assessment of Therapeutic Strategies and Hospital Stay Variance, in Tertiary Care Rural Hospital – An Observational Study

Acute Diarrhoea, it is one of the leading causes of under 5 childrens’ morbidity and mortality in India. It is most common in children especially those between 6 months and 2 years. Antimicrobials are mostly used drug for acute diarrhoeal cases according to many studies but according to WHO antibiotics are not required for all the diarrhoeal cases except few bacterial diarrhoeas. Other way, WHO recommends Zinc with low osmolarity ORS for acute diarrhoea. So, this study was designed for assessing the treatment pattern and its outcome in our setup. Objectives: - To assess the use of antibiotics and Zinc among children under 2 years suffering from acute Diarrhoea by analysing average of use and hospital stay. Materials and Methods: - This observational study includes 76 patients, admitted under Paediatric Department of Mahatma Gandhi Institute of Medical Sciences, in the period of 6 months. All the patients admitted during the study period having acute Diarrhoea with moderate dehydration as per definition of WHO was included in the study. Patients with other existing diseases, bloody diarrhoea and seriously ill were excluded. Data was collected from Paediatric ward and was analysed by using GraphPad software. Results: - Over all among the 76 patients, 25(32.89%) patients received antimicrobials only and 31(40.79%) received Zinc only and11(14.47%) patients received both. Hospital stay difference was not statistically significant in culture negative acute diarrhoea cases with the use of zinc and antimicrobials (p = 0.08) but it was significant in culture positive cases (p = 0.03). Conclusion: - In culture negative acute diarrhoeal cases Zinc was mostly used and hospital stay was not found to be significant with and without antimicrobials. Implication: - Uncomplicated acute diarrhoeal cases may be treated with Zinc alone effectively.

In adult horses with diarrhoea, does faecal microbiota transplantation in addition to standard treatments improve the outcomes compared to standard treatments alone?

SummaryAcute diarrhoea due to colitis/typhlocolitis is a life‐threatening disease of adult horses that is both a diagnostic and therapeutic challenge. Treatments are predominantly supportive, including fluid therapy, colloid oncotic support and nutritional support. There are a lack of specific and effective therapies for equine colitis, providing a challenge in practice for the prevention of serious and fatal complications. Faecal microbiota transplantation (FMT) involves the transfer of faecal bacteria and other microbes from a healthy individual into another individual, with the aim of restoring a healthy gut microbiota and is often used as a ‘last resort’ therapy. This procedure has been recommended as a treatment for acute diarrhoea in horses and has proven efficacy in the treatment of some cases of acute diarrhoea in people. This critically appraised topic reviewed the published literature on the outcomes associated with faecal transplantation in adult horses affected by acute diarrhoea/colitis. Only six published studies met the inclusion criteria (including one systematic review). The studies found varying results regarding the efficacy of FMT in the treatment of colitis/diarrhoea in the adult horse but overall there was weak evidence to support the use of faecal transplantation in addition to other standard treatments for the management of adult horses affected by colitis, although further controlled studies of defined categories of disease are required.

Acute watery diarrhoea cases during cholera outbreak in Syria: a cohort study

ObjectivesThe aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in...

Characteristics of acute diarrhea under the sentinel surveillance system at the Vietnam National Children’s Hospital from 2018 to 2022

The study describes a sentinel diarrhea surveillance system at the Vietnam National Children’s Hospital from 2018 - 2022, characterizing the epidemiology of acute diarrhea (AD) due to rotavirus (RV) and identifying circulating RV strains. Of 4,765 AD cases, 861 were positive for RV, accounting for 18.07%. The disease appeared in all months, peaking in the winter-spring months (from October to March of the following year). The groups of children aged 6 - 11 months, 12 - 23 months, and 6 weeks-6 months had the highest number of cases, but the highest positive rate is 24 - 47 months old. About 24% of RV patients under 2 years of age have already been vaccinated, while this proportion among 3 - 5 years of age patients is 41%. Dehydration and no dehydration account for 96,7%, while severe dehydration only accounts for 3.3%, the prevalent RV types identified were G3P[8], G8P[8], G1P[8], G9P[8], which account for 50.7%, 20.6%, 11.4%, and 9%, respectively and changed annually. It is necessary to implement RV vaccines in the Expanded Program on Immunization. Meanwhile maintaining an RV sentinel surveillance system and continuing research on the effectiveness of RV vaccines in Viet Nam are also critical for controlling RV in Vietnam.

