Burden and etiology of moderate and severe diarrhea in children less than 5 years of age living in north and south of China: Prospective, population-based surveillance

Gut Pathogens

Rong-Cheng Li¹  Zhao-Jun Mo¹  Yu-Liang Zhao²  Jing-Chen Ma²  Can-Jing Zhang³  Gan Zhao³  Hong-Lu Zhou³  Jin-Xia Wang³  Chao Qiu³  Xuan-Yi Wang⁴  Song-Mei Wang⁵  Baoming Jiang⁶  Theresa Bessey⁶  Leslie Barclay⁶ 

[1] Guangxi Center for Disease Control and Prevention, 530028, Nanning, People’s Republic of China;Hebei Province Center for Disease Control and Prevention, 050021, Shijiazhuang, People’s Republic of China;Key Laboratory of Medical Molecular Virology of Ministry of Education & Ministry of Health, and Institutes of Biomedical Sciences, Fudan University, 200032, Shanghai, People’s Republic of China;Key Laboratory of Medical Molecular Virology of Ministry of Education & Ministry of Health, and Institutes of Biomedical Sciences, Fudan University, 200032, Shanghai, People’s Republic of China;Children’s Hospital, Fudan University, 201102, Shanghai, People’s Republic of China;Laboratory of Molecular Biology, Training Center of Medical Experiments, School of Basic Medical Sciences, Fudan University, 200032, Shanghai, People’s Republic of China;Viral Gastroenteritis Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;

关键词: Burden;    Etiology;    Children;    Diarrhea;    China;   

DOI  :  10.1186/s13099-021-00428-2

来源: Springer

【 摘 要 】

BackgroundDiarrhea remains the leading cause of childhood illness in China. Better understanding of burden and etiology of diarrheal diseases is important for development of effective prevention measures.MethodsPopulation-based diarrhea surveillance was conducted in Sanjiang (southern China) year-round and Zhengding (northern China) in autumn/winter. Stool specimens were collected from children < 5 years of age experiencing diarrhea. The TaqMan Array Card (TAC), based on multiplex real-time PCR, was applied to detect multiple enteric microbial agents simultaneously. Results using these methods were compared to those derived from conventional PCR assays.ResultsDuring the study period, 6,380 children in Zhengding and 3,581 children in Sanjiang < 5 years of age participated. Three hundred and forty (31.2%) and 279 (22.9%) diarrhea episodes were identified as moderate-to-severe in the two counties, with incidence of 60.4 and 88.3 cases per 1,000 child-years in Zhengding and Sanjiang, respectively. The five most frequently detected bacterial and viral agents in Sanjiang were adenovirus, enterovirus, enteroaggregative Escherichia coli (EAEC), rotavirus, and sapovirus all the year round, while the most common viral agents in Zhengding were rotavirus, followed by astrovirus and adenovirus during the cool season. Compared to conventional PCR assay, the average incremental detection via the TAC method was twofold.ConclusionOur study demonstrated high diversity and prevalence of multiple major bacterial and viral agents, including rotavirus and calicivirus, among children in China. Further studies are needed to define the public health significance of neglected but frequently detected pathogens such as EAEC, enterotoxigenic E. coli, Campylobacter, adenovirus, and enterovirus.

【 授权许可】

CC BY