Cause Of Diarrhea In Children Research Articles

Evaluation of Optimal Antibiotic Use in Children with Gastroenteritis Abstract

Introduction: Due to the side effects of overuse of antibiotics, the aim of study was to evaluate the optimal antibiotic use in children with gastroenteritis.
 Methods: This descriptive-analytical study was conducted on 178 children with gastroenteritis from January to December 2018. Data including age, gender, clinical symptoms and laboratory findings were extracted from records.
 Results: Out of 178 cases of diarrhea, 32 cases were due to bacteria and 146 cases were due to viruses. The most clinical symptoms in the patients were fever (34.40 %), vomiting (33.2 %) and coryza (13.1%). The most frequency of viral (46.2%) and bacterial diarrhea (32.2%) were seen in autumn season. Antibiotics were used mostly in spring (39 %) and autumn (25 %) seasons. In 14% of cases, the appropriate treatment was not selected. In addition, 50.56 % of treated children were less than 1 years old. No significant relation was also seen between season with bacterial or viral cases (p>0.05). Significant relation was seen between taking antibiotics at admission and clinical signs such as abdominal pain and suspicious food (p<0.01). Data were analyzed throgh SPSS, version16. Chi Square test was used for analysis of data
 Conclusion: Virus is the main cause of diarrhea in children with gastroenteritis. Moreover, the most frequency of diarrhea was seen in autumn and spring season. However, there was no significant relation between seasons with bacterial and viral cases. It indicates that bacterial and viral diarrhea was not affected by season. For preventing microbial resistance, antibiotic therapy should be administered more carefully in children with diarrhea.

Molecular Characterisation of Cryptosporidium spp. in Mozambican Children Younger than 5 Years Enrolled in a Matched Case-Control Study on the Aetiology of Diarrhoeal Disease.

Cryptosporidium is a leading cause of childhood diarrhoea and associated physical and cognitive impairment in low-resource settings. Cryptosporidium-positive faecal samples (n = 190) from children aged ≤ 5 years enrolled in the Global Enteric Multicenter Study (GEMS) in Mozambique detected by ELISA (11.5%, 430/3754) were successfully PCR-amplified and sequenced at the gp60 or ssu rRNA loci for species determination and genotyping. Three Cryptosporidium species including C. hominis (72.6%, 138/190), C. parvum (22.6%, 43/190), and C. meleagridis (4.2%, 8/190) were detected. Children ≤ 23 months were more exposed to Cryptosporidium spp. infections than older children. Both C. hominis and C. parvum were more prevalent among children with diarrhoeal disease compared to those children without it (47.6% vs. 33.3%, p = 0.007 and 23.7% vs. 11.8%, p = 0.014, respectively). A high intra-species genetic variability was observed within C. hominis (subtype families Ia, Ib, Id, Ie, and If) and C. parvum (subtype families IIb, IIc, IIe, and IIi) but not within C. meleagridis (subtype family IIIb). No association between Cryptosporidium species/genotypes and child’s age was demonstrated. The predominance of C. hominis and C. parvum IIc suggests that most of the Cryptosporidium infections were anthroponotically transmitted, although zoonotic transmission events also occurred at an unknown rate. The role of livestock, poultry, and other domestic animal species as sources of environmental contamination and human cryptosporidiosis should be investigated in further molecular epidemiological studies in Mozambique.

Genetic Diversity of Enteric Viruses in Children under Five Years Old in Gabon.