Molecular and Genomic Epidemiology of Non-O1/Non-O139 and O1/O139 Vibrio cholerae: A Molecular typo-genomics strategy for studying Emerging Potential Environmental Bacterial Pathogens

Recent happening of epidemic, sporadic and pandemic associated with bacteria pathogens around the globe continue to arouse fear amongst the populace. Specific examples amongst such pathogens are the non-O1/non-O139 and O1/O139 Vibrio cholerae which are implicated in acute watery diarrhea (AWD) and cholera cases. It was reported that more than ten Southern/Eastern African countries have suffered the scourge since the beginning of 2018. Considering the highlights on the rapid transmission or spread of AWD/Cholera and the relative impact on public/environmental health, molecular epidemiology of transmitting agents has shown promising relevance in diverse field of interest. This study reviewed researches on some published articles on Cholera/AWD within the Southern African Development Communities (SADC), other East and West African countries and elsewhere. The role of molecular epidemiological tools in understanding the dynamics of Non-O1/Non-O139 and O1/O139 Vibrio cholerae transmission/spread, source tracking of outbreaks and possible management/control in probable and confirmed cases of vibriosis was discussed. It also emphasized on the current updated nature/burden of the pathogen in endemic, epidemic and pandemic area in Southern African countries as the problem of safe-water and hygienic-food for-all continues to resurface. The need for application of molecular and gene based epidemiological approach in profiling bacterial strains cannot be overemphasize especially amongst emerging or reemerging strains of Non-O1/Non-O139 Vibrio cholarae and O1/O139 Vibrio cholerae.

Asociación entre madres adolescentes e infecciones agudas en menores de cinco años en el Perú 2015-2019

Abstract Objectives: to assess the association between mothers age and the presence of acute respiratory infections (ARIs) and acute diarrhea (AD) in Peruvian children under five years old. Methods: secondary analysis of the database of the “Demographic and Family Health Survey” of 2015 and 2019. We analyzed data from children under five and their reproductive-age mothers who live in the same household. Poisson regression models were used to generate adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) to assess the association between mothers’ age group and the presence of ARIs and AD in their children. Results: 84,671 mother/child data were analyzed. In the adjusted regression model, being a young mother (aPR= 1.18; 95%CI= 1.11-1.25; p&lt;0.001) or an teenage (aPR= 1.11; 95%CI= 1.01-1.22; p=0.045) were associated with a higher prevalence of ARIs in their children. In addition, being a young mother a teenage (aPR= 1.18; 95%CI= 1.11-1.25; p&lt;0.001) or a teenage (aPR= 1.22; 95%CI= 1.10-1.35; p&lt;0.001) were also associated with a higher prevalence of AD cases in their children. Conclusions: mothers’ age was found to be associated with the prevalence of ARIs and AD in Peruvian children under five, with teenagers and young mothers having the greatest probability of ARIs and AD.

Serotyping and Phage Typing of Vibrio cholerae Isolated AtTertiary Care Hospital, Ahmedabad, Gujarat

