Cases Of Diarrhea In Children Research Articles

Sanitation risk factors contributing to diarrhea in children below five years in Igembe South Sub-County, Meru County, Kenya.

Introduction: Lack of safe water, poor hygiene, and poor sanitation account for about 90% of the diarrheal diseases in the world. Globally, half a million people lack adequate sanitation, leading to fatalities for over five million people annually. In Kenya, diarrhea still remains one of the top five causes of morbidity and mortality in children below 5 years.
 Aim: To identify the household sanitation risk factors contributing to diarrhea in under-five-year-old children in Igembe South Sub County in Meru County, Kenya.
 Study Design: A retrospective and cross-sectional study.
 Place and Duration of the study: Nyambene Sub-County Hospital, Igembe South Sub-County in Meru County, Kenya between December 2022 and March 2023.
 Methodology: The sample size was 196 children calculated from a population of 3,332 children who had diarrhea in Igembe South Sub County out of 22412 children who had diarrhea in Meru County for the last year. Data was analyzed by use of SPSS (2022) and ANOVA.
 Results: The study found a strong link (p=0.0034) between diarrhea cases in children under five and the absence of household latrines, as well as sanitation-related factors. It noted that many households lacked proper latrines, and many caregivers did not practice hand washing after handling child feces.
 Conclusion: The study identified access to safe drinking water as a key factor in reducing diarrhea in young children. The study recommends close monitoring of sanitation facilities and ongoing assessments of water source safety by the County Government of Meru and other stakeholders to improve overall hygiene and reduce diarrhea cases in the region.

PEMETAAN KASUS DIARE PADA BALITA DENGAN MENGGUNAKAN SISTEM INFORMASI GEOGRAFIS DI KOTA DENPASAR TAHUN 2022

Background: Diarrhea is the biggest contributor to the number one mortality rate among toddlers in Indonesia. Based on data findings from the Denpasar City Health Office, cases of diarrhea under five in Denpasar City from 2020-2022 have increased. Therefore, it is necessary to provide information in the form of a digital map that can be used to find out trends, descriptions of demographic characteristics, and the distribution of cases of diarrhea under five in the city of Denpasar. Methods: This study uses a quantitative descriptive research method. The sample in this study was 354 data from toddler patients with diarrhea. Data collection for arrest is carried out by taking the coordinates of the patient directly in the field. Results: The results of this study indicate that the trend of cases of diarrhea in children under five from 2020-2022 has increased. Based on the incident, the highest cases of diarrhea in toddlers occurred in South Denpasar District and the lowest cases occurred in East Denpasar District. Demographic data shows that diarrhea among toddlers is most common in toddlers aged less than two years and is male and is supported by an unhealthy environment and overcrowding. Conclusion: Therefore the use of the ArcView application can be a solution to make it easier for the Health Office or other health installations to obtain complete information about cases of diarrhea under five from reporting the presentation of statistical data in map form.

Analysis of Knowledge and Attitudes of Mothers with Toddlers at Risk of Diarrhea in the Moramo Health Center Working Area South Konawe Regency

Background: The incidence of diarrhea in Indonesia is the second leading cause of death in children under 5 (five) years of age. Data on the number of cases of diarrhea in children in 15 districts and 2 (two) cities in Southeast Sulawesi Province. South Konawe Regency is in second place with the most cases of diarrhea in toddlers, totaling 77 cases. South Konawe Regency has 24 Community Health Center working areas. In the Moramo Community Health Center area, there were 41 cases of diarrhea in 2021.
 Method: The type of research used in this research is quantitative with an observational method with a Case Control Study Design approach. This research was carried out in August 2022. This research will be carried out in the Moramo Health Center Work Area, South Konawe Regency, Southeast Sulawesi Province. With a sample of 76 respondents. The sampling technique used in this research was Simple Random Sampling.
 Result: The results of the research are known from the results of the analysis X2Hit 15.221 > Hit 10,344> df=1), ϕ = 0.504.
 Conclusion: It is hoped that parents, especially mothers who have toddlers, can increase their knowledge about the causes of diarrhea, improve their attitudes to avoid diarrheal disease, especially in toddlers.