Enteric viruses are the leading cause of diarrhea in children globally. Identifying viral agents and understanding their genetic diversity could help to develop effective preventive measures. This study aimed to determine the detection rate and genetic diversity of four enteric viruses in Gabonese children aged below five years. Stool samples from children <5 years with (n = 177) and without (n = 67) diarrhea were collected from April 2018 to November 2019. Norovirus, astrovirus, sapovirus, and aichivirus A were identified using PCR techniques followed by sequencing and phylogenetic analyses. At least one viral agent was identified in 23.2% and 14.9% of the symptomatic and asymptomatic participants, respectively. Norovirus (14.7%) and astrovirus (7.3%) were the most prevalent in children with diarrhea, whereas in the healthy group norovirus (9%) followed by the first reported aichivirus A in Gabon (6%) were predominant. The predominant norovirus genogroup was GII, consisting mostly of genotype GII.P31-GII.4 Sydney. Phylogenetic analysis of the 3CD region of the aichivirus A genome revealed the presence of two genotypes (A and C) in the study cohort. Astrovirus and sapovirus showed a high diversity, with five different astrovirus genotypes and four sapovirus genotypes, respectively. Our findings give new insights into the circulation and genetic diversity of enteric viruses in Gabonese children.

Re-evaluation of a Neonatal Mouse Model of Infection With Enterotoxigenic Escherichia coli.

Enterotoxigenic E. coli (ETEC) is a common cause of diarrhea in children in low- and middle-income countries, and in travelers to these countries. ETEC is also an important cause of morbidity and premature mortality in piglets, calves, goat kids and lambs. The major virulence determinants of ETEC are enterotoxins and colonization factors, which enable the pathogen to colonize the small intestine and deliver enterotoxins, such as the heat-stable enterotoxins, STp and STh, to epithelial cells. Because most ETEC strains are host-specific, there are few convenient animal models to investigate the pathogenesis of ETEC infections or to evaluate specific anti-ETEC interventions, such as drugs and vaccines. An exception is ETEC strains bearing F41 pili, which mediate intestinal colonization of various young animals, including neonatal mice, to cause disease and in some cases death. In this study, we used the archetypal F41-producing bovine ETEC strain, B41 (O101:NM; K99, F41, STp) to validate and further explore the contribution of F41 and STp to bacterial virulence. By using targeted gene deletion and trans-complementation studies, augmented by whole genome sequencing, and in vitro and animal studies of virulence, we established that F41 mediates colonization of the mouse intestine and is essential for bacterial virulence. In addition, we showed for the first time that STp is as important as F41 for virulence. Together, these findings validate the use of neonatal mice to study the pathogenesis of F41-bearing ETEC and to investigate possible specific anti-ETEC interventions including vaccines that target heat-stable enterotoxins.

Molecular Diversity of Giardia duodenalis, Cryptosporidium spp., and Blastocystis sp. in Symptomatic and Asymptomatic Schoolchildren in Zambézia Province (Mozambique).

Infections by the protist enteroparasites Giardia duodenalis, Cryptosporidium spp., and, to a much lesser extent, Blastocystis sp. are common causes of childhood diarrhoea in low-income countries. This molecular epidemiological study assesses the frequency and molecular diversity of these pathogens in faecal samples from asymptomatic schoolchildren (n = 807) and symptomatic children seeking medical attention (n = 286) in Zambézia province, Mozambique. Detection and molecular characterisation of pathogens was conducted by polymerase chain reaction (PCR)-based methods coupled with Sanger sequencing. Giardia duodenalis was the most prevalent enteric parasite found [41.7%, 95% confidence interval (CI): 38.8–44.7%], followed by Blastocystis sp. (14.1%, 95% CI: 12.1–16.3%), and Cryptosporidium spp. (1.6%, 95% CI: 0.9–2.5%). Sequence analyses revealed the presence of assemblages A (7.0%, 3/43) and B (88.4%, 38/43) within G. duodenalis-positive children. Four Cryptosporidium species were detected, including C. hominis (30.8%; 4/13), C. parvum (30.8%, 4/13), C. felis (30.8%, 4/13), and C. viatorum (7.6%, 1/13). Four Blastocystis subtypes were also identified including ST1 (22.7%; 35/154), ST2 (22.7%; 35/154), ST3 (45.5%; 70/154), and ST4 (9.1%; 14/154). Most of the genotyped samples were from asymptomatic children. This is the first report of C. viatorum and Blastocystis ST4 in Mozambique. Molecular data indicate that anthropic and zoonotic transmission (the latter at an unknown rate) are important spread pathways of diarrhoea-causing pathogens in Mozambique.

