Surveillance of bacterial pathogens associated with acute diarrheal disease in the Republic of Korea during one year, 2003

An epidemiological survey of human enterobacterial infections was conducted to determine the prevalence of enteropathogens in the Republic of Korea during one year, 2003. We tested for infectious diseases in 26,992 stool samples obtained from people who visited clinics located in six big cities and six rural provinces. From these samples, we isolated 1,291 cases of enteritis bacterial infection (4.8%). In the urban areas, 821 cases of bacterial infection (6.4%) were identified and, in the rural areas, 479 bacterial strains (3.3%) were isolated. Seasonal patterns were seen for diarrhea associated with S. aureus, E. coli and V. parahaemolyticus, while Salmonella and Shigella infections showed slight seasonal variation. We found that S. aureus and Salmonella were more frequently isolated from children and the elderly; however, the prevalence of E. coli, V. parahaemolyticus, and Shigella were similar in different age groups. Routine monitoring of these infections is considered a worthwhile means by which to elucidate their epidemiology and modes of transmission and ultimately to control them more effectively. Continuous laboratory-based surveillance for findings of enteritis bacterial infection should be emphasized in the prevention of these infections.     

Cryptosporidiosis in children of Costa Rica: a cross section and longitudinal study

The present report is a systematic study of children, with and without diarrhea from Costa Rican metropolitan areas and southern rural higlands. Children were observed, respectively, at emergencies, Hospital Nacional de Ni?os, and in a field station in Puriscal; urban children were studied vertically, rural children were observed prospectively (cohort study). Cryptosporidium sp. was found in 4.3% of the cases of diarrhea; diarrhea was generally severe in urban children, but mild in the rural. Infection was detected in urban children less than one year of age: contrasting, no rural infants were found infected, which might be related to breast-feeding, since Puriscal infants were intensively breast-fed for several months, while many urban infants were not breast-fed or were weaned earlier. Cryptosporidium sp. appeared during the warm, rainy and humid months of May through August, when the coccidium was associated with 14.8% of the urban and 15.4% of the rural diarrheas. All urban cases presented dehydration which was corrected with oral rehydration salt therapy, and occasionally with intravenous fluids; dehydration was not common in the rural cases.     

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

IntroductionDiarrheal 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.MethodsStool 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.ResultsThe 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.ConclusionsDiarrheal 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.     

Pediculosis among urban and rural school children in Kumba, Meme division, south-west Cameroon

Pediculosis is an important and common health problem in both urban and rural areas of Kumba. Out of a total of 2,312 children examined (1,462 urban and 850 rural), there was a rather disquieting overall infestation rate of 31.6% in the urban and 32.6% in the rural schools, respectively, and there was a much higher incidence of infestation among girls (36.3% urban, 35.1% rural) than boys (26.9% urban, 30.0% rural). Pubic infestation was more rampant among girls aged 13-15 years (0.3%) than boys (0.1%) of the same age-group, an age which coincides with the characteristic pubertal development of pubic hair. There was a higher incidence of lice infestation in the 9-12 year age-group (33.6% urban, 33.3% rural) than in both the 5-8 year age-group (29.3% urban, 31.6% rural) and the 13-18 year age-group (31.1% urban, and 31.7% rural). Given the nature of Cameroonian society with its African extended family system and its peculiar hospitality traits, it was not possible to correlate socioeconomic status of the children with their infestation rates. Additionally, the schools studied were not class-oriented thus social mixing occurred. Body hygiene has become a mere theoretical exercise in today's schools. Children are neither closely monitored for body cleanliness nor expelled for scandalously poor and unkempt hair and clothing. Inspection of children must be stepped up in order to improve these declining health standards.     

Prevalence of Dermatophytic Fungal Infections in Children: A Recent Study in Anambra State,Nigeria

We conducted a recent survey of dermatological fungal infections amongst children in both urban and rural parts of Anambra State in the south-east geographical flank of Nigeria during the period January 2003 to December 2003. Samples were collected from 1624 children with clinically suggestive lesions and also between the ages of 4 and 16. Young children aged 7–11 and 4– 6 years had significantly higher incidences (P < 0.05) than their older colleagues aged 12–16 years among samples proved to be mycologically positive by microscopy, culture or both. There was a significant difference in the incidence of dermatophytoses amongst children in urban and rural areas investigated (P < 0.05). Tinea capitis was the predominant clinical type. Trichophyton tonsurans was the most prevalent etiological agent while Microsporum audouinii was the least in occurrence. We compared our result with a recent study in the northern geographical zone and observed that although incidence of dermatophytoses is higher in northern Nigeria, tinea capitis was the predominant clinical type in both regions. In addition, the etiological agents appear to vary from time to time in their occurrence and the reasons for these observations are discussed. A regular surveillance and assessment of the etiologic agent and its prevalence by medical mycologists is strongly recommended to facilitate monitoring, reduce/prevent transmission and spread of dermatophytes in countries like Nigeria where they constitute a public health problem.     

