Diarrheal Disease In Children Research Articles

Spatial prevalence and associated risk factors of childhood diarrhea: A cross-sectional study in rural Indian context

Diarrheal disease is the most prevalent health issue among children under the age of five, contributing to a staggering toll of approximately 525,000 deaths worldwide each year. Despite its devastating consequences, it is essential to note that this disease is both preventable and treatable. The present study aims to investigate the prevalence of childhood (under 5 years) diarrheal disease in rural parts of India and identify relevant factors associated with diarrheal disease, encompassing maternal, household, environmental, and individual-level characteristics. In addition, the study highlights the spatial distribution of diarrheal disease across India, identifying hot-spot and cold-spot regions, along with the associated risk factors. The study utilized secondary data extracted from the fifth round of the National Family Health Survey, conducted in India between 2019 and 2021 (N=161,368). Binary logistic regression analysis and spatial clustering techniques, specifically utilizing Global Moran’s I, were employed to achieve the study’s objectives. The findings revealed that diarrhea cases are more prevalent among the poor, rural, and children of Muslim families, as well as among those residing in environments lacking hygienic or adequate sanitation facilities and in households without floors, walls, or roofs built with concrete material. The highest prevalence is observed in the eastern and western parts of India. Necessary interventions are required to reduce diarrhea cases among children under the age of five in rural Indian areas. Given the vector-borne nature of this disease, public awareness of the importance of maintaining fresh and clean drinking water facilities is imperative.

Spatio-temporal distributions and determinants of diarrhea among under-five children in Ethiopia.

The purpose of this study was to evaluate the spatio-temporal pattern of Ethiopia's childhood diarrheal disease and identify its contributing factors. We conducted analyses on secondary data from four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. Moran's I was used to determine spatial dependence and spatial models were used to evaluate variables associated with diarrhea in under-five children at the zonal level. Childhood diarrhea showed spatial clustering in Ethiopia (Moran's I; p < 0.05). The spatial regression model revealed significant factors at the zonal level: children born at home ( = 1.355, 95% CI: 1.052-1.544, p < 0.001), low birth weight ( = 1.18, 95% CI: 1.017-1.691, p < 0.05), and unimproved source of water ( = 0.8568, 95% CI: 0.671-1.086, p < 0.01). The prevalence of diarrhea among under-five children varied over time by zone, with the Assosa, Hundene, and Dire Diwa zones having the highest rates. Home births and low birth weight contributed to the prevalence of childhood diarrhea. In high-risk zones of Ethiopia, reducing childhood diarrhea requires integrated child health interventions and raising awareness about the potential hazards associated with unimproved water sources.

The Incidence and Risk Factors for Enterotoxigenic E. coli Diarrheal Disease in Children under Three Years Old in Lusaka, Zambia.

This study aimed to estimate the incidence and risk factors for Enterotoxigenic Escherichia coli (ETEC) diarrhea. This was a prospective cohort study of children recruited in a household census. Children were enrolled if they were 36 months or below. A total of 6828 children were followed up passively for 12 months to detect episodes of ETEC diarrhea. Diarrheal stool samples were tested for ETEC using colony polymerase chain reaction (cPCR). Among the 6828 eligible children enrolled, a total of 1110 presented with at least one episode of diarrhea. The overall incidence of ETEC diarrhea was estimated as 2.47 (95% confidence interval (CI): 2.10-2.92) episodes per 100 child years. Children who were HIV-positive (adjusted Hazard ratio (aHR) = 2.14, 95% CI: 1.14 to 3.99; p = 0.017) and those whose source of drinking water was public tap/borehole/well (aHR = 2.45, 95% CI: 1.48 to 4.06; p < 0.002) were at increased risk of ETEC diarrhea. This study found that children whose mothers have at least senior secondary school education (aHR = 0.49, 95% CI: 0.29 to 0.83; p = 0.008) were at decreased risk of ETEC diarrhea. Our study emphasizes the need for integrated public health strategies focusing on water supply improvement, healthcare for persons living with HIV, and maternal education.

Effect of the Built Environment on the Cumulative Incidence of Acute Diarrheal Diseases: A Community-Based Cohort Study From Underprivileged Areas of Bhopal, India.