Escherichia coli Nissle 1917 administered as a dextranomar microsphere biofilm enhances immune responses against human rotavirus in a neonatal malnourished pig model colonized with human infant fecal microbiota

Human rotavirus (HRV) is a leading cause of diarrhea in children. It causes significant morbidity and mortality, especially in low- and middle-income countries (LMICs), where HRV vaccine efficacy is low. The probiotic Escherichia coli Nissle (EcN) 1917 has been widely used in the treatment of enteric diseases in humans. However, repeated doses of EcN are required to achieve maximum beneficial effects. Administration of EcN on a microsphere biofilm could increase probiotic stability and persistence, thus maximizing health benefits without repeated administrations. Our aim was to investigate immune enhancement by the probiotic EcN adhered to a dextranomar microsphere biofilm (EcN biofilm) in a neonatal, malnourished piglet model transplanted with human infant fecal microbiota (HIFM) and infected with rotavirus. To create malnourishment, pigs were fed a reduced amount of bovine milk. Decreased HRV fecal shedding and protection from diarrhea were evident in the EcN biofilm treated piglets compared with EcN suspension and control groups. Moreover, EcN biofilm treatment enhanced natural killer cell activity in blood mononuclear cells (MNCs). Increased frequencies of activated plasmacytoid dendritic cells (pDC) in systemic and intestinal tissues and activated conventional dendritic cells (cDC) in blood and duodenum were also observed in EcN biofilm as compared with EcN suspension treated pigs. Furthermore, EcN biofilm treated pigs had increased frequencies of systemic activated and resting/memory antibody forming B cells and IgA+ B cells in the systemic tissues. Similarly, the mean numbers of systemic and intestinal HRV-specific IgA antibody secreting cells (ASCs), as well as HRV-specific IgA antibody titers in serum and small intestinal contents, were increased in the EcN biofilm treated group. In summary EcN biofilm enhanced innate and B cell immune responses after HRV infection and ameliorated diarrhea following HRV challenge in a malnourished, HIFM pig model.

The structure of enteric human adenovirus 41-A leading cause of diarrhea in children.

Human adenovirus (HAdV) types F40 and F41 are a prominent cause of diarrhea and diarrhea-associated mortality in young children worldwide. These enteric HAdVs differ notably in tissue tropism and pathogenicity from respiratory and ocular adenoviruses, but the structural basis for this divergence has been unknown. Here, we present the first structure of an enteric HAdV-HAdV-F41-determined by cryo-electron microscopy to a resolution of 3.8 Å. The structure reveals extensive alterations to the virion exterior as compared to nonenteric HAdVs, including a unique arrangement of capsid protein IX. The structure also provides new insights into conserved aspects of HAdV architecture such as a proposed location of core protein V, which links the viral DNA to the capsid, and assembly-induced conformational changes in the penton base protein. Our findings provide the structural basis for adaptation of enteric HAdVs to a fundamentally different tissue tropism.

The first evaluation relationship of integron genes and the multidrug-resistance in class A ESBLs genes in enteropathogenic Escherichia coli strains isolated from children with diarrhea in Southwestern Iran.

Enteropathogenic Escherichia coli (EPEC) is one of the most important diarrheagenic agents among infants under 5years in developing countries. This study aimed to investigate the relationship of integron genes and class A extended-spectrum ESBLs genes in MDR E. coli strains isolated from children with diarrhea in Southwestern Iran. Totally, 321 fecal samples were collected from diarrheal children under 5years admitted to teaching hospitals of Abadan and Khorramshahr, southwest Iran. Routine bacteriological tests were performed for the identification of E. coli isolates. Multiplex PCR was used for the presence of eae, bfp, stx1, and stx2 genes to detected EPEC strains. Serogrouping was performed for EPEC strains. The EPEC isolates' antibiotic resistance pattern was determined by the disk-diffusion technique. All EPEC isolates were screened for integron and class A β-lactamase genes. Of the 14 EPEC isolates, 12 (85.7%) were found to be ESBL-positive by double disk synergy test (DDST) and PCR. In addition, blaCTX-M and blaTEM genes were detected in 83.3% (n = 10) and 58.3% (n = 7) of EPEC isolates, respectively. None of the isolates had the blaKPC gene. On the other hand, 64.2% (n = 9) and 7.1% (n = 1) were positive only for intlI and intlII genes, respectively. The results demonstrated that EPEC is one of the major causes of childhood diarrhea in our region and that the distribution of class 1 integrons and ESBLs in EPEC strains is highly prevalent. Moreover, the results revealed that continuous monitoring of the emergence and expansion of MDR in EPEC strains is necessary.