Intestinal parasites infestation and anemia in primary school children in Gaza Governorates--Palestine

A comparative study was carried out to identify the prevalence of anemia, nutritional indices and intestinal parasitic infestation in primary school children. The target population included 209 pupils aged 6-11 years, attending schools in two areas, Rimal area (urban) and Jabalia village (rural), in Gaza Governorates. Prevalence of intestinal parasites was high in Jabalia village (more than 53%) in comparison to Rimal area (33%). The main intestinal parasites were Entamoeba histolytica, Giardia intestinalis and Ascaris lumbricoides. Polyparasitism frequency is higher especially in rural area. In both areas anemia showed a high prevalence in children due to malnutrition and intestinal parasitic diseases. There was no association between intestinal parasitic infestation and children growth, but there was association between anemia and intestinal parasitic infestation in children, particularly in rural area. The correlation between anemia and mixed infestation reaches a highly significant level.     

Giardia duodenalis: The double-edged sword of immune responses in giardiasis

Giardiasis is one of the most common intestinal protozoan infections worldwide. The etiological agent, Giardia duodenalis (syn. Giardia lamblia, Giardia intestinalis), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts (Adam, 2001). The symptoms of giardiasis include abdominal cramps, nausea, and acute or chronic diarrhea, with malabsorption and failure of children to thrive occurring in both sub-clinical and symptomatic disease (Thompson et al., 1993). Infections are transmitted by cysts which are excreted in the feces of infected humans and animals. Human giardiasis is distributed worldwide, with rates of detection between 2-5% in the developed world and 20-30% in the developing nations (Farthing, 1994). There is significant variation in the outcome of Giardia infections. Most infections are self-limiting, although re-infection is common in endemic areas and chronic infections also occur. Moreover, some individuals suffer from severe cramps, nausea and diarrhea while others escape these overt symptoms. This review will describe recent advances in parasite genetics and host immunity that are helping to shed light on this variability.     

Enterotoxigenic capacity of strains of Klebsiella and Enterobacter genera isolated in acute intestinal diseases in children

234 strains, including 104 K. pneumoniae strains, 28 K. oxytoxica strains, 64 E. cloacae strains and 40 E. aerogenes strains, have been isolated from the intestine of 266 children with diarrhea, aged up to 1 year, and studied for enterotoxigenicity. By the coagglutination test, made with G. Kronvall's staphylococcal reagent prepared with the use of antiserum to Escherichia coli LT-enterotoxin, and the biological assay on suckling mice enterotoxigenic activity has been revealed in 119 strains, including 48 K. pneumoniae strains (12.6%), 33 E. cloacae strains (27.4%) and 23 E. aerogenes strains (19.7%). The strains producing only LT-enterotoxins, only ST-enterotoxins, and both LT- and ST-enterotoxins have been found. The determination of the enterotoxigenic activity of the clinical isolates of opportunistic enterobacteria makes it possible to improve the etiological interpretation of acute intestinal infections.     

Epidemiology of bacillary dysentery in Algeria. I. The epidemiological aspects of dysentery in Algeria

Bacterial dysentery plays an important role among infectious diseases in Algeria. A tendency to the growth of the morbidity rate has been observed. Dysentery is irregularly spread in different zones of the country. The highest morbidity rate is registered in the Sahara zone and in the eastern part of the country. The morbidity rate among the urban population is higher than among the rural population. S. flexneri prevail in the etiological structure of dysentery infection. Of all age groups, the highest morbidity rate is observed among children during the first 2 years of life. In recent years lethality varies between 2.9% and 7.5%. Patients are hospitalized mainly on the basis of clinical symptoms.     

Enteroparasitoses in the V Region, Chile. A study of rural school children from Santo Domingo, 1987]

The results of a new enteroparasitological survey carried out by the authors are analyzed with the aim of contributing to the knowledge of the situation of these infections in the V Region, Chile. In 1987 the children of five rural schools of Santo Domingo were studied by means of the modified Telemann method, the Ziehl-Neelsen stain and seried Graham test. The parasites more frequently found were: E. vermicularis (50.4%) and G. lamblia (10.8%). No E. histolytica was found in these children. The most frequent commensal was E. nana (21.9%). Cryptosporidium sp. presented a low frequency (0.9%), a figure that in these asymptomatic subjects is in accordance with that found in outpatients with chronic diarrhea in Valparaíso, V Region.     

Epidemiological study of blood lead levels of children and adolescents living in Campania, Italy.