Background Diarrhea is a major public health problem in under-five children worldwide. Various sociodemographic, environmental, and behavioral factors play a role in the occurrence of diarrheal disease in children under the age of five. This study aims to estimate the cumulative incidence of acute diarrheal diseases during a one-year study period and examine its association with the built environment factors among children under the age of five in selected underprivileged areas of Bhopal. Methodology We conducted this study in Bhopal, a city in central India. We surveyed the underprivileged dwellers of Vajpayee Nagar, Sanjay Nagar, and Mother India Colony of Bhopal city. This is a prospective cohort study with a one-year follow-up period to examine the cumulative incidence of acute diarrheal diseases among under-five-year-old children in the study area. Data were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results Data were collected from February 2021 to February 2022. A total of 658 families of eligible children were contacted to participate in the study. After excluding 38 participants for various reasons (denied consent: 3; lost to follow-up: 32; moved out of the study area: 3), data were finally analyzed for 620 participants. In the study among the under-five-year-old children, the cumulative incidence of acute diarrheal diseases was 23.8% (148 out of 620). In our study, lower age (adjusted odds ratio (OR) = 0.86, 95% confidence interval (CI) = 0.75-0.99, p = 0.041) and non-availability of flush latrine in the house (adjusted OR = 4.95, 95% CI = 1.80-13.59, p = 0.002) were statistically associated with a higher incidence of acute diarrheal disease among the study population. Conclusions In our investigation, we observed a cumulative incidence of diarrhea at 23.8% (148 out of 620) among the underprivileged under-five population residing in Bhopal, India. This incidence exhibited significant associations with younger age and the absence of in-house flush latrines.

Minimal impact on the resistome of children in Botswana after azithromycin treatment for acute severe diarrhoeal disease.

Macrolide antibiotics, including azithromycin, can reduce under-five mortality rates and treat various infections in children in sub-Saharan Africa. These exposures, however, can select for antibiotic-resistant bacteria in the gut microbiota. Our previous randomized controlled trial (RCT) of a rapid-test-and-treat strategy for severe acute diarrhoeal disease in children in Botswana included an intervention (three-day azithromycin dose) group and a control group that received supportive treatment. In this prospective matched cohort study using stools collected at baseline and 60 days after treatment from RCT participants, the collection of antibiotic resistance genes or resistome was compared between groups. Certain macrolide resistance genes increased in prevalence by 13% to 55% at 60 days, without differences in gene presence between the intervention and control groups. These genes were linked to tetracycline resistance genes and mobile genetic elements. Azithromycin treatment for bacterial diarrhoea for young children in Botswana resulted in similar effects on the gut resistome as the supportive treatment and did not provide additional selective pressure for macrolide resistance gene maintenance. The gut microbiota of these children contains diverse macrolide resistance genes that may be transferred within the gut upon repeated exposures to azithromycin or co-selected by other antibiotics.

Infant diarrheal disease in rhesus macaques impedes microbiome maturation and is linked to uncultured Campylobacter species

Diarrheal diseases remain one of the leading causes of death for children under 5 globally, disproportionately impacting those living in low- and middle-income countries (LMIC). Campylobacter spp., a zoonotic pathogen, is one of the leading causes of food-borne infection in humans. Yet to be cultured Campylobacter spp. contribute to the total burden in diarrheal disease in children living in LMIC thus hampering interventions. We performed microbiome profiling and metagenomic genome assembly on samples collected from over 100 infant rhesus macaques longitudinally and during cases of clinical diarrhea within the first year of life. Acute diarrhea was associated with long-lasting taxonomic and functional shifts of the infant gut microbiome indicative of microbiome immaturity. We constructed 36 Campylobacter metagenomic assembled genomes (MAGs), many of which fell within 4 yet to be cultured species. Finally, we compared the uncultured Campylobacter MAGs assembled from infant macaques with publicly available human metagenomes to show that these uncultured species are also found in human fecal samples from LMIC. These data highlight the importance of unculturable Campylobacter spp. as an important target for reducing disease burden in LMIC children.