An impact assessment of the use of aerial logistics to improve access to vaccines in the Western-North Region of Ghana

BackgroundPrevention of infectious diseases among children is crucial to improve child health and survival. However, many countries in Sub-Saharan Africa struggle to achieve vaccination targets due to supply chain challenges, which lead to vaccine shortages, stockouts, and increased costs. We evaluated the effects of aerial logistics (centralized storage and delivery by drones) on vaccine stock, stockouts, vaccination coverage and vaccine preventable outcomes in the Western North Region of Ghana. MethodsThe study combined retrospective quasi-experimental and cross-sectional designs to evaluate supply chain, programmatic, and clinical outcomes. Surveys to health providers were used to collect information from a random sample of 156 facilities, and secondary data on vaccination coverage and clinical outcomes was analyzed at the district level for the years 2017–2021. ResultsFacilities served by aerial logistics reported significant reductions in the duration of vaccine stockouts (30 %, p-value < 0.05), as well as in the frequency of missed opportunities for vaccination (44 %, p-value < 0.05). Being served by aerial logistics was associated with increased satisfaction with access to vaccines. Significant differences in vaccination coverage were found for most vaccines, in a range between 13.1 and 37.5 percentage points in vaccination coverage for served districts. Infectious diarrhea cases in children between 5 and 9 years old were reduced by 41.6 % (p-value < 0.05). ConclusionEnd-to-end aerial logistics appears as an effective tool to improve the performance of the supply chain for vaccines. The strategy potentially increases the resilience of the health system and contributes to increased vaccination coverage and higher levels of satisfaction among providers in the Western North Region of Ghana.

Genotyping of Escherichia Coli Isolated from Diarrhea Cases in Children under Five Years of age Using the PFGE Method

Twenty –five isolates of Escherichia coli isolated from cases of diarrhea in children under five years of age were obtained, characterized by Extensively Drug-Resistant(XDR) resistance patterns, and sensitivity screening of isolates was performed.E7 isolates were resistant to 4 groups of antibiotics and E5 - E13 - E14 - E17 - E18 - E20 - E47 - E46 - E42 - E31 - E26 isolates resistant to 5 groups of antibiotics and 48E isolate resistance to 6 groups of antibiotics and consisting of E2 E38 - E36 - E34 - E28 - E16 - E10isolates showed resistance to 7 groups of antibiotics, and E41 - E24 - E19 - E9 –E1 isolates resistance to 8 groups of antibiotics. The genotyping of 25 E.coliisolates was carried out by Pulsed-field Gel Electrophoresis (PFGE) using restriction endonucleases (Xbal) which belong to different phylogenetic groups, were as group A, group B2, group D (2/25 and 8%) group C (4/25 and 16%), group F (3/25 and 12%), group E (12/25 and 48%). The genetic convergence rate of isolates is 83%, and this is due to the similarity in genetic content, the source of isolation, and the place of isolation itself. Bangladesh Journal of Medical Science Vol.22 (Special Issue) 2023 p.18-24

Prevalence of rotavirus infection in children under five years, referring to Indira Gandhi Children's Health Hospital, Kabul, Afghanistan

Background: bout 5% of children's deaths in Afghanistan are related to severe rotavirus infections. The aim of this research is to investigate the status of rotavirus gastroenteritis among Afghan children referred to Indira Gandhi Children's Health Hospital from May 2018 to May 2019. Methods: A cross-sectional study has conducted at Indira Gandhi Children's Health Hospital. 422 stool samples were examined for rotavirus and questionnaires were filled Results: Out of 422 children (244 (57.8%) male and 178 (42.2%) female) examined, 215 children (131 (60.9%) male and 84 (39.1%) female) were positive for rotavirus infection. Significant differences were observed between positive and negative rotavirus cases from the point of view of diarrhea duration time, frequency of diarrhea/24hours and frequency of vomiting/24 hours. Conclusion: Still more than 50% of diarrhea cases in children are related to rotavirus. The findings of this research emphasize the fact that the Ministry of Health of Afghanistan should seriously follow control and preventive strategies, especially in warm seasons.

