Prevalence Of Diarrhea Research Articles

Prevalence and factors associated with rotavirus diarrhea among children aged 3–24 months after the introduction of the vaccine at a referral hospital in Uganda: a cross-sectional study

BackgroundRotavirus has a significant morbidity and mortality in children under two years. The burden of rotavirus diarrhea 4 years post introduction of rotavirus vaccine in Uganda is not well established. This study aimed to determine the prevalence, severity of dehydration and factors associated with rotavirus diarrhea among children aged 3 to 24 months after the introduction of the vaccine at Fort Portal Regional Referral hospital.MethodsThis was a cross-sectional hospital-based study in which children with acute watery diarrhea were included. A rectal tube was used to collect a stool sample for those unable to provide samples. Stool was tested for rotavirus using rapid immunochromatographic assay. Data was analysed using SPSS version 22 with logistic regression done to determine the factors.ResultsOut of 268 children with acute watery diarrhea, 133 (49.6%) were females. Rotavirus test was positive in 42 (15.7%), majority of whom had some dehydration 28(66.7%). The factors that were independently associated with rotavirus diarrhea were; age < 12 months (AOR = 8.87, P = 0.014), male gender (AOR = 0.08, P = 0.001), coming from a home with another person with diarrhea (AOR = 17.82, P = 0.001) or a home where the water source was a well (AOR = 50.17, P = 0.002).ConclusionThe prevalence of rotavirus diarrhea was three times less in the post rotavirus vaccination period compared to pre-rota vaccination period. Majority of the participants with rotavirus diarrhea had some dehydration. There is need for provision of safe water sources to all homes. Surveillance to determine the cause of the non rota diarrhea should be done.

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.

Influence of hydrometeorological risk factors on child diarrhea and enteropathogens in rural Bangladesh.

A number of studies have detected relationships between weather and diarrhea. Few have investigated associations with specific enteric pathogens. Understanding pathogen-specific relationships with weather is crucial to inform public health in low-resource settings that are especially vulnerable to climate change. Our objectives were to identify weather and environmental risk factors associated with diarrhea and enteropathogen prevalence in young children in rural Bangladesh, a population with high diarrheal disease burden and vulnerability to weather shifts under climate change. We matched temperature, precipitation, surface water, and humidity data to observational longitudinal data from a cluster-randomized trial that measured diarrhea and enteropathogen prevalence in children 6 months-5.5 years from 2012-2016. We fit generalized additive mixed models with cubic regression splines and restricted maximum likelihood estimation for smoothing parameters. Comparing weeks with 30°C versus 15°C average temperature, prevalence was 3.5% higher for diarrhea, 7.3% higher for Shiga toxin-producing Escherichia coli (STEC), 17.3% higher for enterotoxigenic E. coli (ETEC), and 8.0% higher for Cryptosporidium. Above-median weekly precipitation (median: 13mm; range: 0-396mm) was associated with 29% higher diarrhea (adjusted prevalence ratio 1.29, 95% CI 1.07, 1.55); higher Cryptosporidium, ETEC, STEC, Shigella, Campylobacter, Aeromonas, and adenovirus 40/41; and lower Giardia, sapovirus, and norovirus prevalence. Other associations were weak or null. Higher temperatures and precipitation were associated with higher prevalence of diarrhea and multiple enteropathogens; higher precipitation was associated with lower prevalence of some enteric viruses. Our findings emphasize the heterogeneity of the relationships between hydrometeorological variables and specific enteropathogens, which can be masked when looking at composite measures like all-cause diarrhea. Our results suggest that preventive interventions targeted to reduce enteropathogens just before and during the rainy season may more effectively reduce child diarrhea and enteric pathogen carriage in rural Bangladesh and in settings with similar meteorological characteristics, infrastructure, and enteropathogen transmission.