Detection of Some Virulence Genes in Diarrheagenic Escherichia Coli Pathotypes in Children Under Five Years in Aleppo City

Diarrheagenic Escherichia coli (DEC) strains can be classified into six main pathotypes based on their specific virulence properties. These pathotypes are associated with certain serotypes and exhibit distinct epidemiological and clinical features. The identification of DEC cannot be based solely on cultural and biochemical criteria, as they are indistinguishable from the non-pathogenic E. coli. However, the presence of virulence genes and DNA sequences specific to DEC can be used to determine its identity. The aim of this study is to investigate the prevalence of Diarrheagenic Escherichia coli (DEC) pathotypes among infected children under 5 years living in the city of Aleppo Syria. From June 2020 to September 2021, one hundred samples of diarrheal were collected from children under five years suffering from diarrhea admitted at Aleppo University Hospital and from some private laboratories in Aleppo city. Escherichia coli pathotypes were detected by using multiplex polymerase chain reaction and Phylogenetic genes were detected by Triplex PCR. The frequency of diarrheagenic E. coli was (48%), the most frequently isolated pathotypes were atypical enteropathogenic E. coli. (42%), followed by enterotoxigenic E. coli (4%), and enteroinvasive E. coli (2%). Enterohemorrhagic E. coli, enteroaggregative E. coli and Diffusely Adherent E. coli were not detected in any sample (0%). The most prevalent phylogenetic group of E. coli was "Phylogenetic group B2" which represented (62%), followed by "Phylogenetic group D" that comprised 33%, followed by "Phylogenetic group A" strains (3%). Strains of the "Phylogenetic group B1" were rare (2%). This study revealed that DEC strains contribute to cause diarrheal diseases in children, EPEC is the most commonly identified DEC strain. B2 and D groups are the most prevalent phylogenetic groups. In addition, they are virulent because these groups are associated with the presence of several virulence factors.

Assessing the relationship of recommended diarrhea case management practices with the nutritional status of children aged between 0 to 59.9 months.

Background Paediatric diarrhoea and malnutrition have a bidirectional relationship, which in turn augments the presence of each other. The diarrhoeal diseases in children can be prevented by using oral rehydration solution (ORS) and oral zinc sulfate. The relationship between paediatric diarrhoea treatment guidelines with the nutritional status is not yet investigated, and this study primarily aims to examine the relationship of recommended diarrhoea case management practices with paediatric undernutrition (wasting, stunting and underweight) among children aged between 0 to 59 months. Methods Data from Pakistan Demographic &amp; Health Surveys (PDHS) conducted in 2012–2013 and 2017–2018 were used in this study to investigate the relationship between paediatric diarrhoea treatment adherence with the various forms of paediatric undernutrition. Data from children with complaints of acute watery non-dysenteric diarrhoea was used in this study, whereas data from those children presented with complaints of either dysentery, and/or severe dehydration, and/or incomplete anthropometry were excluded. Children were classified as complete adherent, partial adherent and non-adherent based on ORS and oral zinc sulfate consumption. The relationship of diarrhoea case management practices with different types of nutritional status was assessed using a binomial logistic regression method. Results The malnutrition in children with acute non-dysenteric diarrhoea is 54.2% in 2012–2013, which decreased to 48.2% in the succeeding survey of 2017–2018. Only 6.2% (1% in 2012–2013 ~ 10% in 2017–2018) children of Pakistan received appropriate treatment for managing their diarrhoea. However, no relationship between the diarrhoea case management and paediatric undernutrition was observed. Conclusion This study found did not demonstrate a significant connection of diarrhoea case management strategies with paediatric undernutrition. This highlights the complexity of addressing both diarrhoea and malnutrition in children. Future research should emphasize the identification and resolution of the multifactorial factors, which contribute to paediatric undernutrition, integrating both diarrhoea management and nutritional improvement strategies.

The value of promoting standardized diagnosis and treatment technology for childhood diarrheal diseases within county medical communities

