While many pathogens cause serious diarrhea in children in developing countries, four stand out as culprits in most of the infections, a finding that could drive new prevention strategies, an international research team reported today.
The group spent 3 years in seven developing countries, collecting health information, lab samples, and outcome data on 3,439 youngsters who had moderate-to-severe diarrhea. They published their findings today in an early online release from The Lancet.
On a global scale each year, diarrheal diseases kill about 800,000 children under age 5, most of them in sub-Saharan Africa and southern Asia, according to the report.
Though interventions such as rotavirus vaccines are starting to have an impact on deaths and disease incidence, scientific data to guide other strategies to curb the diseases are scarce, especially in regions where child deaths are the highest, the group wrote.
To fill the gap, the team focused their analysis on kids under age 5 who did and didn’t have moderate-to-severe diarrhea in selected cities in Bangladesh, Gambia, India, Kenya, Mali, Mozambique, and Pakistan. The study included 13,129 matched controls.
The researchers collected clinical and epidemiologic information, took anthropometric measurements, and took fecal samples to identify pathogens. For each child they made a follow-up home visit 60 days later to assess health status, clinical outcome, and growth measures.
Four pathogens were the most common causes of diarrhea across all sites: rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli (ETEC) producing heat-stable toxin (ST), and Shigella, according to the study.
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