Contextual factors associated with diarrhea among under-five children in the Gambia: a multi-level analysis of population-based data

BackgroundDiarrhea poses a significant threat to the lives of children in The Gambia, accounting for approximately 9% of all deaths among children under the age of five. Addressing and reducing child mortality from diarrhea diseases is crucial for achieving the Sustainable Development Goal (SDG) 3, specifically target 3.2, which aims to eliminate preventable deaths in newborns and children under the age of five by 2030. Thus, this research aims to assess the prevalence and contextual factors associated with diarrhea among under-five children in The Gambia.MethodsThis research employed secondary data from the 2019/20 Gambia Demographic Health Survey (GDHS). The study initially involved 8,362 women aged between 15 and 49 years. Of these, 6,929 women with children under five were included in this analysis. Data were analyzed using STATA with cross-tabulation and model fitting. Multilevel logistic regression was applied to accommodate the hierarchical structure of the demographic health survey data. The model comparison parameters were BIC, AIC, deviance, and LLR. Variables with a p-value less than 0.05 were selected for multivariable analysis. The statistical significance of the factors was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a p-value of less than 0.05.ResultsThe prevalence of diarrhea in under-five children was 53.2% in males and 46.8% in females. In the final model, Kerewan (aOR = 0.58; 95% CI = 0.33–0.98) and Basse (aOR = 0.59; 95% CI = 0.35–0.98) have significantly lower odds of childhood diarrhea compared to Banjul, female children show slightly lower, yet significant, odds of diarrhea compared to males (aOR = 0.96; 95% CI = 0.86–0.98), deliveries at government health centers are associated with higher odds of childhood diarrhea compared to home births (aOR = 1.24; 95% CI = 1.01–1.52). Mothers with post-secondary education had significantly lower odds of having children with diarrhea than those without any education (aOR = 0.50; 95% CI = 0.26–0.99) after controlling for confounders.ConclusionThe study findings indicate that several factors significantly impact the risk of childhood diarrhea in The Gambia. These factors include region of residence, sex of the child, place of delivery, and education level of the mother. The study suggests that existing interventions aimed at improving child health outcomes in the country should take into consideration these influential factors. Addressing these modifiable factors can enhance the effectiveness of interventions and promote better health outcomes for children in Gambia.

69 Effect evaluation of two sources of zinc at EU-authorized level on growth performance and gut health of piglets with a low or normal birth weight

Abstract This study aimed to investigate the effect of ZnSO4 or a porous form of ZnO, at EU-authorized level, on growth performance, gut health and colon microbiota in low and normal birth body weight (BBW) piglets. At birth, 64 piglets were chosen by their BBW and divided into low BBW (LBBW &amp;lt; 1 kg; 32 piglets) and normal BBW (NBBW &amp;gt; 1 kg; 32 piglets). At weaning, 25 d old (d 0), piglets were allocated into four groups (8 piglets/group, 2 pigs/replicate) and fed a standard diet plus 120 ppm of Zn from ZnSO4 or from a porous source of Zn (HZ - HiZox, Animine, France). Groups were balanced for litter of origin and category of BBW. Piglets were weighed weekly until d 21 post-weaning. The prevalence of diarrhea was determined by the fecal index (percentage of animals with fecal score &amp;gt; 3), and feed intake per pen was recorded daily. On d 9 and d 21, one piglet/replicate was slaughtered, and jejunum tissue was collected for morphology, colon content for microbiota analyzes, and distal jejunum pH was measured. Performance, pH, and morphometric parameters were analyzed using a linear mixed model, fecal index using a generalized linear mixed model with a Poisson distribution, including treatment, class of BBW and their interaction as fixed factors, and the litter as random factor. The statistical analysis on alpha, beta diversity and taxonomic composition were carried out using phyloseq, vegan and microbiomeMarker packages. Piglets in the NBBW group had greater BW throughout the study (P &amp;lt; 0.01). The treatment HZ tended to increase the average daily gain (ADG) at d 9-14 (P &amp;lt; 0.10), and significantly increased the gain to feed ratio (G:F) ratio (P &amp;lt; 0.05) at d 0-14. The HZ-fed piglets had a greater G:F in the overall period (P = 0.04). Additionally, the jejunum pH of the HZ-fed piglets was reduced (P = 0.02) at d 21. An interaction was observed between treatment and BBW for fecal index during d 0-14 and d 0-21 (P &amp;lt; 0.01), in which HZ decreased the index in LBBW. An interaction was also observed in villus height (P = 0.05) and absorptive mucosal surface (P = 0.02) on d 21, that resulted greater in NBBW piglets fed ZnSO4. For Beta diversity, using the Adonis test, BBW category tended to affect the microbial structure at d 9 (R2 = 0.04; P = 0.07) and significantly affected the bacterial structure (R2 = 0.05, P = 0.03) at d 21. At d 21, the NBBW piglets fed ZnSO4 had a greater abundance of Succinivibrio which is able to degrade complex carbohydrates, while the NBBW piglets fed HZ had a greater abundance of Ruminococcus gauvreauii which is linked to the production of short chain fatty acids (SCFAs). The use of HZ seems can be a part of the strategy to replace the pharmacological level of ZnO.