Relationship between Human Development Index and Gross Regional Domestic Product on Sanitation Access in East Java Region in Achieving Sustainable Development Goals

The policy of full access to sanitation through the Sustainable Development Goals (SDGs) (2015–2030) requires community participation. The role of society in this regard can depend on the Human Development Index (HDI) and Gross Regional Domestic Product (GRDP). The incidence of diarrhea in all age groups is only 3.5%. East Java is a province that contributes significantly to the number of cases of diarrhea in children under five in Indonesia, so sanitation is critical. This study aimed to determine the effect of HDI and GRDP simultaneously on sanitation access in districts and cities in East Java Province. This research was conducted using secondary data from the Central Statistics Agency of East Java Province. The data analysis method used is multiple linear. HDI and GRDP variables positively and significantly impact the number of sanitation access districts and cities of East Java Province in 2016-2019. GRDP partially has a regression coefficient of 0.223 greater than HDI, which means that an increase in GRDP by one unit of rupiah causes an increase in the achievement of sanitation access in East Java Province. As policymakers and implementers, local governments must pay attention to HDI and GRDP to access proper sanitation in East Java Province.

THE INFLUENCE OF CLIMATE FACTORS ON DIARRHEA CASES IN CHILDREN UNDER FIVE YEARS BEFORE AND AFTER THE COVID-19 PANDEMIC IN BANJARMASIN

Abstract: Background: Diarrhea still become one of the leading causes of morbidity and mortality in children, especially under 5 years. Anthropogenic climate change, mainly due to global warming process, is expected to change the epidemiological pattern of infectious diseases, including diarrhea. COVID-19 pandemic that has occurred globally since March 2020 may also have an impact. Banjarmasin as a city in a wetland area with tropical savanna climate that also affected by COVID-19 pandemic is also at risk. We conducted a research to study the influence of climate factors on diarrhea cases in children under 5 years before and after the COVID-19 pandemic in Banjarmasin.Methods: Data of monthly diarrhea cases in children under 5 years at public health centers from Banjarmasin City Health Office and monthly climate data (amount of rainfall, number of rain days, temperature, humidity, sunshine duration, wind speed) from BMKG and BPS between January 2010 to April 2021 were collected. Statistical analysis was carried out to determine the correlation between climate factors and diarrhea cases before and after COVID-19 pandemic.Results: There was a decrease in the average monthly visits of children under five years with diarrhea before (497 ±47.4) and after (132 ±45.8) COVID-19 pandemic. Among climate factors, amount of rainfall (r=-0.753; p=0.005), number of rain days (r=-0.774; p=0.003), and humidity (r=-0.590; p=0.044) were negatively correlated, while sunshine duration (r=0.674; p=0.016) was positively correlated with diarrhea cases in the period before COVID-19 pandemic. No correlation was found between any climate factor and diarrhea cases in the subsequent period.Conclusion: Diarrhea cases in children under 5 years in Banjarmasin tend to increase in dry season, however during COVID-19 pandemic there were some changes in society, such as working from home, reluctance to go to health facilities which might affect the usual trend. Keywords: Anthropogenic climate change; Climate factors; COVID-19 pandemic; Diarrhea under 5 years; Wetland

Indirect effects of the SARS CoV-2 pandemic on the prevalence of breastfeeding: Modeling its impact.

:Introduction: Breastfeeding has a protective effect against acute respiratory and diarrheal infections. There are psychological and social effects due to physical isolation in the population in the mother-child group.Objective: To assess the impact on infant mortality due to a decrease in the prevalence of breastfeeding during 2020 due to the physical isolation against the SARS CoV-2 (COVID-19) pandemic in Colombia.Materials and methods: We used the population attributable risk approach taking into account the prevalence of breastfeeding and its potential decrease associated with the measures of physical isolation and the relative risk (RR) of the association between exclusive breastfeeding and the occurrence of acute infection consequences in the growth (weight for height) of children under the age of five through a mathematical modeling program.Results: We found an increase of 11.39% in the number of cases of growth arrest in the age group of 6 to 11 months with a 50% decrease in breastfeeding prevalence, as well as an increase in the number of diarrhea cases in children between 1 and 5 months of age from 5% (5.67%) on, and an increased number of deaths in children under 5 years (9.04%) with a 50% decrease in the prevalence of exclusive breastfeeding.Conclusions: A lower prevalence of breastfeeding has an impact on infant morbidity and mortality in the short and medium-term. As a public health policy, current maternal and childcare strategies must be kept in order to reduce risks in the pediatric population.