EPEC Recruits a Cdc42-Specific GEF, Frabin, To Facilitate PAK Activation and Host Cell Colonization.

Enteropathogenic Escherichia coli (EPEC) is an extracellular pathogen that tightly adheres to host cells by forming "actin pedestals" beneath the bacteria, a critical step in pathogenesis. EPEC injects effector proteins that manipulate host cell signaling cascades to trigger pedestal assembly. We have recently shown that one such effector, EspG, hijacks p21-activated kinase (PAK) and sustains its activated state to drive the cytoskeletal changes necessary for attachment of the pathogen to target cells. This EspG subversion of PAK required active Rho family small GTPases in the host cell. Here we show that EPEC itself promotes the activation of Rho GTPases by recruiting Frabin, a host guanine nucleotide exchange factor (GEF) for the Rho GTPase Cdc42. Cells devoid of Frabin showed significantly lower EPEC-induced PAK activation, pedestal formation, and bacterial attachment. Frabin recruitment to sites of EPEC attachment was driven by EspG and required localized enrichment of phosphatidylinositol 4,5-bisphosphate (PIP2) and host Arf6. Our findings identify Frabin as a key target for EPEC to ensure the activation status of cellular GTPases required for actin pedestal formation.IMPORTANCE Enteropathogenic Escherichia coli (EPEC) is a leading cause of diarrhea in children, especially in the developing world. EPEC initiates infection by attaching to cells in the host intestine, triggering the formation of actin-rich "pedestal" structures directly beneath the adherent pathogen. These bacteria inject their own receptor into host cells, which upon binding to a protein on the pathogen surface triggers pedestal formation. Multiple other proteins are also delivered into the cells of the host intestine, which work together to hijack host signaling pathways to drive pedestal production. Here we show how EPEC hijacks a host protein, Frabin, which creates the conditions in the cell necessary for the pathogen to manipulate a specific pathway that promotes pedestal formation. This provides new insights into this essential early stage in disease caused by EPEC.

The Clinical Presentation of Culture-positive and Culture-negative, Quantitative Polymerase Chain Reaction (qPCR)-Attributable Shigellosis in the Global Enteric Multicenter Study and Derivation of a Shigella Severity Score: Implications for Pediatric Shigella Vaccine Trials

Background Shigella is a leading cause of childhood diarrhea and target for vaccine development. Microbiologic and clinical case definitions are needed for pediatric field vaccine efficacy trials.MethodsWe compared characteristics of moderate to severe diarrhea (MSD) cases in the Global Enteric Multicenter Study (GEMS) between children with culture positive Shigella to those with culture-negative, quantitative polymerase chain reaction (qPCR)-attributable Shigella (defined by an ipaH gene cycle threshold <27.9). Among Shigella MSD cases, we determined risk factors for death and derived a clinical severity score.ResultsCompared to culture-positive Shigella MSD cases (n = 745), culture-negative/qPCR-attributable Shigella cases (n = 852) were more likely to be under 12 months, stunted, have a longer duration of diarrhea, and less likely to have high stool frequency or a fever. There was no difference in dehydration, hospitalization, or severe classification from a modified Vesikari score. Twenty-two (1.8%) Shigella MSD cases died within the 14-days after presentation to health facilities, and 59.1% of these deaths were in culture-negative cases. Age <12 months, diarrhea duration prior to presentation, vomiting, stunting, wasting, and hospitalization were associated with mortality. A model-derived score assigned points for dehydration, hospital admission, and longer diarrhea duration but was not significantly better at predicting 14-day mortality than a modified Vesikari score.ConclusionsA composite severity score consistent with severe disease or dysentery may be a pragmatic clinical endpoint for severe shigellosis in vaccine trials. Reliance on culture for microbiologic confirmation may miss a substantial number of Shigella cases but is currently required to measure serotype specific immunity.

