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  India   Childhood diarrhoea still a concern

Childhood diarrhoea still a concern

Published : Sep 23, 2016, 1:21 am IST
Updated : Sep 23, 2016, 1:21 am IST

In a startling revelation, international experts have found that the number of cases of childhood diarrhoea attributable to pathogens (bacteria, parasites, viruses or other infections) may be nearly t

In a startling revelation, international experts have found that the number of cases of childhood diarrhoea attributable to pathogens (bacteria, parasites, viruses or other infections) may be nearly twice as high as previously estimated. Citing that they have been substantially underestimated previously, the analysis of over 10,000 samples from Bangladesh, India, Pakistan, The Gambia, Kenya, Mali, and Mozambique found that Shigella and rotavirus were the most common infections among children under 5 years old, followed by adenovirus, enterotoxin-producing E coli (Etec), cryptosporidium, and campylobacter.

In the new research published in The Lancet, experts have therefore highlighted the need for prioritisation of shigella and Etec vaccines. Researchers re-analysed samples from 10,608 children with and without diarrhoea obtained from regions in seven countries in Asia (Bangladesh, India and Pakistan) and Africa (The Gambia, Kenya, Mali, and Mozambique). While earlier the original GEMS study, published in 2013, estimated that 51.5 per cent of childhood diarrhoea cases could be attributed to pathogens, but the new re-analysis finds the proportion is much higher at 89.3 per cent. The original study identified four major pathogens: rotavirus, shigella spp, cryptosporidiumspp and heat-stable enterotoxin-producing E coli (ST-ETEC). “This re-analysis reaffirmed these four and added two others adenovirus 40/41 and Campylobacter jejuni/coli. Together, these six pathogens accounted for 77.8 per cent of all diarrhoea,” said the Lancet.

Among the children who had a diarrhoea-causing pathogen, about half had more than one infection. “Childhood diarrhoea remains an enormous problem, made more confusing by the long list of possible infections,” says lead author Professor Eric R. Houpt from University of Virginia. The authors recommend longitudinal studies to further understand these pathogens.

Writing in a linked Comment, Dr Karen Keddy, Centre for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa, and co-authors write: “These results imply that prioritising vaccine development for these six pathogens could lead to a substantial decrease in diarrhoea burden among children younger than 5 years over the next few decades, as has been seen for rotavirus. Follow-up studies will indicate which molecular diagnostics complement traditional methods.”

Location: India, Delhi, New Delhi