ASSESSMENT OF KNOWLEDGE, ATTITUDES AND PRACTICES OF CONSUMERS REGARDING FOOD SAFETY IN BAHRI LOCALITY, KHARTOUM STATE, SUDAN

Food borne illnesses are prevalent in all parts of the world. Contaminated food Contributes to 1.5 billion cases of diarrhea in children each year, resulting in more than three million premature deaths (WHO).&#x0D; This study was conducted in August 2016 in Bahri locality, Khartoum state, to evaluate the knowledge, attitudes and practices of the consumers regard food safety.&#x0D; A total of questionnaire guided face to face interview with 120 respondents were carried out. Major food safety knowledge concepts include clean and hygiene, general sanitation, safe storage of food, proper cooking of food, use of thermometer in cooking. In general, the respondents had good knowledge about some food safety related issues and not enough knowledge about other issues.&#x0D; The results of the questionnaire showed that most of the respondents know the importance of washing hands before handling food 63% and wash the instruments and cleaning of the counter just after the preparation of the meal 83%. The results of the questionnaire revealed that 50% of the respondents know the importance of covering hands with a bandage and gloves when preparing food with cuts on their hands. Also, its reveal that 80% of the respondents didn`t know the proper way of thawing, and 84.2% of the respondents didn`t know food thermometer which use to ensuring proper cooking.&#x0D; This study recommend for Consumers should know and apply the five keys to safer food and implementing more training programs to the consumers to improve knowledge, attitudes and practices towards food safety.

SYNERGISTIC IMMUNOMODULATORY ACTIVITY OF PROBIOTICS BIFIDOBACTERIUM ANIMALIS AND LACTOBACILLUS CASEI IN ENTEROAGGREGATIVE ESCHERICHIA COLI (EAEC)-INFECTED CACO-2 CELLS.

Enteroaggregative Escherichia coli (EAEC) is an E. coli pathotype that presents aggregative adhesion patterns on in vitro cultivated cells, mainly related to persistent diarrhea cases in children. EAEC virulence factors are important for host colonization and pathogeni-city. Intestinal epithelial cells (IECs) recognize pathogen-associated molecular patterns (PAMPs) and initiate an immune response. Several studies using in vivo and in vitro models emphasize the probiotic activity and immunomodulatory capacity of Lactobacillus and Bifidobacterium species. To evaluate the modulation of cytokine production by probiotics Bifidobacterium animalis and Lactobacillus casei in human intestinal Caco-2 cells exposed to different strains of EAEC. Caco-2 cells were incubated with EAEC strains in the presence or absence of probiotics. The production of cytokines IL-8, TNF-α, IL-1β and IL-10 was evaluated in the supernatants by a sandwich enzyme-linked immunosorbent assay (ELISA). Cytokine production did not change when uninfected and EAEC-infected Caco-2 cells were exposed to probiotics separately. All EAEC induced a significant increase in IL-8 production by Caco-2 cells, but the probiotics, even together, could not reduce its production. On the other hand, the synergic activity of probiotic strains significantly increased TNF-α production but decreased the basal production of IL-1ß. Also, probiotics induced a significant increase in the production of the anti-inflammatory cytokine IL-10 during EAEC infection. Our results reinforce the synergistic immunomodulatory activity of probiotics during EAEC infection.

Factors Associated with the Incidence of Diarrhea in Toddlers in Legok Village

The number of diarrhea cases in children under five in Jambi City in 2019 was 3,621 cases. Of the 20 existing community health centers, the Putri Ayu community health center had the highest prevalence, namely 11.79% cases of diarrhea in children under five. Kelurahan Legok is a sub-district in the working area of the Putri Ayu community health center with the highest cases of diarrhea in under-five, namely 45 cases. The research design was case control. The sample of the research case was 45 mothers who had diarrhea with toddler, the control sample was 45 mothers who had no diarrhea. The research instruments were questionnaires and observation sheets. Data collection techniques are interviews and observation. Data were analyzed by univariate and bivariate using the chi-square test. The analysis showed that 73.2% of respondents had low risk clean water facilities, 57.1% of respondents had medium risk latrines and 60.7% of respondents had good parenting styles. The biariat results showed a relationship between clean water facilities (p = 0.016; OR = 6.25), latrine risk level (p = 0.015; OR = 4.6) and parenting patterns (p = 0.014; OR = 4.9) with the incidence of diarrhea in children under five in the Kelurahan Legok, the Working Area of the Putri Ayu community health center, Jambi City in 2020. The community health center conducts community empowerment in relation to the availability of basic sanitation facilities to reduce the risk of diarrhea incidence Increase parental awareness in preventing diarrhea through efforts to improve maternal parenting, both feeding practices, caring for toddlers, maintaining personal and toddler hygiene and time to interact with toddlers.