Objective: To investigate the clinical value of promoting standardized diagnosis and treatment techniques for childhood diarrhea in county medical communities. Methods: In January 2022, the “standardized diagnosis and treatment of diarrhea in children” was implemented in the pediatric department of the county medical community. We selected 100 children with diarrhea, categorizing them into the control and experimental groups for the first 6 months and 6 months after implementation, respectively. We compared the rate of doctors’ mastery of standardized diarrheal disease treatment before and after training, the rate of children receiving standardized diarrhea treatment before and after training, the time to symptoms normalization in both groups, treatment cost, and parental satisfaction. Results: After training, physicians achieved a mastery rate of 97.5% in the standardized diarrhea treatment, significantly higher than the 83.75% before training. The rate of children receiving standardized treatment increased to 94% after training, significantly higher than the 79% rate before training. In the experimental group, the time to normalization of diarrhea, vomiting, dehydration, and fever was (2.4±0.7) days, (2.2±0.7) days, (2.3±0.7) days, and (2.2±0.7) days, respectively. These times were significantly shorter than those in the control group, which were (2.6±0.7) days, (2.4±0.7) days, (2.6±0.6) days, and (2.4±0.7) days. The differences were statistically significant (t-values = 4.321, 2.22, 4.264, 2.895, P &lt; 0.05, respectively). The treatment cost for the children in the experimental group was less (CNY 75.8±6.6) than that of the control group (CNY 96.1±12.5), and the difference was statistically significant (t-value 16.141, P &lt; 0.01). The satisfaction rate of the families of the children in the experimental group was 97.00%, significantly higher than the 85.00% satisfaction rate in the control group (χ2=11.234, P = 0.004). Conclusion: Promoting standardized diagnosis and treatment technologies for childhood diarrheal within county medical communities has clinical value, improving efficacy in children while reducing treatment costs and increasing parental satisfaction.

Shigella and childhood stunting: Evidence, gaps, and future research directions.

Early childhood growth deficits have been shown to have lifelong health and economic impacts, yet their connection to one of their underlying causes, diarrheal diseases, has remained difficult to characterize. Identifying the processes and mechanisms that underlie this link has remained a challenge due to the complexity of the relationship and limitations in access to more advanced laboratory methods. In recent years, however, several large-scale, multisite studies have extensively investigated and reported the prevalence, etiology, and impacts of diarrheal diseases in children under 5 years (CU5) in low- to middle-income countries (LMICs). These studies, in combination with several single-site studies, have applied more advanced laboratory methods to uncover the etiology, true prevalence, infection mechanisms, and inflammation biomarkers of diarrheal disease. Of the multiple pathogens that have been shown to be strongly associated with diarrheal disease in CU5, Shigella is one of the more prevalent and impactful of these pathogens. In this narrative review, we highlight key insights from these studies and identify knowledge gaps and directions for future research. According to these studies, Shigella is most commonly detected in toddlers and young children; however, it can cause more severe disease and has a greater impact on linear growth for infants. Shigella often has a stronger relationship to linear growth faltering (LGF) than other enteropathogens, with higher Shigella loads resulting in greater growth deficits. Future studies should employ more Shigella-specific molecular assays and identify diarrheal etiologies using standardized diagnostics to improve child anthropometric and Shigella surveillance. Also, they should focus on uncovering the mechanisms of the relationship underlying Shigella and growth faltering to better characterize the role of asymptomatic infections and intestinal inflammation in this relationship.

Risk Factors Affecting the Incidence of Diarrhea in Children Under Five Years Old in the Working Area of Tarus Public Health Center, Kupang District, in 2022

Diarrhea is a disorder of defecation characterized by defecation more than 3 times a day with the consistency of liquid stool, may be accompanied by blood. Until September 2022 Puskesmas Tarus had the highest incidence of diarrhea compared to other health centers with 126 cases of diarrhea in toddlers. The purpose of this study was to determine the risk factors associated with the incidence of diarrheal disease in children under five years of age in the working area of Puskesmas Tarus, Kupang Regency. This study was an analytic observational study using a case control study research design. This study was conducted in the working area of Puskesmas Tarus Kupang Regency in February-March 2023. The results showed a significant relationship between maternal knowledge (p=0.000; OR=3,974), maternal attitude (p=0.000; OR=4,594), hand washing behavior (p=0.000; OR=4,421), exclusive breastfeeding history (p=0.001; OR=3,632) and maternal education (p=0.023; OR=2,400) with the incidence of diarrhea in toddlers. There is no significant relationship between maternal employment status and the incidence of diarrhea in toddlers (p=0,114; OR=0,489). Conclusion, that the variables of maternal knowledge, maternal attitude. hand washing behavior, exclusive breastfeeding history and maternal education have a significant relationship with the incidence of diarrhea in toddlers, and the variable maternal employment status has no significant relationship with the incidence of diarrhea in toddlers in the working area of Puskesmas Tarus, Kupang Regency.