The aim of the present study is to evaluate blood levels (PbB) in a group of 500 (245 M, 255 F) children and adolescents of Campania (Italy) aged from 0.197 to 16.915 years, 269 (136 M, 133 F) of whom lived in urban zones and 231 (109 M, 122 F) in rural zones. PbB was assayed by electrothermal atomic absorption spectroscopy. The parents of the examined subjects children were interviewed about common risk factors for lead exposure using a standardized questionnaire. The PbB of children living in urban zones were significantly higher than the PbB of those living in rural zones (60.0 +/- 3.0 mg/L vs. 40.0 +/- 2.0 mg/L, p < 0.001). A PbB higher than 100 mg/L was found in 27 children (5.4%). We observed a significant correlation between age and PbB (p < 0.001, r = 0.529). Our data regarding children and adolescents demonstrate that the prevalence of PbB higher than 100 mg/L is greater in children living in urban areas (6.89%) than in subjects living in rural areas (3.89%). The findings can be explained by the higher presence of risk factors of Pb exposure in urban areas. Our data, if compared with those of previous studies concerning children of Campania, show a clear decrease of PbB. The correlation that we found between age and PbB indicates that long-term exposure at low doses more than a more intensive but short-term exposure seems to be important for the increase of blood lead levels.     

Nosocomial infection in a children's hospital. A retrospective study

The investigations the frequency of the occurrences of hospital infections were carried in a General Pediatric Ward. Most of the infections (77 per cent) appeared in children up to one year of age. The hospital infections mostly affected children residing in rural areas. The etiological agent was E. coli (36 per cent), Proteus (22.7 per cent) Klebsiella and Staphylococcus. The infections caused by E. coli mainly appeared in girls, others- in boys. The frequency of the occurrences of hospital infections was also analysed with respect to the primary disease of a child. In most cases of additional infections were found in children with upper respiratory tract infections, pneumonia and bronchitis. The above differences are statistically valid.     

Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore,India

Diarrhea causes significant morbidity and mortality in Indian children under 5 years of age. Flies carry enteric pathogens and may mediate foodborne infections. In this study, we characterized fly densities as a determinant of infectious diarrhea in a longitudinal cohort of 160 urban and 80 rural households with 1,274 individuals (27% under 5 years of age) in Vellore, India. Household questionnaires on living conditions were completed at enrollment. Fly abundance was measured during the wet and dry seasons using fly ribbons placed in kitchens. PCRs for enteric bacteria, viruses, and protozoa were performed on 60 fly samples. Forty-three (72%) fly samples were positive for the following pathogens: norovirus (50%), Salmonella spp. (46.7%), rotavirus (6.7%), and Escherichia coli (6.7%). Ninety-one episodes of diarrhea occurred (89% in children under 5 years of age). Stool pathogens isolated in 24 of 77 (31%) samples included E. coli, Shigella spp., Vibrio spp., Giardia, Cryptosporidium, and rotavirus. Multivariate log-linear models were used to explore the relationships between diarrhea and fly densities, controlling for demographics, hygiene, and human-animal interactions. Fly abundance was 6 times higher in rural than urban sites (P < 0.0001). Disposal of garbage close to homes and rural living were significant risk factors for high fly densities. The presence of latrines was protective against high fly densities and diarrhea. The adjusted relative risks of diarrheal episodes and duration of diarrhea, associated with fly density at the 75th percentile, were 1.18 (95% confidence interval [CI], 1.03 to 1.34) and 1.15 (95% CI, 1.02 to 1.29), respectively. Flies harbored enteric pathogens, including norovirus, a poorly documented pathogen on flies.     

The spread of rotavirus gastroenteritis in the Republic of Tajikistan

The article deals with the results of the investigation which has demonstrated the spread of rotavirus infection on the territory of the Republic of Tajikistan. This infection has gained an important place in the regional pathology and requires increased epidemiological surveillance on its spread. As established in the course of this investigation, in patients with the clinical manifestations of pronounced gastroenteritis rotavirus plays the role of the etiological agent in 25.8% of cases in children aged up to 14 years and in 11.0% of cases in adults. Synchronism in the seasonal dynamics of morbidity in acute enteric infections of unclear etiology and rotavirus gastroenteritis among children aged 0-2 years, annually reaching morbidity peak in October, has been revealed. Rotavirus gastroenteritis requires close attention as regards its prophylaxis as one of the main nosological forms of acute enteric infections in the Republic.     