Vaccines for Protecting Infants from Bacterial Causes of Diarrheal Disease.

The global diarrheal disease burden for Shigella, enterotoxigenic Escherichia coli (ETEC), and Campylobacter is estimated to be 88M, 75M, and 75M cases annually, respectively. A vaccine against this target trio of enteric pathogens could address about one-third of diarrhea cases in children. All three of these pathogens contribute to growth stunting and have demonstrated increasing resistance to antimicrobial agents. Several combinations of antigens are now recognized that could be effective for inducing protective immunity against each of the three target pathogens in a single vaccine for oral administration or parenteral injection. The vaccine combinations proposed here would result in a final product consistent with the World Health Organization’s (WHO) preferred product characteristics for ETEC and Shigella vaccines, and improve the vaccine prospects for support from Gavi, the Vaccine Alliance, and widespread uptake by low- and middle-income countries’ (LMIC) public health stakeholders. Broadly protective antigens will enable multi-pathogen vaccines to be efficiently developed and cost-effective. This review describes how emerging discoveries for each pathogen component of the target trio could be used to make vaccines, which could help reduce a major cause of poor health, reduced cognitive development, lost economic productivity, and poverty in many parts of the world.

Time series analysis of the relationship between diarrhea in children and Rota 2 vaccine in the Fanteakwa District of the eastern region of Ghana

BackgroundRotavirus is considered the main causal factor of severe gastroenteritis among infants and children globally. The association with severe rotavirus infection is mostly worse among the least developed countries, mainly due to inadequate access to medical care and poverty. This study was conducted to determine the seasonal effects in respect of diarrhea cases in children, the association between diarrhea cases and Rota2 vaccine in the Fanteakwa District of the Eastern Region of Ghana.MethodsThe study compares monthly diarrhea cases against children vaccinated with Rota2 extracted from DHIMS2 spanning May 2012 to December 2017 in Fanteakwa District. A univariate association between diarrhea cases and children vaccinated with Rota 2 was conducted using the R-software version 3.4.4 with the use of forecast, tseries and TSAPred. Pearson Correlation coefficient was also computed between monthly diarrhea cases and Rota 2 as well as lagged values of Rota 2 and Diarrhea cases.ResultsThe study shows that February recorded the highest average number of diarrhea cases (172) over the period 2012 to 2017 with a standard deviation of 59. However, a one-way analysis of variance shows a significant difference amongst the monthly averages with an F-statistic of 0.042 and P-value of 0.064. It is observed that the correlations between each of the Rota2 doses and the lagged cases are positive, showing higher Rota2 doses a month ago ((Xt − 1),0.346 to0.735), two months ago ((Xt − 2),0.383 to 0.746), three months ago ((Xt − 3), 0.330 to 0.737) and four months ago ((Xt − 4), 0.236 to 0.723) are associated with lower diarrhea cases. The results also show that an increase in the previous two month’s Rota2 figures by 100 is associated with a significant decrease in the currently expected diarrhea cases by approximately 36.ConclusionSeasonal variations exist in the occurrence of diarrhea in children, with January recording the highest number of diarrhea cases (172). There is a relationship between episodes of diarrhea in children and Rota2 (p-value = 0.064); thus, the more children are vaccinated with Rota2, the less diarrhea cases are recorded. Diarrhea cases in Fanteakwa district are generally low, except 2013 and 2016 where the cases are higher than the rest of the other years.

Assessment of the Rapid Immunochromatographic Test as a Diagnostic Tool for Norovirus Related Diarrhea in Children

In developing countries, Norovirus is the second-leading cause of acute diarrhea, after rotavirus. The approved gold standard method for diagnosis of norovirus infection is RT-PCR. The rapid immunochromatographic test is a novel and expedient method for diagnosing norovirus that is relatively affordable. However, the use of the rapid immunochromatographic test remains controversial because of its accuracy. This study aimed to explore whether the rapid immunochromatographic test could be used for diagnosing norovirus-related diarrhea in children. Rapid immunochromatographic test (QuickNaviTM-Norovirus2) and RT-PCR on stool samples was used to diagnose norovirus. Stool samples were obtained from pediatric patients aged between 1 and 60 months who had diarrhea and were admitted to the pediatric ward at Dr. Soetomo General Hospital Surabaya, between April 2013 and March 2014. Ninety-four subjects provided stool samples that were tested using QuickNaviTM-Noro2 and RT-PCR. Using the test, 64 samples tested positive for norovirus and 30 tested negatives. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the rapid immunochromatographic test were consecutively 90.3%, 42.9%, 43.8%, 90%, and 58.5%. RT-PCR was used to test all samples to assess the accuracy, which showed that one from 31 samples contained the GI strain (1.1%), while 30 samples (32%) contained the GII strain. This study definitively establishes that the rapid immunochromatography test is not sufficiently accurate for use as a screening or diagnostic tool in norovirus-related diarrhea cases in children.