High Clostridium difficile Infection among HIV-Infected Children with Diarrhea in a Tertiary Hospital in Mwanza, Tanzania.

Clostridium difficile causes a million of illnesses each year worldwide and can affect people of all ages. Limited data exist on the prevalence of C. difficile infections (CDI) among children below five years of age in developing countries. This study is aimed at determining the prevalence, associated factors, and outcome of the Clostridium difficile infection among children with diarrhea attending a tertiary hospital in Mwanza, Tanzania. Stool samples were collected and cultured anaerobically to isolate Clostridium difficile, followed by C. difficile toxin A and B assay and ribotyping. A total of 301 children with diarrhea were enrolled. A total of 22 (7.31%, 95% CI: 0.89-0.95) nonrepetitive stool samples were positive for Clostridium difficile. Eighteen (81%) of C. difficile isolates were toxigenic, and 16 (72.7%) had unknown ribotypes. Independent predictors of positive C. difficile were as follows: positive HIV status, hospital stay of more than four days, high stool leukocyte count, and watery stool. Clostridium difficile-positive children had significantly higher median duration of the diarrhea than those without C. difficile. Clinicians should consider C. difficile as a possible cause of diarrhea in children living in developing countries and institute appropriate management to prevent associated morbidities and mortalities. Furthermore, there is a need of joint effort to improve C. difficile diagnosis and surveillance in developing countries to establish the unknown epidemiology of CDI in these countries.

Sapovirus: an emerging cause of childhood diarrhea

Sapovirus, a genus in the Caliciviridae family alongside norovirus, is increasingly recognized as an important cause of childhood diarrhea. Some challenges exist in our ability to better understand sapovirus infections, including the inability to grow sapovirus in cell culture, which has hindered diagnosis and studies of immunity. Another challenge is that individuals with sapovirus infection are commonly coinfected with other enteric pathogens, complicating our ability to attribute the diarrhea episode to a single pathogen. Development of molecular methods for sapovirus detection has increased our ability to measure disease prevalence. The prevalence of sapovirus varies between 1 and 17% of diarrhea episodes worldwide, with the highest burden in young children and older adults. Further, epidemiological studies have used novel approaches to account for the presence of coinfections with other enteric pathogens; one multisite cohort study of children under two years of age found that sapovirus had the second-highest attributable incidence among all diarrheal pathogens studied. Especially in settings where rotavirus vaccines have been introduced, efforts to reduce the overall burden of childhood diarrhea should focus on the reduction of sapovirus transmission and disease burden.

Prevalence and associated factors to rotavirus infection in children less than 5years in Enugu State, Nigeria.

Rotavirus is an important cause of morbidity and mortality in children 5 years and below. An epidemiological study was carried out to determine the prevalence of rotavirus in Enugu state and factors that contribute to the incidence in the state. Stool samples were collected from 179 children from different parts of the state. Rotavirus antigen was detected using enzyme immunoassay kit. A standardized structured questionnaire was used to obtain additional information from the parents/guardian of the children. Chi square was used to analyze the results and significance was determined at 0.05. The results showed 31.5% prevalence of rotavirus among children with acute gastroenteritis (AGE) and 25.7% prevalence in the general population. The prevalence was highest (60.9%) among children 0–12 months and decreased as the age increased. Rotavirus infection was significantly higher in bottle-fed children than in those feed exclusively breast milk. More viruses were detected in O (48.8%) and A (47.6%) blood group children than in children of other blood groups. More rotavirus caused AGE occurred in dry season compared to wet season, with highest incidence of both AGE and rotavirus infection occurring in January. Rotavirus diarrhoea was significantly associated with fever, vomiting and dehydration. The results of this study show that rotavirus continues to be an important cause of diarrhoea in children in this part of Nigeria and emphasize the need to factor in rotavirus and other viral agents in the diagnosis and treatment of diarrhoea in children 5 years and below.