Major changes in prevalence and genotypes of rotavirus diarrhea in Beijing, China after RV5 rotavirus vaccine introduction.

To analyze the epidemiological characteristics of group A rotavirus (RVA) diarrhea in Beijing between 2019 and 2022 and evaluate the effectiveness of the RV5 vaccine. Stool specimens were collected from patients with acute diarrhea, and RVA was detected and genotyped. The whole genome of RVA was sequenced by fragment amplification and Sanger sequencing. Phylogenetic trees were constructed using Bayesian and maximum likelihood methods. Descriptive epidemiological methods were used to analyze the characteristics of RVA diarrhea. Test-negative design was used to evaluate the vaccine effectiveness (VE) of the RV5. Compared with 2011-2018, RVA-positive rates in patients with acute diarrhea under 5 years of age and adults decreased significantly between 2019 and 2022, to 9.45% (249/634) and 3.66% (220/6016), respectively. The predominant genotype of RVA had changed from G9-VIP[8]-III between 2019 and 2021 to G8-VP[8]-III in 2022, and P[8] sequences from G8-VP[8]-III strains formed a new branch called P[8]-IIIb. The complete genotype of G8-VP[8]-III was G8-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2. The VE of 3 doses of RV5 was 90.4% (95%CI: 28.8%-98.7%) against RVA diarrhea. The prevalence of RVA decreased in Beijing between 2019 and 2022, and the predominant genotype changed to G8P[8], which may be related to RV5 vaccination. Continuous surveillance is necessary to evaluate vaccine effectiveness and improve vaccine design.

Practices of diarrhoea disease prevention measures among caregivers in Nyalenda, Kisumu County

This study aims to assess the practice of diarrhoea disease prevention measures among caregivers to enhance the effectiveness of prevention strategies. Diarrhoea disease poses a significant health risk, particularly among children, and caregivers play a crucial role in preventing its occurrence. However, the actual practice of diarrhoea disease prevention measures among caregivers is not well understood. Understanding the current practices and identifying areas for improvement can inform targeted interventions and educational programs to enhance the effectiveness of prevention strategies. This study employed a quasi-experimental design with mixed methods analysis. A sample of 302 households with caregivers of children aged 6-24 months. In-depth interviews and structured questionnaires were employed for data collection entered into SPSS. Descriptive analysis, multivariate logistic regression, independent samples t-test, chi-square test, and qualitative thematic analysis were employed for data analysis. The findings revealed the level of adherence to preventive measures among caregivers and identified specific areas where improvements are needed. The study contributes to the understanding of caregivers’ practices in preventing diarrhoea diseases and highlights the necessity for targeted interventions to improve adherence to preventive measures. By identifying specific areas for improvement, healthcare providers and policymakers can design educational programs and interventions that address the gaps in practice, ultimately reducing the incidence of diarrhoea diseases among children. The study recommends incorporating visual charts as an intervention strategy to improve caregivers’ practice of diarrhoea disease prevention measures. Visual charts can effectively enhance adherence to preventive measures among caregivers, ultimately reducing the prevalence of diarrhoea in children.

Spatial disparity and associated factors of diarrhea among under-five children in Rwanda: a multilevel logistic regression analysis

BackgroundDiarrhea, defined as three or more loose stool per day, is a major cause of child mortality. Exploring its spatial distribution, prevalence, and influencing factors is crucial for public health decision and targeted interventions. This study aimed to investigate these aspects using 2019 Rwanda demographic health survey data.MethodA total 7,978 (weighted) under-five children were included in this study. Spatial clustering (hotspots areas) were mapped using ArcGIS and SaTscan software. A multilevel logistic regression model was fitted to assessed factors associated with diarrhea, reporting significance at p < 0.05 and a 95% confidence interval.Resultsdiarrheal diseases in Rwanda showed a clustered spatial pattern (Moran’s I = 0.126, p = 0.001), with the primary cluster in west and north provinces. Under-five diarrhea prevalence was 14.3% (95% CI: 13.55, 15.08). Factors increasing likelihood included maternal age 15–34 years, child age 7–24 months, while full immunization was protective (aOR = 0.74, 95% CI: 0.56, 0.98).ConclusionSpatial clustering of diarrheal diseases is found in west and north provinces of Rwanda. Being born to a young mother, being a child aged 7–24 months, being fully immunized, being born to a low-educated mother and belonging to a community having low level education are factors associated with diarrheal diseases in Rwanda. Developing interventional plans based on identified clusters and approaching children based on their immunization status, maternal education and age could be cost-effective in reducing diarrheal diseases in Rwanda. Location based intervention could allow for the efficient allocation of resources by focusing on areas with higher prevalence and need.