Chronic Diarrhea in Children Under Five Years Old

Diarrhea is an endemic disease in Indonesia and has the potential to cause outbreaks that are often accompanied by death, even the mortality rate during outbreaks in 2017, amounting to 1.97%, had not yet reached the expected target by the government, which is less than 1%. This study aims to determine the distribution of sex, age, nutritional status based on weight/age, and how to leave the hospital for chronic diarrhea patients and to know the correlation between nutritional status based on weight/age and death cases of chronic diarrhea in children under five years old treated at RSUD Dr. Soetomo in the period 2015-2019. This research was a retrospective analytical and descriptive study using secondary data from a patient's electronic medical record. Results showed that out of 45 chronic diarrhea patients, 28 (62,2%) were male, 16 (35,6%) children were in the 0 - 5 months age group, 18 (40,0%) children had good nutritional status, 39 (86,7%) children were discharged from the hospital, and there was a significant correlation between nutritional status based on weight/age and death cases of chronic diarrhea in children (p = 0,017). It could be concluded that the majority of children with chronic diarrhea were male, were in the 0 - 5 months age group, had good nutritional status, and were discharged from the hospital which meant that their condition had improved or cured and there was a significant correlation between nutritional status based on weight/age with death cases of chronic diarrhea in children.

Using RFLP-PCR Technique in Determining Genotypes of Giardia lamblia from Diarrhea Cases in Children in AL-Diwaniyah City, Iraq

Introduction: Giardia lamblia is one of the most prevalent intestinal protozoa in the world, which affect children in both undeveloped and developing countries. This study aimed to determine genotypes of the Giardia lamblia using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP)-PCR techniques. Additionally, the relationship between genotype patterns and their geographical distribution, gender, and age was investigated. Methods: The current study included 926 samples of faeces of children suffering from diarrhoea, who visits the internal clinics at Teaching Hospital, and Child Hospital in AL- Diwaniyah City from November 2012 - Jun 2013. For age groups of 1-12 years exclusively. The samples were examined using a direct mount wet smear, The positive samples were preserved without adding preservatives at a temperature of -20°C until the DNA extraction for G. lamblia genotyping by using PCR and RFLP-PCR technique. Results: Giardia lamblia was detected in 2.15% (20/926) of samples from diarrhea cases in children by amplification of glutamate dehydrogenase gene (gdh) using two specific primers GDHiR and GDHiF. It was revealed that 7 samples belonged to genotype A (35%) and 13 samples belonged to genotype B (65%). All genotype A samples belonged to subgenotype AII (100%), while genotype B samples belonged to subgenotypes BIII (53.61 %) and BIV (47.38 %). Genotype A was detected in children of 1-6 years of age while B genotype was detected in all age groups. Both of the genotypes have been detected in both genders (male and female) and genotype B was found in both urban and rural areas; however, its prevalence was higher in rural areas than in urban areas (100% and 30%, respectively). Conclusion: There are two genotypes of Giardia lamblia, genotype A and genotype B, each of which has secondary genetic patterns which include AII, BIII, and BIV.

Acute Diarrhea in Children Under-5 Years at Tanah Kali Kedinding Primary Health Care Surabaya

Diarrhea is a disease that still be a health problem in the world, including Indonesia. The number of cases of diarrhea in children under five in East Java had increased in prevalence from 6.6% in 2013 to 10.7% in 2018. Deaths in diarrhea usually occurred as a result of severe dehydration which 70% -80% of them were children under-5 years. This study aimed to know the characteristics of children under-5 years who had acute diarrhea at Tanah Kali Kedinding Primary Health Care in September 2018 - January 2019. This type of research was a descriptive study, where the results was only a picture, using a cross-sectional approach. Statistical analysis was performed to describe the characteristics of each patient by using a frequency descriptive test. The results of this study found that in September 2018 - January 2019, of 116 children under-5 years suffering from acute diarrhea in the Tanah Kali Kedinding Health Care, Surabaya, most of them were females, within 1-2 years, had exclusive breastfeeding, had parents with the last education graduated from high school and family income under minimum of wage in Surabaya. It is hoped that this research will become a source of information for the Government and Primary Health Care to reduce the incidence of acute diarrhea.