Evidence for zoonotic transmission of species A rotavirus from goat and cattle in nomadic herds in Morocco, 2012-2014.

Species A rotaviruses (RVAs) are a leading cause of diarrhea in children and in the young of a large variety of mammalian and avian host species. The purpose of this study was to identify RVA in nomadic goats and calves during severe diarrhea outbreaks in 2012 and 2014 in Bouaarfa, Morocco, and to characterize the complete genomic constellation of two bovine and caprine strains (S18 and S19) and their genetic relatedness with the human strain ma31 detected in 2011 in Morocco. Partial nucleotide sequencing of VP4 and VP7 genes for the twenty-two positive samples revealed three circulating genotypes: G6P[14], G10P[14], and G10P[5] with predominance of G6P[14] genotype. Full-genome sequencing for both strains S18 and S19 presented, respectively, the following genomic constellations: G6-P[14]-I2-R2-C2-M2-A3-N2-T6-E2-H3 and G10-P[14]-I2-R2-C2-M2-A11-N2-T6-E2-H3. Phylogenetic analyses and the analysis of the VP8* antigenic epitopes for S18, S19 and ma31 revealed a shared similarity with bovine, caprine, ovine and human strains from Morocco and other countries. The VP2 and NSP1 genes of the S19 strain were closely related to those of the cognate genes of the human ma31 strain, while the VP4 gene of S18 strain was closely related to the cogent gene of the ma31 strain. Our findings revealed cases of zoonotic transmission and confirmed the risk of emergence of new genotypes in some environments such as nomadic regions, where close physical proximity between human and livestock is common. The present study is novel in reporting whole-genome analyses of RVA isolates obtained from nomadic livestock in Morocco.Electronic supplementary materialThe online version of this article (10.1007/s11262-020-01778-w) contains supplementary material, which is available to authorized users.

Common occurrence of Cryptosporidium hominis in children attending day-care centers in Medellin, Colombia.

Cryptosporidium spp. are apicomplexan protozoa associated with chronic diarrhea in AIDS and other immunocompromised patients, and one of the commonest causes of childhood diarrhea and malnutrition, particularly in low-income settings. In Colombia, there are few molecular epidemiological studies on Cryptosporidium spp.; thereby, the transmission dynamics of this parasite in the country is poorly known. This study evaluated the diversity of Cryptosporidium at species, subtype family, and subtype level in children attending various day-care centers in Medellin, Colombia. Two hundred and ninety stool samples from children < 5years of age were collected from April to November of 2015. All samples were processed by PCR and sequence analysis of the ssu RNA gene and the gp60 gene. An infection rate of 2.4% was observed, with only two Cryptosporidium species identified: C. hominis (6/7) and C. meleagridis (1/7). Cryptosporidium hominis isolates belonged to the subtypes IbA10G2, IaA13R6 and IaA13R7; IIIbA26G1R1 C. meleagridis subtype was also detected. There is a C. hominis predominance in the children evaluated, suggesting an important role of the anthroponotic transmission cycle in the day-care centers analyzed. Further investigation is required to determine infection sources and susceptible hosts in order to define appropriate management of cryptosporidiosis.

Immunochromatographic Test and ELISA for Detection of Rotavirus in Fecal Sample : A Comparative Study