Reasons for extraction of permanent teeth in urban and rural populations of Croatia

The survey aimed to determine the reasons for extraction of permanent teeth by general dental practitioners in urban and rural population of the Senj region, Adriatic coast, Croatia. During a two-year period (1998-9), a total of 2006 teeth were extracted in both regions, in patients aged 15+. The causes were defined as follows: (1) decay or root without a crown (radix relicta), (2) periodontal disease, (3) endodontic or periapical diseases and (4) other reasons--orthodontics/prosthodontics and dental trauma. The statistical Chi-square-test was used to determine the significant difference between the populations and the sexes. Dental caries was the most frequent cause for extraction (over 50%), followed by endodontic and periapical diseases (23%) as the result of untreated caries and at the end periodontal disease (21%). Urban population more often lose teeth due to periodontal disease (22.75%) than rural (18.93%, p < 0.05). Similarly, this is more frequent in the urban male population (25.61%) than the female urban population (20%, p < 0.05). In rural areas, people more often lost teeth as a result of endodontic and periapical disease (25.85%) than in the urban locations (19.07%, p < 0.01) and this is more frequent in women from rural areas (28.37%) than the rural men (22.44%, p < 0.05). Periodontal disease was not the main cause of tooth loss in either the rural or the urban population. Dental caries and its sequel remain the most important challenge for the dental service. It also reveals the inadequacy of dental services. Education of both the population and the general dental practitioners must be conducted in order to improve oral hygiene and to insist on conservative rather than extraction therapy.     

轮状病毒检测技术

轮状病毒是人和动物急性腹泻的重要病原 ,对轮状病毒进行快速、准确的检测对于疾病监测和疫情控制极为重要。从病原学、免疫学以及基因检测三方面 ,总结了轮状病毒检测技术的发展状况 ,重点介绍了较为成熟的免疫学技术 ,最新发展的实时荧光定量PCR、核酸序列依赖的扩增等分子生物学新技术 ,并对未来轮状病毒检测技术的发展趋势进行了展望。     

Enteroviruses: new findings on the role of enteroviruses in type 1 diabetes

Common enterovirus infections appear to initiate or facilitate the pathogenetic processes leading to type 1 diabetes, and sometimes also precipitate the clinical disease. It is not known in detail how enterovirus infections bring about the loss of insulin-producing beta-cells, a phenomenon characteristic of the disease. Recent results from studies on pancreases from human autopsies and cultured human islets support the idea that during systemic enterovirus infections, the virus may reach pancreatic islets and cause direct beta-cell damage. Although individual enteroviruses (EV) exhibited differences in their beta-cell tropism in the cultured human islets, all serotypes studied contained highly destructive strains. The final confirmation on the role of enteroviruses in type 1 diabetes can only be obtained from intervention studies. If the association holds true then it would be possible to reduce the risk of developing type 1 diabetes by preventing enterovirus infections with a multivalent enterovirus vaccine that could be given to children soon after birth.     

Attitudes to Animal use in Children

ABSTRACT

Six hundred and fifty children, aged between 11 and 15 years, from an urban and a rural area, completed a questionnaire in which they provided information regarding their attitudes towards 13 issues involving the use of animals. Information regarding the pets the children owned was also obtained. The child's sex (male, female), age (11–15 years), and residence area (urban, rural) were related to pet ownership, and, including pet ownership, to attitudes towards the use of animals. Over 90% of the sample owned a pet, with the dog being the most common. More pets were owned by children from rural than urban areas. With regards to the animal-use issues, all the children discriminated between animal uses that lead to death of or injury to the animal and those regarded as exploitation. Children disagreed more with uses leading to the animal's death or injury. Females expressed more disagreement than males, and children from urban areas expressed more disagreement than children from rural settings. The study revealed pet ownership to be high among school children. This was matched by a high concern over activities leading to the animal's death or injury, indicating that strong attitudes to animal use are formed early during development. Early education may be important in shaping these attitudes.     

Clinical and epidemiological description of acute intestinal infections in children of the lower Volga region

In accordance with the results of laboratory diagnostics, carried out by bacteriological, serological and PCR methods, the etiological structure of acute bacterial and viral intestinal infections, most frequently occurring in children of the Astrakhan region, is presented. An important role of viral diarrhea cases, prevailing among the total number of cases of intestinal infections in children, is emphasized. The data on the irregular distribution of morbidity by months, especially in viral intestinal infections and salmonellosis with the prevalent involvement of children aged up to 2 years into the epidemic process, are presented. Infections affect mainly children given artificial feeding, as well as those with complicated premorbid state and frequently having acute respiratory viral infections.     

The prevalence of head louse infestation among urban and rural children in Korea

The prevalence of head louse (Pediculus hamanus var. capitis) infestation in preschool and school children in 9 urban and 8 rural areas of Korea, was investigated. Of 11,865 children who were examined for head lice and nits, 2,900(24.4%) were found infested. The over-all infestation rate of rural children, 58.9%, was higher than that of urban children, 14.4%. There also existed significant differences in the infestation rate among various regions of urban as well as rural areas. Females were more infested than males. But there was no differences in infestation rate in either sex of preschool age. The infestation rate increased gradually from the age of 6, reached a plateau between 9-12 years of age and thereafter slowly decreased. The infestation rate of an orphanage children was higher than that of general childhood population. Health education and mass-delousing attempt are urgently required to lower such a high prevalence of head louse infestation in Korea.