PREVALENCE OF ROTAVIRUS AND CORONAVIRUS ORIGIN DISEASES BY AGE GROUPS AMONG CALVES IN THE NORTH-WEST REGION OF AZERBAIJAN

The purpose of the study was to identify the prevalence of diarrhea caused by rotavirus and coronavirus in newborn calves located in the North-West region of the republic using rapid testing. The study was conducted among 45 heads of calves of local races and crosses in 20 farms of the Ismailli, Gabala, and Zagatala districts. In 14 heads of calves out of 45 calves (35.5%), pathogens were not identified, and in 31 heads of calves pathogens were identified in single or mixed cases. The identified pathogens among them were distributed as follows: rotavirus in 22 calves (48.9%), coronavirus in 3 calves (6.7%), in 8 calves – (Cryptosporodium parvum) 17.8%), in 5 calves – Giardia (11.1%) and another 5 calves had E. coli K99 (11.1%). The results of the study show that the causes of diarrhea in calves in the North-West region of the republic, among other pathogens, include rotavirus and coronavirus infections, and it is important that this be taken into account when carrying out treatment and preventive measures

Therapeutic Effect of Synbiotics (Lactobacillus reuteri, Lactobacillus rhamnosus, Bifidobacterium infantis, and Fructooligosaccharides (FOS)) on Acute Non-bloody Diarrheal Episodes in Hospitalized Children Aged Between 6 - 24 Months: Randomized Double-Blind Placebo-Controlled Trial

Background: Regarding the appropriate effect of probiotics in treating acute diarrhea and the high prevalence of non-bacterial acute diarrhea among children in the population. Objectives: The present study evaluates the effect of synbiotic drops in children with acute diarrhea, including the number of hospitalization days, daily excreted diarrhea volume, duration of diarrhea, and reduction in the number of excretions between the case and control groups. Methods: This was a prospective double-blinded and randomized-controlled clinical trial on children aged 6 - 24 months with non-bloody acute diarrhea were included. The reason for hospitalization was diarrhea. In the case group, the patients consume PediLact (Zisttakhmir, Tehran, Iran) drop (Lactobacillus rhamnosus, Lactobacillus reuteri, and bifidobacterium infantis) 109 CFU and fructooligosaccharides. PediLact drop was used with milk or lukewarm food for five days along with other routine hospital cares. The number of hospitalization days, the daily excreted diarrhea, diarrhea duration, and decreasing numbers of excretion in patients were compared. Results: In the current study, 114 children were included. The duration of hospitalization was 3.87 ± 0.9 days in the synbiotic group and 4.26 ± 0.12 days in the placebo group (P-value = 0.001). The time between the onset of diarrhea and recovery was significantly higher in the placebo group than in the synbiotic group (P = 0.032). The number of evacuations was 1.89 ± 0.13 in the synbiotic group and 2.52 ± 0.18 in the placebo group (P = 0.014).

Impact of Rotaviral Diarrhea on Child Growth in Sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study.

Rotavirus is the leading cause of dehydrating diarrhea among children in developing countries. The impact of rotaviral diarrhea on nutritional status is not well understood. We aimed to determine the association between rotavirus-positive moderate-to-severe diarrhea and nutrition in children under 5 years of age. We analyzed data from the Global Enteric Multicenter Study on children 0-59 months old from South Asia and sub-Saharan Africa. The relationships between explanatory variables and outcome variables were assessed using multiple linear regression; the explanatory variable was the presence of rotavirus in the stool sample, and the outcome variables were z scores [length/height-for-age (LAZ/HAZ), weight-for-age (WAZ), and weight-for-length/height (WLZ/WHZ)] at follow-up (∼60 days). The prevalence of rotaviral diarrhea was 17.3% (905/5,219) in South Asia and 19.95% (842/4,220) in sub-Saharan Africa. Rotavirus was associated with higher LAZ/HAZ (β: 0.19; 95% CI: 0.12, 0.26; P <0.001) and WAZ (β: 0.15; 95% CI: 0.79, 0.22; P <0.001) in sub-Saharan Africa and with lower WLZ/WHZ (β coefficient: -0.08; 95% CI: -0.15, -0.009; P = 0.027) in South Asia. Our study indicates that rotaviral diarrhea is positively associated with nutritional status in sub-Saharan Africa and is negatively associated with nutritional status in South Asia. An expedited implementation policy of ongoing preventive and control strategies, including vaccination against rotavirus, is necessary to reduce the burden of rotaviral diarrhea, which may further help to reduce the potential nutritional ramifications.