Introduction: Cholera continues to be a growing concern in most developing countries. Cholera is an acute diarrheal disease endemic in India. Yet there are few reliable population-based estimates of laboratory-confirmed cholera in endemic areas around the world. The aim of this hospital-based study was to isolate and serogrouping of Vibrio cholerae in patients with diarrhea at tertiary care hospital, Ahmedabad during January 2021 to July 2022. Material &amp; Methods: A retrospective study involving cases of acute watery diarrhea was done during January 2021 to July 2022. All stool samples from suspected cases were tested for Vibrio cholerae by standard microbiological procedures. Out of total 1294 stool samples Vibrio cholerae were isolated in 179 samples and sent to the NICED (National Institute of Cholera and Enteric Diseases) for serotyping and phage typing. Results: In present study rate of isolates of V. cholerae was 13.83 % (179 out of 1294 cases). V. cholerae O1 serotype Ogawa (78.77%) belonging to phage type 27 (54.74%) was the most common in the cases of acute diarrhea in present study. Conclusion: The present study identified serotype Ogawa and phage type 27 as the most dominant type and was found continuous in circulation throughout the study period. Phage typing is still an internationally recognized method of choice for characterizing circulating strains. This knowledge will be helpful to design a novel strategy to manage future cholera outbreaks. Keywords: Cholera, Vibrio cholerae, Serotyping, Phage typing

Monsoon Floods: A Challenge To Pakistan's Already Fragile Healthcare Infrastructure.

Madam, This monsoon season's floods from mid-July 2022 onwards have proven to be the most catastrophic climate disaster in Pakistan's history, flooding a third of the country, killing more than 1290 people, and forcing a staggering 634,000 people to take refuge in relief camps [1]. Furthermore, of greater concern is the implications of the floods on already fragile healthcare infrastructure in a country with a weak economy and limited fund allocation for Health Services. In this regard, the World Health Organization has reported damage to 1460 health facilities; 432 are inoperable and 1,028 were partially destroyed [1]. Considering the deficit of healthcare centres, and medical professionals and the availability of medications in low-lying, agricultural, and rural setups of the major provinces, the transmission of infectious diseases is inevitable. Subsequently, there is a significant concern surrounding the feasibility of relief camps set up, where overcrowding of displaced individuals, lack of proper sanitation and sewage systems, and inadequate hygienic food further stimulate communicable disease spread. Notably, the stagnant water surface remaining after flood water recedes serves as an ideal reservoir for mosquito vector growth and hence transmission of infectious diseases such as malaria and dengue affecting vulnerable populations, primarily the refugees in congested camps lacking basic sanitation and insecticidal net beds to sleep under. Moreover, overcrowding and destruction of sewage systems causing water contamination could lead to the oral-faecal transfer of gastrointestinal pathogens, causative agents of diarrheal diseases [2]. Cholera is the most prevalent infectious disease outcome of the floods as evidenced by reports of 115 922 cases of acute diarrhoea in KPK in the aftermath of the summer 2010 floods [2]. In addition, one of the major concerns identified among the displaced population is the alarming number of pregnant women in dire need of proper medical and residential facilities to facilitate their infants. In this context, the United Nations Population Fund (UNFPA), released a startling estimate of 650,000 pregnant women affected by floods of which over 73,000 are expected to deliver within a month [3]. UNFPA has set a precedent by providing 8,311 dignity kits, 7,411 newborn baby kits, and 6,412 clean delivery kits. However, this would not be enough considering the magnitude of mass displacement [3]. ---Continue

Are non-lactose-fermenting Escherichia coli important diarrhoeal pathogens in children and adults?

