Le SIDA au Ghana (serveur d'exploration)

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Gastrointestinal Infections and Diarrheal Disease in Ghanaian Infants and Children: An Outpatient Case-Control Study

Identifieur interne : 000338 ( Main/Exploration ); précédent : 000337; suivant : 000339

Gastrointestinal Infections and Diarrheal Disease in Ghanaian Infants and Children: An Outpatient Case-Control Study

Auteurs : Ralf Krumkamp [Allemagne] ; Nimako Sarpong [Ghana] ; Norbert Georg Schwarz [Allemagne] ; Julia Adelkofer [Allemagne] ; Wibke Loag [Allemagne] ; Daniel Eibach [Allemagne] ; Ralf Matthias Hagen [Allemagne] ; Yaw Adu-Sarkodie [Ghana] ; Egbert Tannich [Allemagne] ; Jürgen May [Allemagne]

Source :

RBID : PMC:4349824

Abstract

Introduction

Diarrheal diseases are among the most frequent causes of morbidity and mortality in children worldwide, especially in resource-poor areas. This case-control study assessed the associations between gastrointestinal infections and diarrhea in children from rural Ghana.

Methods

Stool samples were collected from 548 children with diarrhea and from 686 without gastrointestinal symptoms visiting a hospital from 2007–2008. Samples were analyzed by microscopy and molecular methods.

Results

The organisms most frequently detected in symptomatic cases were Giardia lamblia, Shigella spp./ enteroinvasive Escherichia coli (EIEC), and Campylobacter jejuni. Infections with rotavirus (adjusted odds ratio [aOR] = 8.4; 95% confidence interval [CI]: 4.3–16.6), C. parvum/hominis (aOR = 2.7; 95% CI: 1.4–5.2) and norovirus (aOR = 2.0; 95%CI: 1.3–3.0) showed the strongest association with diarrhea. The highest attributable fractions (AF) for diarrhea were estimated for rotavirus (AF = 14.3%; 95% CI: 10.9–17.5%), Shigella spp./EIEC (AF = 10.5%; 95% CI: 3.5–17.1%), and norovirus (AF = 8.2%; 95% CI 3.2–12.9%). Co-infections occurred frequently and most infections presented themselves independently of other infections. However, infections with E. dispar, C. jejuni, and norovirus were observed more often in the presence of G. lamblia.

Conclusions

Diarrheal diseases in children from a rural area in sub-Saharan Africa are mainly due to infections with rotavirus, Shigella spp./EIEC, and norovirus. These associations are strongly age-dependent, which should be considered when diagnosing causes of diarrhea. The presented results are informative for both clinicians treating gastrointestinal infections as well as public health experts designing control programs against diarrheal diseases.


Url:
DOI: 10.1371/journal.pntd.0003568
PubMed: 25738935
PubMed Central: 4349824


Affiliations:


Links toward previous steps (curation, corpus...)


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<sec id="sec001">
<title>Introduction</title>
<p>Diarrheal diseases are among the most frequent causes of morbidity and mortality in children worldwide, especially in resource-poor areas. This case-control study assessed the associations between gastrointestinal infections and diarrhea in children from rural Ghana.</p>
</sec>
<sec id="sec002">
<title>Methods</title>
<p>Stool samples were collected from 548 children with diarrhea and from 686 without gastrointestinal symptoms visiting a hospital from 2007–2008. Samples were analyzed by microscopy and molecular methods.</p>
</sec>
<sec id="sec003">
<title>Results</title>
<p>The organisms most frequently detected in symptomatic cases were
<italic>Giardia lamblia</italic>
,
<italic>Shigella</italic>
spp./ enteroinvasive
<italic>Escherichia coli</italic>
(EIEC), and
<italic>Campylobacter jejuni</italic>
. Infections with rotavirus (adjusted odds ratio [aOR] = 8.4; 95% confidence interval [CI]: 4.3–16.6),
<italic>C</italic>
.
<italic>parvum/hominis</italic>
(aOR = 2.7; 95% CI: 1.4–5.2) and norovirus (aOR = 2.0; 95%CI: 1.3–3.0) showed the strongest association with diarrhea. The highest attributable fractions (AF) for diarrhea were estimated for rotavirus (AF = 14.3%; 95% CI: 10.9–17.5%),
<italic>Shigella</italic>
spp./EIEC (AF = 10.5%; 95% CI: 3.5–17.1%), and norovirus (AF = 8.2%; 95% CI 3.2–12.9%). Co-infections occurred frequently and most infections presented themselves independently of other infections. However, infections with
<italic>E</italic>
.
<italic>dispar</italic>
,
<italic>C</italic>
.
<italic>jejuni</italic>
, and norovirus were observed more often in the presence of
<italic>G</italic>
.
<italic>lamblia</italic>
.</p>
</sec>
<sec id="sec004">
<title>Conclusions</title>
<p>Diarrheal diseases in children from a rural area in sub-Saharan Africa are mainly due to infections with rotavirus,
<italic>Shigella</italic>
spp./EIEC, and norovirus. These associations are strongly age-dependent, which should be considered when diagnosing causes of diarrhea. The presented results are informative for both clinicians treating gastrointestinal infections as well as public health experts designing control programs against diarrheal diseases.</p>
</sec>
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</TEI>
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<li>Allemagne</li>
<li>Ghana</li>
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<name sortKey="Adelkofer, Julia" sort="Adelkofer, Julia" uniqKey="Adelkofer J" first="Julia" last="Adelkofer">Julia Adelkofer</name>
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<name sortKey="May, Jurgen" sort="May, Jurgen" uniqKey="May J" first="Jürgen" last="May">Jürgen May</name>
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<name sortKey="Schwarz, Norbert Georg" sort="Schwarz, Norbert Georg" uniqKey="Schwarz N" first="Norbert Georg" last="Schwarz">Norbert Georg Schwarz</name>
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<name sortKey="Tannich, Egbert" sort="Tannich, Egbert" uniqKey="Tannich E" first="Egbert" last="Tannich">Egbert Tannich</name>
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<country name="Ghana">
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<name sortKey="Sarpong, Nimako" sort="Sarpong, Nimako" uniqKey="Sarpong N" first="Nimako" last="Sarpong">Nimako Sarpong</name>
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