Prevalence and risk factors associated with under-five years children diarrhea in Malawi: Application of survey logistic regression

BackgroundDiarrhea is a leading cause of illness and mortality among children under five, posing a significant public health challenge in Malawi. The current study assesses the prevalence and risk factors linked to diarrhea among under-five children in Malawi. MethodThe researcher used the Malawi Multiple Indicator Cluster Survey (MICS) 2019-20 as the dataset for this study. Due to the complex sampling design, survey logistic regression was used to accomplish the study objectives. The sample size was 15569 children who were aged under five. ResultsThe study found that the prevalence of diarrhea was 24.9%, with a higher percentage observed among children aged 12–23 months (38.5%) compared to other age groups. Additionally, children from the southern region had a higher prevalence of diarrhea at 27% compared to those from the northern region at 19.3%. Children from the poorest households also had a higher prevalence of diarrhea at 28.9% compared to those from the richest households at 22.6%. Furthermore, children with fever had a higher prevalence of diarrhea at 33.3% compared to those who did not have fever at 19.4%. ConclusionThe current study concluded that the prevalence of diarrhea was higher among children aged 12–23 months. Subsequently, policymakers should apply policies to reduce this high prevalence among this age group of children. In addition, the government needs special consideration in diarrhea control for children from the southern region because of the high prevalence of the disease compared to the other regions in Malawi. My study can help policymakers understand the scope and nature of the problem, which can notify the development of policies and programs intended to decrease the prevalence of risk factors and enhance child health outcomes.

Factors Contributing to the Prevalence of Diarrhea in Children Under the age of 5 years at Hoima Regional Referral Hospital, Western Uganda

Three or more loose stools per day, or more frequent passages than is typical for an individual, are considered diarrhea. In addition to rapidly resulting in dehydration, diarrhea can negatively affect a child's growth and cognitive development. Since children have a larger surface area and lose fluids more quickly, diarrhea can lead to dehydration and mortality as well as long-term consequences like malnutrition. Even though the majority of diarrhea episodes in children are minor, acute occurrences can cause significant fluid loss and dehydration. If fluids are not replaced as soon as diarrhea appears, this might lead to death or other serious effects. Fortunately, diarrhea is curable and preventative. In this study, the causes of diarrheal illnesses in children under five who are patients at Hoima Regional Referral Hospital were evaluated. This was a cross-sectional, descriptive study. It employed both quantitative and qualitative research techniques for gatheringand analyzing data. Youngsters under the age of five who experienced diarrhea within the six months before to the study were examined. There were 241 in the sample. Children under five who visit Hoima Regional Referral Hospital have a moderately high prevalence of diarrhea. The age range of 1-3 years old, having an open spring or well as a water source, and discarding household waste within the compound have all been linked to an increase in the occurrence of diarrhea. While caregivers could accurately advice regarding preventive measures, their understanding of the proper treatment of severe diarrhea was lacking, particularly with regard to dehydration. Therefore, in order to reduce the high rate of diarrhea in children under five, the government should make it very easy for people to access safe water. Health education programs focusing on these aspects should also be strengthened in order to train caregivers in home management, which will effectively and sustainably contribute to a reduction in child mortality. Keywords: Dehydration, Diarrhea, Health education, Child mortality, Children

Abstract 121: Gut microbiome association with dietary habits and abemaciclib-induced diarrhea:A multicenter, prospective study

