Common Diarrheal Diseases Research Articles

Prevalence of Water Borne Diseases within Households in the Bamendankwe Municipality-North West Cameroon

In the developing countries four-fifth of all the illnesses are caused by water-borne diseases with diarrhea leading to dehydration being the leading cause of childhood death. Cholera, typhoid fever and hepatitis A are caused by bacteria, and are among the most common diarrheal diseases. Other illnesses, such as dysentery, are caused by parasites that live in water contaminated by the feces of sick individuals. The most common manifestation and cause of mortality in water borne diseases were as result of dehydration due to loss of copious amounts of electrolytes either in vomiting or diarrhea. The research question for the study was: What knowledge do households in Bamendankwe village possess in the practice of the prevention of water-borne diseases and what measures are employed in the prevention of the occurrence of water-borne diseases? The general objective was to assess the knowledge and practices of households in Bamendankwe village in the prevention of the occurrence of water-borne diseases; identify the problems encountered in its prevention and ascertain practical measures to be employed to resolve their occurrence. The specific objectives were: to assess the knowledge of households on the causes of water borne diseases; to determine the practical measures put in place to prevent the occurrence of water borne diseases; to identify the problems they face in the practice of the preventive measures against water borne diseases and to ascertain opinions of households on how to resolve difficulties/constraints in the implementation of preventive measures against water borne diseases.The descriptive cross-sectional study design was employed for the study where-in primary data was collected at one point in time from inhabitants of Bamendankwe municipality in order to collect responses on their knowledge and practices in the prevention of waterborne diseases as well as the constraints encountered in the prevention of its occurrence. The target population for this study comprised of youths, men and women who have lived in this village within the past 6 months irrespective of their sex, religion, occupation, nationality and socio-economic status. A sample size of 120 respondents was recruited for the study. Results show that out 120 respondents, 44 (37%) had basic education, 40(33%) went to secondary school and 36 (30%) attained university education. Eighty (67%) said water borne diseases were diseases transmitted by pathogenic micro-organisms, 40(33%) said that water borne diseases were diseases caused by drinking water from doubtful sources. They gave diverse responses as to the different types of waterborne diseases; with 18 (18%) out of the 60(60%) knew of typhoid, 15(25%) named cholera, 12(20%) talked of diarrhea, 10(17%) point out malaria and 5(8%) of the 60 knew of dysentery. Concerning the complications that ensue from waterborne pathologies, 40(33.3%) said severe dehydration can result as a complication of water borne diseases, 32 (26.6%), 40(33.3%) said death can result while 08 (6.6%) said it can result to hypovolemia. Thirty-six (30%) of respondents both faced financial and educational constraints in the prevention of water diseases, 30(25%) said they lack time, and 18 (15%) said it was difficult due to lack of community water project. Diverse proposal were made to salvage the encountered problems; 20% proposed frequent hand-washing, 25% proposed keeping containers always clean, 22% proposed the construction of pipe-borne stand-pipes, 17% proposed health educational lectures on waterborne diseases while 6% wished filters be provided in homes. From the data collected, and analysis made it be can be concluded that there exist knowledge deficit on the causes of water-borne diseases as well as the practical measures employed in the prevention of their occurrence as evidenced by the diverse responses gotten from them. Their understanding of the notions of hygiene and sanitation, the knowledge and practices on the prevention of water-borne diseases were not based on the level of education but on how much information they got via public health education concerning the causes and preventive measures of water-borne diseases. So, an up-to-date knowledge and practices on the prevention of the occurrence of water-borne diseases through corporate approach by stakeholders is necessary for the wellbeing of the Bamendankwe community. The Bamendankwe Council hygiene and sanitation officers should take it a responsibility to organize regular household checks for the availability of properly constructed toilet facilities in homes and equally provide public health education lectures in social institutions in order to enlighten the community on the importance of constructing appropriate toilets with lids at a satisfactory distance from the households to avoid flies contaminating foodstuffs.

A presentation of latent tropical sprue in a Canadian hospital

Tropical sprue (TS) is a chronic diarrheal disease of unknown etiology characterized by malabsorption and small bowel mucosal abnormalities. TS affects residents of, and visitors to, endemic tropical regions. Rarely the disease may remain latent for several years, and to date, few cases of latent TS have been reported in Europe or North America. However, in our increasingly multicultural communities and in a 'global village' where travel is common, clinicians must maintain a high index of suspicion for TS in patients presenting with diarrhea and malabsorption who have traveled to endemic regions. TS may mimic common diarrheal diseases that are seen in developed nations, including celiac disease, Crohn's disease, bacterial overgrowth, and other infectious etiologies. Accordingly, once these more common etiologies have been ruled out, TS must be considered in patients presenting with diarrhea after travel to endemic regions. We present a unique Canadian case of latent TS, with a brief review of the diagnostic approach and treatment.