Background: Rotavirus is a common cause of diarrhea in children. Early diagnosis of rotavirus infection helps to determine appropriate treatment thus preventing unnecessary use of antibiotics and minimizes its spread. Rapid test using lateral flow immunochromatography is a good alternative to Enzyme Linked Immunosorbent Assay (ELISA) with good sensitivity. This study was undertaken to compare Immunochromatographic Test (ICT) with ELISA for detection of rotavirus antigen in stool sample.&#x0D; Materials and methods: Ninety stool samples from hospitalized children less than two years of age with symptoms of acute gastroenteritis were tested by both ICT and ELISA. Sensitivity and specificity was compared.&#x0D; Results: Out of 90 samples 63.3% were positive for rotavirus antigen by ELISA and 51% were positive by ICT. Sensitivity and specificity of ICT was determined considering ELISA as a gold standard. Sensitivity of ICT was 80.7% whereas specificity was 100%.&#x0D; Conclusion: Rotavirus gastroenteritis cases can be diagnosed by rapid test (Immunochromatography) with high sensitivity and specificity&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 7-11

Enfeksiyöz ishallerde Campylobacter jejuni prevalansının çeşitli yöntemlerle araştırılması

In our study, stool samples that were sent to the department of Microbiology for routine bacteriologic culture and parasitological examination were used in to estimate the prevalence of Campylobacter jejuni. Samples collected for 6 months. We depend on traditional methods such as culture for identifying the C. jejuni strains and molecular methods. Fresh diarrheal stool samples were streaked on Skirrow blood agar and incubated in a microaerophilic conditions at two different temperatures (35°C, 42°C) for 48 hours. Conventional methods were used for identification of C. jejuni. Antibiotic susceptibilities of the isolates were tested by disc diffusion method and the results were evaluated according to the EUCAST guidelines. All stool specimens were re-evaluated using (BD MAX™) Enteric Bacterial Panel system by real-time PCR method targeting tuf gen regions of C. jejuni/coli. From a total of 300 stool samples tested by both culture and molecular methods, only 3 C. jejuni strains were isolated by culture; however, using molecular method a total of 5 C. jejuni/coli positive were given.In conclusion, the culture for Campylobacter jejuni should be routinely included in our laboratories because of its importance as a bacterial cause of diarrhea in children. Also molecular methods are thought to be useful in the detection.

Valeriana jatamansi Jones Inhibits Rotavirus-Induced Diarrhea via Phosphatidylinositol 3-Kinase/Protein Kinase B Signaling Pathway.

Rotavirus (RV), as the main cause of diarrhea in children under 5 years, contributes to various childhood diseases. Valeriana jatamansi Jones is a traditional Chinese herb and possesses antiviral effects. In this study we investigated the potential mechanisms of V. jatamansi Jones in RV-induced diarrhea. MTT assay was performed to evaluate cell proliferation and the diarrhea mice model was constructed using SA11 infection. Mice were administered V. jatamansi Jones and ribavirin. Diarrhea score was used to evaluate the treatment effect. The enzyme-linked immunosorbent assay was performed to detect the level of cytokines. Western blot and quantitative reverse transcription-PCR were used to determine protein and mRNA levels, respectively. Hematoxylin-eosin staining was applied to detect the pathological change of the small intestine. TdT-mediated dUTP nick-end labeling was conducted to determine the apoptosis rate. The results showed V. jatamansi Jones promoted MA104 proliferation. V. jatamansi Jones downregulated phosphatidylinositol 3-kinase (PI3K) and protein kinase B (AKT) in protein level, which was consistent with the immunohistochemistry results. Moreover, V. jatamansi Jones combined with ribavirin regulated interleukin-1β (IL-1β), interferon γ, IL-6, tumor necrosis factor α, and IL-10, and suppressed secretory immunoglobulin A secretion to remove viruses and inhibit dehydration. V. jatamansi Jones + ribavirin facilitated the apoptosis of small intestine cells. In conclusion, V. jatamansi Jones may inhibit RV-induced diarrhea through PI3K/AKT signaling pathway, and could therefore be a potential therapy for diarrhea.