Diarrhoeagenic Escherichia coli (DEC) remains one of the major causes of acute diarrhoea episodes in developing countries. The percentage of acute diarrhoea cases caused by DEC is 30-40 % in these countries. Approximately 10% of E. coli isolates obtained from stool specimens have been reported to be non-lactose-fermenting (NLF). The available literature is sparse regarding the pathogenicity of NLF E. coli causing infectious diarrhoea. We aimed to elucidate the importance of NLF E. coli in causing diarrhoea in both adults and children by detecting various DEC pathotypes among NLF E. coli in stool samples taken from gastroenteritis cases. A total of 376 NLF E. coli isolates from 3110 stool samples from diarrhoea/gastroenteritis patients were included in the study. Up to three NLF colonies that were not confirmed as Vibrio cholerae , Aeromonas spp., Salmonella spp. or Shigella spp., but were identified as E. coli using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), were carefully picked up from each MacConkey agar plate and then meticulously streaked onto freshly prepared, sterilized nutrient agar plates, and biochemical reactions were conducted. Multiplex PCR was conducted for the EAEC, EPEC, ETEC and EHEC pathotypes and PCR for the ipaH gene was conducted for EIEC. The disc diffusion method was used for antibiotic sensitivity testing. Using multiplex PCR and ipaH PCR, a total of 63 pathotypes of DEC were obtained, with EAEC being the most predominant (n=31) followed by EIEC (n=22), EPEC (n=8) and ETEC (n=2). To further differentiate EIEC from Shigella , additional biochemical tests were performed, including acetate utilization, mucate and salicin fermentation, and aesculin hydrolysis. Antimicrobial susceptibility testing (AST) showed that maximum resistance was seen against ciprofloxacin (82.5 %) followed by ampicillin (77.8 %) and cotrimoxazole (68.2 %), and minimum resistance was seen against ertapenem (4.8 %). In our study two pathotypes (EAEC, EIEC) were predominant among NLF E. coli and these were not only important aetiological agents in children, but also in adults. Our study also sheds light on the epidemiology of EIEC, which is one of the most neglected DEC pathotypes, as hardly any microbiological laboratories process NLF E. coli for EIEC.

Evaluation of antibiotic utilization pattern in the treatment of acute diarrheal diseases at Debre Tabor comprehensive specialized hospital, Debre Tabor, Ethiopia: A retrospective cross-sectional study

BackgroundIn clinical settings all across the world, including Ethiopia, the irrational use of antibiotics to treat acute diarrhea is common. The main causes of resistance are antibiotic abuse, misuse, and underuse, and among infectious diseases, antibiotic overuse is pervasive in diarrheal infections around the world. As a result, the primary goal of this study was to evaluate antibiotic use patterns for the treatment of acute diarrheal diseases at Debre Tabor Comprehensive Specialized Hospital in North-West Ethiopia. MethodologyA retrospective cross-sectional study was conducted to assess the antibiotic utilization pattern used to treat acute diarrheal illness, taken from the record cards of 243 patients who received treatment for acute diarrheal illness, employing structured questions from September 1 to September 30, 2022. The results are displayed using percentages and frequency distributions in tables along with figures. ResultsA total of 243 patients were involved, 134 (55.1%) of whom were male and 134 (55.1%) were under the age of five. Out of the 103 cases of acute watery diarrhea, 83 received antibiotics that were given improperly. Additionally, 88 individuals had bloody diarrhea diagnoses, but 58 of them received the currently administered antibiotics. Amoxicillin and co-trimoxazole were the most frequently prescribed medications, with 193 (79.5%) of the 243 cases of patients receiving some form of antibiotic. ConclusionThe results of the study revealed that there is inappropriate antibiotic use in acute diarrheal disease at Debre Tabor Comprehensive Specialized Hospital, which might be the cause for the overall increase in antimicrobial resistance as well as the associated costs of treatment. The finding is helpful as evidence for prescribers' inappropriate use of antibiotics for the treatment of acute diarrheal sickness.

Incidencia de pacientes pediátricos con enfermedades diarreicas del puesto de salud tres cerritos - pasaje en el periodo 2020 – 2022

Objective: This study aims to determine the incidence of diarrheal diseases in pediatric patients of the Tres Cerritos Health Post in the Pasaje Canton during the period 2020 - 2022. Methods: A cross-sectional observational-descriptive study was conducted. The pediatric population studied consisted of 5,774 children, among whom 76 cases of acute diarrhea were observed in children of both sexes. The PRAS system (Plataforma Registro de Salud) was used for data collection. Statistical analysis was carried out with Epi Info and Excel, presenting qualitative variables with frequency values (f), percentage (%) and quantitative variables with measures of central tendency and dispersion (mean, median/standard deviation, interquartile range). Results: According to the data collected in PRAS, an incidence of acute diarrhea of 13.16 per 1,000 inhabitants was determined. The average age of the affected children ranged from 2 to 9 years, with a predominance of the male sex (54%). The most affected age group was 2 to 4 years (49%). The most frequent symptomatology was diarrhea (42%), followed by the combination of diarrhea and vomiting (16%). Conclusion: The incidence of diarrhea in the Tres Cerritos Health Post was relatively low in the pediatric population. This is due to the fact that respiratory pathologies predominated during the study period, affecting the male sex more frequently.