Plant‐derived pharmaceuticals for the developing world

Plant-produced vaccines and therapeutic agents offer enormous potential for providing relief to developing countries by reducing the incidence of infant mortality caused by infectious diseases. Vaccines derived from plants have been demonstrated to effectively elicit an immune response. Biopharmaceuticals produced in plants are inexpensive to produce, require fewer expensive purification steps, and can be stored at ambient temperatures for prolonged periods of time. As a result, plant-produced biopharmaceuticals have the potential to be more accessible to the rural poor. This review describes current progress with respect to plant-produced biopharmaceuticals, with a particular emphasis on those that target developing countries. Specific emphasis is given to recent research on the production of plant-produced vaccines toward human immunodeficiency virus, malaria, tuberculosis, hepatitis B virus, Ebola virus, human papillomavirus, rabies virus and common diarrheal diseases. Production platforms used to express vaccines in plants, including nuclear and chloroplast transformation, and the use of viral expression vectors, are described in this review. The review concludes by outlining the next steps for plant-produced vaccines to achieve their goal of providing safe, efficacious and inexpensive vaccines to the developing world.

PTH-052 Microscopic Colitis Is Expensive To Diagnose: An Analysis Of The Utility Of Random Colonic Biopsies

IntroductionMicroscopic colitis is reported in up to 9.5% of patients with watery diarrhoea, and in almost 20% of those older than 701. The Joint Advisory Group on GI Endoscopy mandates...

Azathioprine and mercaptopurine in the management of patients with chronic, active microscopic colitis

Microscopic colitis (MC) is a common chronic diarrhoeal disease, and remission can be induced with budesonide. However, diarrhoea relapses frequently when budesonide is tapered and a few patients become budesonide intolerant. To examine retrospectively the effect of azathioprine (AZA) and mercaptopurine (MP) in patients with chronic, active MC. Data on all MC patients who received AZA or MP in the years 1997-2011 at three centres representing three countries were pooled for analysis. The indications for thiopurine therapy were frequent relapses after short-term treatment (N = 26), budesonide dependency on 6 mg (N = 15) and budesonide intolerance (N = 5). The response to thiopurine treatment was defined as clinical remission, intolerance or nonresponse. Forty-six MC patients (32 CC and 14 LC), 32 female; median age 59 years (range: 36-83) with a median disease duration of 3 years (range: 0.5-18) were included. Thirteen patients (28%) achieved long-term clinical remission on AZA therapy. AZA failed in 31 patients (67%) due to intolerance and in 2 patients (4%) because of nonresponse. Thirteen of 31 AZA-intolerant patients were switched to MP and 6 patients (46%) obtained clinical remission. Thus, the overall response rate to thiopurines was 19/46 (41%). The main side effects were nausea/vomiting and abnormally elevated liver enzymes. In this retrospective case series, the majority of chronic, active MC patients were intolerant to AZA leading to cessation of treatment. However, further studies are needed to explore the efficacy, acceptance, tolerance and safety of MP in patients with chronic, active MC refractory to budesonide.

A Homogenous Luminescence Assay Reveals Novel Inhibitors for Giardia LambliaCarbamate Kinase

The human pathogen Giardia lamblia is an anaerobic protozoan parasite that causes giardiasis, one of the most common diarrheal diseases worldwide. Although several drugs are available for the treatment of giardisis, resistance to these drugs has been reported and is likely to increase. The Giardia carbamate kinase (glCK) plays an essential role in Giardia metabolism and has no homologs in humans, making it an attractive candidate for anti-Giardia drug development. We have developed a luminescent enzyme coupled assay to measure the activity of glCK by quantitating the amount of ATP produced by the enzyme. This assay is homogeneous and has been miniaturized into a 1536-well plate format. A pilot screen against 4,096 known compounds using this assay yielded a signal-to-basal ratio of 11.5 fold and Z’ factor of 0.8 with a hit rate of 0.9 % of inhibitors of glCK. Therefore, this Giardia lamblia carbamate kinase assay is useful for high throughput screening of large compound collection for identification of the inhibitors for drug development.

Novel Structural Components of the Ventral Disc and Lateral Crest in Giardia intestinalis

Giardia intestinalis is a ubiquitous parasitic protist that is the causative agent of giardiasis, one of the most common protozoan diarrheal diseases in the world. Giardia trophozoites attach to the intestinal epithelium using a specialized and elaborate microtubule structure, the ventral disc. Surrounding the ventral disc is a less characterized putatively contractile structure, the lateral crest, which forms a continuous perimeter seal with the substrate. A better understanding of ventral disc and lateral crest structure, conformational dynamics, and biogenesis is critical for understanding the mechanism of giardial attachment to the host. To determine the components comprising the ventral disc and lateral crest, we used shotgun proteomics to identify proteins in a preparation of isolated ventral discs. Candidate disc-associated proteins, or DAPs, were GFP-tagged using a ligation-independent high-throughput cloning method. Based on disc localization, we identified eighteen novel DAPs, which more than doubles the number of known disc-associated proteins. Ten of the novel DAPs are associated with the lateral crest or outer edge of the disc, and are the first confirmed components of this structure. Using Fluorescence Recovery After Photobleaching (FRAP) with representative novel DAP::GFP strains we found that the newly identified DAPs tested did not recover after photobleaching and are therefore structural components of the ventral disc or lateral crest. Functional analyses of the novel DAPs will be central toward understanding the mechanism of ventral disc-mediated attachment and the mechanism of disc biogenesis during cell division. Since attachment of Giardia to the intestine via the ventral disc is essential for pathogenesis, it is possible that some proteins comprising the disc could be potential drug targets if their loss or disruption interfered with disc biogenesis or function, preventing attachment.