Prevalence and antimicrobial susceptibility of Salmonella and Shigella species isolated from diarrheic children in Ambo town

BackgroundDiarrhea, particularly of enteric bacterial pathogen, remains a major cause of morbidity and mortality in Ethiopia. Despite the high prevalence of diarrheal disease among under-five children, antibiotic resistance of bacterial pathogens test is not part of routine childcare in the study area. This study aimed to investigate the prevalence and antimicrobial susceptibility status of Salmonella and Shigella species among diarrheic children attending public health institutions in Ambo town, west Showa, Ethiopia.MethodsInstitutional based, cross-sectional study was carried out from January to July 2014 among 239 diarrheic children below five years of age in Ambo town, Ethiopia. Information about patient demographics, signs, and symptoms was obtained from the parents/guardians of each child using a questionnaire. Stool samples from diarrheic children were collected and processed for isolation of Salmonella and Shigella using conventional microbiology procedures. Suspected Salmonella isolates were confirmed by genus-specific PCR and serotyped using a slide agglutination test. Susceptibility to 10 commonly used antimicrobials was assessed using the Kirby Bauer disc diffusion method.ResultsFrom the 239 children screened, only nine (3.8%) of them were positive for either Salmonella (n = 3) or Shigella (n = 6) and 19 (7.9%) positive for the intestinal parasite. Three species of Shigella were identified: Shigella flexinari (n = 3), Shigella boydii (n = 2), and Shigella sonnei (n = 1). The three Salmonella isolates were S. chicago, S. caracas, and S. saintpaul. Salmonella and Shigella isolates were resistant to ampicillin (88.9%), followed by tetracycline (66.7%), cotrimoxazole (55.6%), chloramphenicol (44.4%), amoxicillin (33.3%), nalidixic acid (11.1%) and cefotaxime (11.1%). All isolates were sensitive to amikacin, ciprofloxacin, and gentamycin.ConclusionIn this study, either Salmonella or Shigella species were detected only in 3.8% of diarrheic children in Ambo town, suggesting the dominance of other causes of diarrhea in the study area. A further study targeting other causes of diarrhea should be conducted to establish the major causes of childhood diarrhea in the study area.

Prevalence and factors associated with intestinal parasites among children of age 6 to 59\u2009months in, Boricha district, South Ethiopia, in 2018

BackgroundIntestinal parasites are the commonest cause of childhood diarrhea and malnutrition in Ethiopia. Information about intestinal parasites is the first fundamental step for designing intervention strategies against them. Hence, health planners can maximize their efforts. Information is scarce about intestinal parasites among children of under-five years of age in Boricha district. Therefore, this study aimed at assessing prevalence and factors associated with intestinal parasites among children of age 6 to 59 months in Boricha district, South Ethiopia.MethodsA community based analytical cross sectional study was conducted among 624 children of age 6 to 59 months from January 1 to 30; in 2018. We have utilized two stage stratified sampling method. Firstly, simple random sampling was used to select sample Kebeles. Secondly, systematic random sampling method was used to select the study participants. Structured and interviewer administrated questionnaire was used to collect data. Parasitological examination of children’s stool was conducted microscopically. Data were entered into Epi-info, exported and analyzed by SPSS version 22. Logistic regression analysis was conducted to identify association between explanatory variables and outcome variable. Adjusted Odds Ratio (AOR) with 95% confidence interval (95%CI) was computed, and P-value < 0.05 was considered as statistically significant. Descriptive statistics was presented using texts, tables and figures.ResultA total of 622 participants were included in the analysis which makes a response rate of 99.9%. Prevalence of intestinal parasites was 48.7% (95%CI, 44.8–52.6) in this study. Higher family size (AOR = 2.7, 95%CI = 1.5–5.0), medium family size (AOR = 2.3,95%CI,1.3–4.2), absence of laterine facility in the household (AOR = 2.9, 95% CI = 1.6–5.3), unable to put on shoes (AOR = 3.5,95%CI = 2.2–5.7), and eating raw vegetables (AOR = 2.6,95%CI = 1.6–4.7) were factors positively associated with intestinal parasites in this study.ConclusionOverall prevalence of intestinal parasites was almost high. Latrine facility, family size, shoes wearing habit and eating raw vegetables were significantly associated with intestinal parasites. Family planning service, sanitation and hygiene practices should be intensified through community education. Activate support of deworming program should be considered. Moreover, policy makers should give priority on creating awareness to prevent intestinal parasite.