Abstract Background: Abemaciclib, a leading treatment used for HR-positive, HER2-negative metastatic and primary breast cancer patients, often causes diarrhea. Understanding the reasons machinery behind this adverse event leads to reduce the toxicity and improve the quality of life. This study explores a hypothesis that specific gut microbiota profiles are engaged in gastrointestinal toxicities caused by abemaciclib and may be influenced by patients' dietary habits. We assessed it using the Brief Diet History Questionnaire (BDHQ). Materials and Methods: Our research involved collecting blood and stool samples, as well as dietary data through the BDHQ from 39 patients diagnosed with HR-positive, HER2-negative metastatic breast cancer. These were obtained prior to the start of abemaciclib treatment, at the first imaging evaluation, and at either disease progression or treatment discontinuation due to adverse effects. Incidence and severity of diarrhea were evaluated by the Bristol stool scale at baseline, from day 1 to day 14, and at day 90 of treatment. Stool samples were collected at baseline and at day 90 after the start of abemaciclib treatment. We conducted 16S metagenomic sequencing for gut microbiome analysis and used mass cytometry along with RNA-sequencing to profile immune cells. Results: Our findings indicate a significant association between the gut microbiota composition and abemaciclib-induced diarrhea, which also appears to be modulated by dietary patterns. An increase in Dorea was observed with higher Bristol Stool Scale scores, while Bifidobacterium and Sellimonas abundances were inversely related to changes in stool characteristics. The presence of Dorea was also positively associated with the consumption of specific food items such as tea, root vegetables, and dietary minerals. In contrast, Collinsella abundance decreased as the frequency of diarrhea increased and it was associated with the consumption of fried foods and certain fats. Conclusion: The prevalence of diarrhea as a side effect of abemaciclib treatment highlights the need for better management strategies. Our study indicates that gut microbiota, altered by dietary habits, is linked to this adverse effect. The data suggest a possibility of using specific gut bacteria as probiotics to alleviate this condition, pointing towards personalized dietary interventions as a potential avenue for improving treatment tolerance. Citation Format: Yuri Fujimoto, Kosuke Kawaguchi, Yurina Maeshima, Hiroshi Ishiguro, Kazuhiko Yamagami, Sachiko Takahara, Hirofumi Suwa, Masae Torii, Shigenori Nagai, Yasuaki Sagara, Wakako Tsuji, Hiroyasu Yamashiro, Takeshi Kotake, Shinji Fukuda, Kuniaki Saito, Yasuko Yamamoto, Masako Kataoka, Yuki Himoto, Atsushi Yonezawa, Yukiko Fukui, Yuki Nakamura, Wei Li, Sunao Tanaka, Masahiro Takada, Satoshi Morita, Masakazu Toi. Gut microbiome association with dietary habits and abemaciclib-induced diarrhea:A multicenter, prospective study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 121.

Climate change, food security, and diarrhoea prevalence nexus in Tanzania

The impact of climate change on food security and public health has hindered poverty reduction efforts in developing nations, including Tanzania, resulting in the impoverishment of millions and compromising both health and food production. To unravel these complex interactions, rigorous scientific research is indispensable. Leveraging three waves of the Agriculture Sample Census (2002/03, 2007/08, 2019/20), this study meticulously examines the interplay between climate change, food security, and diarrhoea prevalence in Tanzania. Employing Instrumental Variable Probit and Control Function Approach models to address endogeneity and heterogeneity, temperature anomalies serve as instrumental variables. The findings reveal a substantial impact of climate change on both food security (−0.331142, p < 0.01) and diarrhoea incidence (0.214602, p < 0.01). These results signify that climate change places significant stress on food security, rendering households more susceptible to insecurities, and heightens health concerns through increased diarrhoea prevalence. This underscores the urgency of prioritizing public health and well-being through an agricultural lens in climate change mitigation. A comprehensive strategy is imperative, entailing a synergy of sustainable agricultural practices, robust public health interventions, and targeted policies to fortify the adaptive capacity of communities. Special emphasis should be placed on cultivating climate-resilient agricultural systems, ensuring food security, and implementing health programs tailored to address the unique challenges posed by climate-induced factors. Moreover, community engagement and awareness initiatives play a pivotal role in fostering a collective understanding and commitment to sustainable practices, contributing to the overall resilience of societies amidst the challenges of climate change.

Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study

BackgroundDiarrhea is a serious health problem in children under the age of five that is both preventable and treatable. In low-income countries like Ethiopia, children under the age five years frequently experience diarrhea. However, the burden and associated factors of these diarrheal diseases are understudied in Eastern Ethiopia, Thus, this study aimed to determine the factors associated with the prevalence of diarrheal diseases in Eastern Ethiopia from September 1–30, 2022.MethodsA cross-sectional study was conducted on the total of 602 children aged 6 to 59 months in Oda Bultum district in eastern Ethiopia. A multistage sampling method was used. Three kebeles were selected from nine kebeles by the lottery method. Data was entered into Epi data 4.0.2 and exported to SPSS version 21 for analysis. Descriptive analysis was used for frequency, mean, and standard deviations. In addition, bivariable, and multivariable Poisson regression model was used to identify predictors of diarrhea along with a 95% confidence interval. Finally, statistical significance was declared at a p-value of 0.05.ResultA total of 602 children were included in this study. The prevalence of diarrhea 7.4% (47/602), 95% CI; 5.5–9.7%) among the children. Factors such as being unvaccinated for any vaccine (AOR = 10.82, 95%CI; 4.58–25.48) and born from a mother who had medium level of empowerment (AOR = 0.34, 95%CI; 0.11–0.88) in the household had statistically significant association with diarrhea among the children compared to their counterparts.ConclusionThe study found that nearly one out of thirteen children aged 6 to 59 months had any form of diarrheal diseases in Oda Bultum District, Eastern Ethiopia. In addition, the study revealed that children who were vaccinated for their age developed diarrhea less likely compared to those who did not receive any form of vaccine for their age. Moreover, children with mothers who had a medium level of empowerment were less likely to get diarrhea than children with mothers who had a low level of empowerment.

Prevalence, Clinical Features, and Genotypes of Norovirus-Associated Diarrhea in Wuxi, China, 2013-2020.

Norovirus (NoV) is a common pathogen that can cause infectious diarrhea. This study aimed to determine the prevalence, clinical features, and genotypes of NoV-associated diarrhea in Wuxi, China. A total of 4,416 stool samples were collected from patients with diarrhea at enteric disease clinics of sentinel hospitals in Wuxi from February 1, 2013 to December 31, 2020. Univariate and Akaike information criterion stepwise logistic regression were used to identify differences as integrated within a clinical setting (NoV positive [+] versus NoV negative [-], NoV+ versus rotavirus [RV]+, NoV+ versus bacteria+, genogroup [G] I and GII genotypes). Norovirus was detected in 9.85% of stool samples, which was greater than other tested pathogens. Excluding coinfection of NoV and other viruses or bacteria, patients infected with NoV had a lower chance of acquiring the virus in summer (P < 0.001; odds ratio [OR], 0.257; 95% CI, 0.189-0.36) when compared with patients without NoV. Patients with diarrhea infected with NoV featured nausea and vomiting (P < 0.001; OR, 2.297, 95% CI, 1.85-2.86) and loose stools (P = 0.006; OR, 2.247; 95% CI, 1.30-4.10), but less abdominal cramping (P = 0.001; OR, 0.676; 95% CI, 0.54-0.84). Patients infected with RV (P < 0.001; OR, 0.413; 95% CI, 0.25-0.68) or bacteria (P < 0.001; OR, 0.422; 95% CI, 0.26-0.67) were more vulnerable to fever than those infected with NoV. A total of 379 GII strains were detected concomitant with 48 GI strains, and there was a seasonal difference between the GI and GII genotypes. Strengthening pathogen detection for infectious diarrhea was helpful for understanding the epidemiological characteristics of infections with NoV and, potentially, for preventing disease outbreaks.

Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis

Quantifying contributions of environmental faecal contamination to child diarrhoea and growth faltering can illuminate causal mechanisms behind modest health benefits in recent water, sanitation, and hygiene (WASH) trials. We aimed to assess associations between environmental detection of enteropathogens and human or animal microbial source tracking markers (MSTM) and subsequent child health outcomes. In this individual participant data meta-analysis we searched we searched PubMed, Embase, CAB Direct Global Health, Agricultural and Environmental Science Database, Web of Science, and Scopus for WASH intervention studies with a prospective design and concurrent control that measured enteropathogens or MSTM in environmental samples, or both, and subsequently measured enteric infections, diarrhoea, or height-for-age Z-scores (HAZ) in children younger than 5 years. We excluded studies that only measured faecal indicator bacteria. The initial search was done on Jan 19, 2021, and updated on March 22, 2023. One reviewer (AM) screened abstracts, and two independent reviewers (AM and RT) examined the full texts of short-listed articles. All included studies include at least one author that also contributed as an author to the present Article. Our primary outcomes were the 7-day prevalence of caregiver-reported diarrhoea and HAZ in children. For specific enteropathogens in the environment, primary outcomes also included subsequent child infection with the same pathogen ascertained by stool testing. We estimated associations using covariate-adjusted regressions and pooled estimates across studies. Data from nine published reports from five interventions studies, which included 8603 children (4302 girls and 4301 boys), were included in the meta-analysis. Environmental pathogen detection was associated with increased infection prevalence with the same pathogen and lower HAZ (ΔHAZ -0·09 [95% CI -0·17 to -0·01]) but not diarrhoea (prevalence ratio 1·22 [95% CI 0·95 to 1·58]), except during wet seasons. Detection of MSTM was not associated with diarrhoea (no pooled estimate) or HAZ (ΔHAZ -0·01 [-0·13 to 0·11] for human markers and ΔHAZ -0·02 [-0·24 to 0·21] for animal markers). Soil, children's hands, and stored drinking water were major transmission pathways. Our findings support a causal chain from pathogens in the environment to infection to growth faltering, indicating that the lack of WASH intervention effects on child growth might stem from insufficient reductions in environmental pathogen prevalence. Studies measuring enteropathogens in the environment should subsequently measure the same pathogens in stool to further examine theories of change between WASH, faecal contamination, and health. Given that environmental pathogen detection was predictive of infection, programmes targeting specific pathogens (eg, vaccinations and elimination efforts) can environmentally monitor the pathogens of interest for population-level surveillance instead of collecting individual biospecimens. The Bill & Melinda Gates Foundation and the UK Foreign and Commonwealth Development Office.

Molecular survey of certain protozoan agents that cause diarrhea in children in Sudan

Introduction Diarrhea is a significant health problem in Third World. Identification the pathogen that cause diarrhea is vital for measures to prevent and control this disease. There are also very few reports of diarrhea in Sudan. Our study aimed to determine the Prevalenceof specific protozoan pathogens (Entameobia histolytica, Cryptosporidium parvum., and Giardia lamblia) in children in Khartoum, Sudan. Methods We conducted a cross-sectional survey among children under five years of age hospitalized with acute diarrhea between April and December 2014. Diarrheastool samples were collected and examined E. histolytica, C. parvum, and G. lamblia using a multiplex real-time PCR. Results 437 acute children were included in this study; the higher Prevalence of diarrhea was in the age less than ≤2years old (403,92.2%). The male-to -female ratio in this study was 1:1.7. infection with intestinal parasite was found in 155 (35.5%) cases, and co-infection was detected in 16 (3.7%) cases. G. lamblia (18.8%) and C. parvum (15.8 %) were the most frequently identified parasites, followed by E. histolytica (0.9). The parasite infection rate was highest and lowest in the under 2-year-old group (32.7%), and in the 2–4-year-old group (2.7%),the infection rate was higher was higher in boys (23.7%) than in girls (11.7%). tThe incidence of protozoan infection was higher (37.7%) in the rainy season (August to December) (32.7%), corresponding with that in the dry Season (April to June). (2.7%) Discussion Our present study demonstrated the high prevalence of G. lamblia and C. parvum in children with diarrhea in Khartoum region and usefulness of the multiplex real-time method in disclosing pathogenic protozoal agents. Our result highlighted the necessity of developing intervention measurement and control strategies to deal with childhood parasitic diarrhea in this region.

Prevalence and Correlates of Infectious Diarrhoea in Adults at Livingstone University Teaching Hospital, Zambia

Diarrhoea – defined as loose or watery stools for more than three times per day, is a common clinical problem. Worldwide, diseases causing infectious diarrhoea remain a major public health threat. Infectious diarrhoea in adults has been a major concern in developing countries, including Zambia. No study was conducted so far to estimate the infectious diarrhoeal load in the southern province of Zambia. Hence, the study aimed to determine the prevalence and factors associated with infectious diarrhoea in adults at Livingstone University Teaching Hospital. This cross-section study was conducted from January 2019 to December 2020 using a structured data collection tool and random sampling technique to select participants for the research. Of the 4,977 participants that were recorded, 7.9% reported having episodes of diarrhoea. The prevalence of diarrhoea was significantly more in females (55.2%) compared to males (44.8%). Additionally, a slightly high prevalence of patients with diarrhoea did not know their HIV status (35.9%), and more of these patients were from the rural areas (52.7%), and a significantly higher prevalence had no other underlying medical conditions (81.2%). This study concluded that diarrheal diseases are significantly prevalent among adult patients reporting at Livingstone University Teaching Hospital. Age was highly associated with infectious diarrhoea.