High-ThroughputGiardia lambliaViability Assay Using Bioluminescent ATP Content Measurements

The human pathogen Giardia lamblia is an anaerobic protozoan parasite that causes giardiasis, one of the most common diarrheal diseases worldwide. Although several drugs are available for the treatment of giardiasis, drug resistance has been reported and is likely to increase, and recurrent infections are common. The search for new drugs that can overcome the drug-resistant strains of Giardia is an unmet medical need. New drug screen methods can facilitate the drug discovery process and aid with the identification of new drug targets. Using a bioluminescent ATP content assay, we have developed a phenotypic drug screen method to identify compounds that act against the actively growing trophozoite stage of the parasite. This assay is homogeneous, robust, and suitable for high-throughput screening of large compound collections. A screen of 4,096 pharmacologically active small molecules and approved drugs revealed 43 compounds with selective anti-Giardia properties, including 32 previously reported and 11 novel anti-Giardia agents. The most potent novel compound was fumagillin, which showed 50% inhibitory concentrations of 10 nM against the WB isolate and 2 nM against the GS isolate.

Congenital Diarrheal Disorders: Improved Understanding of Gene Defects Is Leading to Advances in Intestinal Physiology and Clinical Management

Congenital diarrheal disorders (CDD, Online Mendelian Inheritance in Man [OMIM] 251850) represent one of the most challenging clinical conditions for pediatric gastroenterologists because of the severity of the clinical picture and the broad range of disorders in its differential diagnosis. The number of conditions included within CDD has gradually increased. Recent advances made in the pathophysiology of these conditions have led to a better understanding of the more common diarrheal diseases. Based on the body of data accumulated in recent years, we suggest that CDD be classified in 4 categories depending on the alteration in absorption and transport of nutrients and electrolytes, enterocyte differentiation and polarization, enteroendocrine cell differentiation, and modulation of the intestinal immune response. Our knowledge of the genes responsible for CDD is also rapidly increasing, thanks to linkage studies based on genome-wide analysis of polymorphisms. In this context, the identification of disease genes is a step forward in the diagnostic approach to a patient in whom CDD is strongly suspected. However, it is conceivable that faster, less expensive molecular procedures will, in the near future, become available. This approach could spare the patient invasive procedures and limit complications associated with a delay in diagnosis. Furthermore, carrier and prenatal molecular diagnosis may help pediatricians better manage the condition in the early stages of life.

Importance of the detection of amoebic antigens in stool samples for the diagnosis ofEntamoeba histolyticainfection, among children in southern Turkey

Entamoeba histolytica is the predominant causative agent of human amoebiasis, a significant and common diarrhoeal disease among children of developing countries. Diagnosis of this illness by the microscopical detection of the parasites in stool samples is insensitive and often incapable of differentiating the pathogenic Entamoeba histolytica from the commensal parasite E. dispar. In this study, the results of testing stool samples in an ELISA, based on a monoclonal antibody, that detects E. histolytica-specific galactose adhesin were compared against the results of the microscopical examination of the same samples. The samples investigated came from 131 children (aged<15 years) with diarrhoea, who lived in the provinces of Adana and Mersin, in southern Turkey. Overall 22 cases of E. histolytica infection, including eight that appeared negative by microscopy, were detected using the ELISA. The 16 patients considered positive for E. histolytica/E. dispar by microscopy included two who were ELISA-negative. With the ELISA results used as the 'gold standard', and assuming that all the E. histolytica/E. dispar cysts seen by microscopy were E. histolytica, microscopy had a specificity of 98.2%, a positive predictive value of 87.5% and a negative predictive value of 93.1% but a sensitivity of only 63.6%. Compared with microscopy, culture and PCR-based assays, the antigen-detection ELISA appears to be easier, faster and probably more cost-effective, with high sensitivity, specificity and predictive values.

Giardiasis: host-pathogen biology.

Giardiasis is the most common waterborne diarrheal disease in the United States and is highly prevalent throughout the world. The clinical spectrum of disease ranges from asymptomatic infection to persistent severe malabsorption. The precise interaction between Giardia and its human host remains conjectural because of the paucity of published studies that address the details of its pathogenesis. The immune system of the host responds to this protozoan parasite, and the intestinal epithelium is a site of interaction between parasite and host. Possible mechanisms whereby Giardia may alter the host's absorption of nutrients at the epithelial level include direct physical interference, toxin secretion, direct physical alteration of the epithelium, competition for nutrients, induction of an inflammatory response, and coincidental infection of the host with a second organism. The host's immune system may play both a protective and a pathogenic role.