1491. Active Norovirus Surveillance in Children Under 5 Years with Diarrhea after Rotavirus Vaccine Introduction in Argentina (2017–2019)

BackgroundAcute diarrhea is one of the leading causes of infant morbidity and mortality. Argentina introduced massive rotavirus vaccination in 2015. In several countries, this introduction has changed the distribution of enteropathogens. The decrease in the prevalence of rotavirus has been described at the expense of an increase in Norovirus (NoV) activity worldwide. The aim of this study was to analyze the role of NoV in acute diarrhea cases in outpatient children under 5 years of age and their epidemiological profile.MethodsA prospective and cross-sectional study in <5 years outpatients attended for acute diarrhea in Children’s Hospital “Dr. Ricardo Gutiérrez” in Buenos Aires, Argentina, between July 2017 and March 2019 was conducted. Active epidemiological surveillance was performed with a specific case reporting form. Stool samples were tested for NoV (RT-qPCR). Clinical and epidemiological data were recorded.ResultsA total of 252 patients were enrolled and 235 stools samples were tested. Median of age was 22.3 months (IQR: 11–30), 58.7% were male. The most frequent symptoms were fever and vomiting in 63.1% and 53%, respectively; 52% had watery diarrhea, 45.2% had moderate diarrhea according to Vesikari Scale, 95.6% were normohydrated and 22% had a household member with diarrhea. There were no immunocompromised children. A 72% had received rotavirus vaccine, 86% of them with full scheme. From samples tested, 27% (n = 63) were NoV positive. NoV was found throughout the year and the frequency of detection was higher in January and June (summer and winter in Argentina). Regarding genetic diversity the most frequent genogroup was GII (65%; 41/63) and genotype GII.P16-GII.4 Sydney (48%; 20/41). Bacterial co-infection was observed in 35%. Compared with negative cases, NoV were younger (18 vs. 20 months; P < 0.001) and were associated with higher prevalence of rotavirus vaccination (88% vs. 66%; P = 0.001). No statistically difference was found regarding to gender, clinical outcome and severity.ConclusionNoV was detected at high frequency (27%) in children presenting moderate acute diarrhea, mainly in those who received rotavirus vaccine. Regarding sporadic acute diarrhea cases in children, it is important to consider NoV as a frequent etiological agent.Disclosures All authors: No reported disclosures.

Assessment of the Rapid Immunochromatographic Test as a Diagnostic Tool for Norovirus Related Diarrhea in Children

In developing countries, Norovirus is the second-leading cause of acute diarrhea, after rotavirus. The approved gold standard method for diagnosis of norovirus infection is RT-PCR. The rapid immunochromatographic test is a novel and expedient method for diagnosing norovirus that is relatively affordable. However, the use of the rapid immunochromatographic test remains controversial because of its accuracy. This study aimed to explore whether the rapid immunochromatographic test could be used for diagnosing norovirus-related diarrhea in children. Rapid immunochromatographic test (QuickNaviTM-Norovirus2) and RT-PCR on stool samples was used to diagnose norovirus. Stool samples were obtained from pediatric patients aged between 1 and 60 months who had diarrhea and were admitted to the pediatric ward at Dr. Soetomo General Hospital Surabaya, between April 2013 and March 2014. Ninety-four subjects provided stool samples that were tested using QuickNaviTM-Noro2 and RT-PCR. Using the test, 64 samples tested positive for norovirus and 30 tested negatives. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the rapid immunochromatographic test were consecutively 90.3%, 42.9%, 43.8%, 90%, and 58.5%. RT-PCR was used to test all samples to assess the accuracy, which showed that one from 31 samples contained the GI strain (1.1%), while 30 samples (32%) contained the GII strain. This study definitively establishes that the rapid immunochromatography test is not sufficiently accurate for use as a screening or diagnostic tool in norovirus-related diarrhea cases in children.