Association between water, sanitation and hygiene practices and diarrhea among under 3-year-old children: Evidence from a nationally representative sample in India (2019–2021)

Abstract Globally, 1.7 billion cases of childhood diarrheal disease occur every year. The Government of India initiated the Intensive Diarrhea Control Fortnight (IDCF) program in 2015 aimed to reduce childhood diarrheal deaths to zero. We aimed to ascertain the association between WASH practices and the prevalence of diarrhea in India's children under three years of age. We analyzed the data from the NFHS-5 survey conducted between 2019 and 2021. We extracted data on household and individual levels. The association between WASH practice in the household and diarrheal episodes in children &amp;lt;3 years old were presented by unadjusted and adjusted prevalence ratio (PR) with a 95% confidence interval (CI). We used STATA v 16 for analysis. We included 132,198 children, 8.4% (n = 11,060) had diarrhea in the 2 weeks preceding the survey. The majority of the children were residing in rural areas (79.8%) and using unprotected water (90%) sources. Diarrhea was associated with using shared toilet facilities (adj. PR: 1.28, 95% CI: 1.17, 1.34), improper disposal of child's stools (adj. PR: 1.12, 95% CI: 1.05, 1.20) and having no separate kitchen (adj. PR: 1.16, 95% CI: 1.08, 1.23). Household WASH practices continue to be independent predictors of diarrhea among &amp;lt;3 children.

Sociodemographic and environmental factors associated with diarrhoeal illness in children under 5 years in Uganda, 2016: a cross-sectional study

BackgroundUganda is among the 10 countries in the sub-Saharan Africa region that have the highest prevalence of diarrhoeal disease. Evidence suggests that the severity of childhood diarrhoeal disease is escalated through various sociodemographic and environmental factors.ObjectivesTo assess prevalence of diarrheal illness in children below the age of 5 years in Uganda in 2016 and associated factors.MethodsA cross-sectional study was employed that analyzed secondary data from the 2016 Uganda Demography and Health Surveys. Children with and without diarrhea were compared. A logistic regression was used to determine sociodemographic and environmental factors associated with diarrheal illness in children with statistical significance at p < 0.05.ResultsThe prevalence of childhood diarrhoeal illness for children below the age of 5 years in Uganda was 20.9% (n = 2838/13,753). There was a statistically significant difference when comparing children diarrhoeal with the following sociodemographic factors: caregiver’s age, child’s age and gender and duration of breastfeeding (p < 0.0001). Children with a caregiver aged between 15 and 24 years (aOR;1.42; 95% CI:1.24–1.62) and 25–34 years (aOR;1.19; 95% CI:1.04–1.37) were more likely to report diarrhoeal disease, compared to those with a caregiver aged 35–49 years. For environmental factors, households using springs water, access to health facility and children who received a dose of vitamin A had a decreased risk of reporting children diarrhoeal.ConclusionSignificant factors in the study like caregiver’s age, gender and duration of breastfeeding will create the opportunity for all interventions to shift their focus to these factors thus a better evidence-based approach to reducing of diarrhoeal disease will be achieved in the country.

Contributing factors of delay in seeking treatment for childhood diarrheal diseases in Berbere Woreda, Ethiopia: an unmatched case–control study

BackgroundA major cause of diarrheal illness mortality is a failure to seek immediate medical assistance. There is currently no evidence on the reasons that induce caregivers in Berbere Woreda to delayed seeking timely treatment for under-five children with diarrheal illnesses. As a result, the goal of this study was to identify determinants of delay in seeking timely treatment for childhood diarrheal diseases in Berbere Woreda, Bale Zone Oromia Region, South Eastern Ethiopia.MethodsAn unmatched case–control study on 418 child caregivers was conducted from April to May 2021. Cases were 209 children and their caregivers who sought treatment after 24 h of the onset of diarrheal disease symptoms, and controls were 209 children and their mothers/caregivers who sought treatment within 24 h of the onset of diarrheal disease symptoms. Data were collected through interviews and chart reviews using consecutive sampling. A multivariable logistic regression analysis was carried out, with variables with a P-value of 0.05 considered statistically significant. The Hosmer–Lemshow goodness of fit test was used to validate the model, and the variance inflation factor (VIF) was used to test for multi-collinearity.ResultsIn this study, we found that among 418 participants, determinants of delay in seeking timely treatment for childhood diarrheal diseases included mothers with more than two under-five children (AOR = 2.23, 95% CI 1.21–4.11), Divorce (AOR = 2.62, 95% CI 1.087–2.76), age of children < 24 months (AOR = 1.597, 95%,CI (1.008–2.531), and preference for a government health facility for treatment (AOR = 2.56, 95% CI 1.51–4.34). Besides, the odds of mothers aged 25–34 years being two times more likely to delay seeking timely treatment for 5 children with diarrhea were 1.537 (0.560–4.213).ConclusionsAge of children, age of mothers, number of children, preference of health facilities, and marital status were factors influencing the failure to seek treatment within 24 h of recognizing diarrhea in children under the age of five.

Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis

BackgroundDiarrhea, the second leading cause of child morbidity and mortality worldwide, is responsible for more than 90% of deaths in children under 5 years of age in low and middle-income countries (LMICs). The high burden of diarrhea is mainly attributable to the limited access to improved water and sanitation. However, the impacts of improved sanitation and drinking water in preventing diarrheal diseases are not well understood. Therefore, this study estimated both the independent and joint effects of improved sanitation and water on diarrhea occurrence among rural under-five children in LMICs.MethodsThe current study utilized secondary data from the Demographic and Health Survey (DHS) datasets conducted between 2016 and 2021 in 27 LMICs. A total weighted sample of 330,866 under-five children was included in the study. We employed propensity score matching analysis (PSMA) to examine the effects of accessing improved water and sanitation on childhood diarrheal disease reduction.ResultsThe prevalence of diarrhea among children under 5 years of age in rural LMICs was 11.02% (95% CI; 10.91%, 11.31%). The probability of developing diarrhea among under-five children from households with improved sanitation and water was 16.6% (Average Treatment Effect on the Treated (ATT) = − 0.166) and 7.4% (ATT = − 0.074) times less likely among those from households with unimproved sanitation and water, respectively. Access to improved water and sanitation is significantly associated with a 24.5% (ATT = − 0.245) reduction of diarrheal disease among under-five children.ConclusionsImproved sanitation and drinking water source reduced the risk of diarrhea among under-five children in LMIC. The effects of both interventions (improved water and sanitation) had a larger impact on the reduction of diarrheal disease than the improvements to water or sanitation alone. Therefore, achieving Sustainable Development Goal 6 (SDG 6) is key to reducing diarrhea among rural under-five children.

WASH and health: from global estimates to whys and hows

New, relevant studies have been published, improving our understanding of the extent to which different interventions in water, sanitation, and hygiene (WASH) can reduce childhood diarrhoea 1 Wolf J Hubbard S Brauer M et al. Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: a systematic review and meta-analysis. Lancet. 2022; 400: 48-59 Summary Full Text Full Text PDF PubMed Scopus (17) Google Scholar and the burden of a series of health outcomes. 2 Wolf J Johnston RB Ambelu A et al. Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. Lancet. 2023; (published online June 5.)https://doi.org/10.1016/S0140-6736(23)00458-0 Google Scholar These efforts provide figures that can inform public policies, support advocacy for these essential needs and human rights, and promote the UN 2030 Sustainable Development Goals (SDGs). Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomesWASH-attributable burden of disease estimates based on the levels of service established under the SDG framework show that progress towards the internationally agreed goal of safely managed WASH services for all would yield major public-health returns. Full-Text PDF Open Access

Potential impact of rotavirus vaccination on reduction of childhood diarrheal disease in India: An analysis of National Family Health Survey-5

Rotavirus is one of the leading causes of diarrhea in infants and young children worldwide. In this study, we investigated the impact of rotavirus vaccination on the prevalence of diarrheal disease among children under five years of age in India. Research on the impact of the rotavirus vaccine on reducing diarrheal disease is therefore important in contributing to the growing body of evidence on the effectiveness of this intervention in improving child health outcomes. We adopted multivariate logistic regression and propensity score matching analysis to examine the association between diarrhea and the rotavirus vaccine. The bivariate analysis finding shows that the prevalence of diarrhea was remarkably higher (9.1%) among children who had not received rotavirus and the prevalence was 7.5%, 7.5%, and 7.2% among children who received one dose, two doses, and three rotavirus doses (all) respectively. The result of multivariate logistic regression shows that children who received all three doses of the rotavirus vaccine were 16% less likely to experience diarrhea compared to those who did not receive any rotavirus vaccine. Our analysis also found that the prevalence of diarrhea decreased significantly in the years following the introduction of the vaccine. The results of this study suggest that the rotavirus vaccine has a significant impact on reducing childhood diarrheal disease in India. These results have the potential to inform policy decisions and enable healthcare professionals to concert their efforts in reducing the diarrheal disease burden and its timely prevention in children. The study will also contribute to the existing literature on the impact of rotavirus vaccination in reducing the prevalence of diarrhea among children in India.