Stool culture &amp; sensitivity for vibrio cholera in acute out break of diarrhea

Background: Acute watery diarrhea is a common clinical entity encountered daily in emergency department worldwide. In adults more than 90% of cases of acute diarrhea are caused by infectious agents spread by ingestion of feces contaminated food and water. Objective: To assess the stool Culture &amp; Sensitivity for Vibrio Cholera in Acute Out Break of Diarrhea. Methodology: This study was prospective cohort study targeting all acute bacterial diarrhea cases in patients of either sex and all ages attending the emergency department of Qazi Hussain Ahmed Medical Complex, Nowshera Pakistan. The overall sample size was 86 on the basis of WHO sample size calculator. Culture and sensitivity was done for all the isolates of Vibrio cholera. All the data was documented in a special designed proforma and then analyzed by SPSS version 24. Results: In the current study, totally 86 patients were enrolled. There were 50 (58.14%) males and 36 (41.86%) females’ patients in our study. Based on identification, 11 (12.79%) samples were positive for vibrio cholera while 3 (3.49%) samples were positive for Salmonella typhi. Ampicillin was susceptible to 2 (18.18%) isolates while 3 (27.27%) isolates were resistant to ampicillin.

Politicization of water, humanitarian response, and health in Syria as a contributor to the ongoing cholera outbreak

In September 2022, the Syrian Ministry of Health declared a cholera outbreak after a surge of acute watery diarrhea cases. Since then, cases have been reported across Syria, particularly in the northwest. This ongoing outbreak reflects a pattern of politicizing water, humanitarian response, and health throughout the country's protracted conflict. Interference with water, sanitation, and hygiene (WASH) infrastructure has been a key component of this politicization, impeding detection, prevention, case management, and control. Droughts and floods have exacerbated the WASH situation, as have the early 2023 Türkiye-Syria earthquakes. The humanitarian response after the earthquakes has also faced politicization, leading to increased risk of surges in cases of cholera and other waterborne diseases. This has all occurred in a conflict where health care has been weaponized, attacks on health care and related infrastructure are the norm, and syndromic surveillance and outbreak response have been influenced and restricted by politics. Cholera outbreaks are entirely preventable; what we see in Syria is cholera reflecting the myriad ways in which the right to health has been brought under fire in the Syrian conflict. The recent earthquakes are additional assaults, which raise urgent concerns that a surge of cholera cases, particularly in northwest Syria, may now become uncontrolled.

The Association of Acute Watery Diarrhea in Iranian Pilgrims of Iraq with Cholera Cases in Iranians.

Despite the advances in the control of infectious diseases like cholera, they can potentially cause epidemics, especially in mass gathering events. One of the most important countries on the walking way of the Arbaeen religious event is Iran, which requires health system preparedness. The aim of this study was to predict the cholera epidemic in Iran by using the syndromic surveillance system of Iranian pilgrims in Iraq. The data of the Iranian pilgrims with acute watery diarrhea in Iraq during the Arbaeen religious event and the confirmed cholera cases of pilgrims after returning to Iran were analyzed. We used the Poisson regression model of the relationship between the numbers of cases to evaluate acute watery diarrhea and cholera. Spatial statistics and hot spot analysis were used to identify the provinces with the highest incidence. SPSS software Version 24 was used for statistical analysis. The frequency of acute watery diarrhea cases was 2232 and the frequency of cholera in pilgrims after returning to Iran was 641. The results of spatial analysis for acute watery diarrhea cases showed a high number of acute watery diarrhea cases in the Khuzestan and Isfahan provinces, located in hot spots. Using Poisson regression, the relationship between the number of acute watery diarrhea reported in the syndromic surveillance system and the number of cholera cases was confirmed. The syndromic surveillance system is useful to predict the outbreak of infectious diseases in large religious mass gatherings.