A systematic review and meta-analysis: the therapeutic and preventive effect of Lactobacillus reuteri DSM 17,938 addition in children with diarrhea

ObjectiveTo summarize the effect of adding Lactobacillus reuteri in the treatment plan for diarrheal disease in children, and analyze the potential of probiotics in preventing the occurrence of diarrheal disease.MethodsSearch for randomized controlled trials of Lactobacillus reuteri for the treatment and prevention of diarrhea in the Pubmed, Web of science, Medline, and Cochrane databases. Data such as the number of diarrhea patients, time, length of stay, clinical symptoms and effect of diarrhea prevention were extracted for meta-analysis. Relative risk and confidence interval (RR and 95% CI) were used as outcome indicators.Results963 participants in the 9 RCTs came from multiple countries/regions. Compared with placebo/no intervention, the number of diarrhea patients in the Lactobacillus reuteri group was significantly reduced on the day 1 (RR = 0.87, 95%CI: 0.78–0.97) and day 2 (RR = 0.61, 95%CI: 0.44–0.83). Cumulative statistics analysis showed that the effect was stable and significant starting on the 4th day after treatment. A few studies have shown that Lactobacillus reuteri can reduce the time of diarrhea, the number of days with watery stools, and days of hospital stay. However, it has no effect on the occurrence of nosocomial diarrhea (RR = 1.11, 95%CI: 0.68–1.83), rotavirus diarrhea (RR = 1.46, 95%CI: 0.78–2.72), antibiotic-related diarrhea (RR = 1.76, 95%CI: 0.77–4.05), and diarrhea (RR = 1.35, 95%CI: 0.95–1.92).ConclusionAddition of Lactobacillus reuteri in the treatment plan has a significant effect on reducing the number of diarrhea and reducing the symptoms of diarrhea, but has no obvious effect on the prevention of diarrhea. Combining probiotics and improving the ability of probiotics to respond is the focus of attention.

Cryptosporidium uses multiple distinct secretory organelles to interact with and modify its host cell

Cryptosporidium is a leading cause of diarrheal disease in children and an important contributor to early childhood mortality. The parasite invades and extensively remodels intestinal epithelial cells, building an elaborate interface structure. How this occurs at the molecular level and the contributing parasite factors are largely unknown. Here, we generated a whole-cell spatial proteome of the Cryptosporidium sporozoite and used genetic and cell biological experimentation to discover the Cryptosporidium-secreted effector proteome. These findings reveal multiple organelles, including an original secretory organelle, and generate numerous compartment markers by tagging native gene loci. We show that secreted proteins are delivered to the parasite-host interface, where they assemble into different structures including a ring that anchors the parasite into its unique epicellular niche. Cryptosporidium thus uses a complex set of secretion systems during and following invasion that act in concert to subjugate its host cell.

Perbandingan Algoritma K-Means dan K-Medoids Untuk Pemetaan Daerah Penanganan Diare Pada Balita di Kabupaten Kuningan

Diarrhea is an endemic disease that contributes to the high mortality rate in Indonesia, especially among children under five. The Kuningan District Health Office had difficulties in monitoring and supervising the spread of diarrheal diseases. This study aims to produce a mapping scheme of priority areas in handling the prevention and control of the spread of diarrheal disease in children under five in Kuningan Regency. The method used is the Data Mining Clustering method by comparing two algorithms, namely the K-Means algorithm and the K-Medoids algorithm. Determination of the optimum number of clusters using the Elbow and Silhouette Coefficient methods. With this method, the result is that in the K-Means algorithm the optimum number of clusters is 3 clusters while the K-Medoids algorithm is 2 clusters. The best cluster evaluation uses the Davies-Bouldin Index (DBI) method and the results show that the K-Means DBI value is always smaller than the K-Medoids algorithm in either 2 clusters or 3 clusters, this shows that the K-Means algorithm is better than the K-Medoids algorithm. Based on these results, it is recommended to map priority areas for handling diarrheal diseases using the K-Means algorithm with 3 clusters, namely medium priority areas consisting of 9 regions, high priority areas consisting of 3 regions and low priority areas consisting of 25 regions. The results of the mapping can be used as input for the Kuningan District Health Office to develop strategies for preventing and preventing diarrheal diseases in children under five.