Persistent digestive disorders in the tropics: causative infectious pathogens and reference diagnostic tests

BMC Infectious Diseases

Review

Fransiska Meyanti¹  Katja Polman²  Jan Jacobs³  Emmanuel Bottieau³  Jürg Utzinger⁴  Stefanie Knopp⁴  Jürg Vogt⁴  Sören L Becker⁵  Suman Rijal⁶  Lisette van Lieshout⁷  Marleen Boelaert⁸  Marcus Panning⁹  François Chappuis^1,10  David C Warhurst^1,11  Michael A Miles^1,11  Pascal Lutumba^1,12  Moussa Sacko^1,13  Lutz von Müller^1,14  Cedric P Yansouni^1,15  Eliézer K N’Goran^1,16  Hanspeter Marti^1,17 

[1]Centre for Tropical Medicine, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia

[2]Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

[3]Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

[4]Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

[5]University of Basel, Basel, Switzerland

[6]Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland

[7]University of Basel, Basel, Switzerland

[8]Institute of Medical Microbiology and Hygiene, University of Saarland Hospital, Homburg/Saar, Germany

[9]Department of Internal Medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal

[10]Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands

[11]Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

[12]Department of Virology, University of Freiburg, Freiburg, Germany

[13]Division of Humanitarian and International Medicine, Geneva University Hospitals, Geneva, Switzerland

[14]Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom

[15]Institut National de Recherche Biomédicale, Kinshasa, Congo

[16]Université de Kinshasa, Kinshasa, Congo

[17]Institut National de Recherche en Santé Publique, Bamako, Mali

[18]Institute of Medical Microbiology and Hygiene, University of Saarland Hospital, Homburg/Saar, Germany

[19]J.D. MacLean Centre for Tropical Diseases, and Divisions of Infectious Diseases and Medical Microbiology, McGill University Health Centre, Montreal, Canada

[20]Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

[21]Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire

[22]Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire

[23]University of Basel, Basel, Switzerland

[24]Department of Medical Services and Diagnostic, Swiss Tropical and Public Health Institute, Basel, Switzerland

关键词: Bacteria;    Clinical microbiology;    Diagnosis;    Digestive disorders;    Gastroenterology;    Helminths;    Intestinal protozoa;    Persistent diarrhoea;    Virus;   

DOI  :  10.1186/1471-2334-13-37

 received in 2012-09-17, accepted in 2013-01-14,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPersistent digestive disorders account for considerable disease burden in the tropics. Despite advances in understanding acute gastrointestinal infections, important issues concerning epidemiology, diagnosis, treatment and control of most persistent digestive symptomatologies remain to be elucidated. Helminths and intestinal protozoa are considered to play major roles, but the full extent of the aetiologic spectrum is still unclear. We provide an overview of pathogens causing digestive disorders in the tropics and evaluate available reference tests.MethodsWe searched the literature to identify pathogens that might give rise to persistent diarrhoea, chronic abdominal pain and/or blood in the stool. We reviewed existing laboratory diagnostic methods for each pathogen and stratified them by (i) microscopy; (ii) culture techniques; (iii) immunological tests; and (iv) molecular methods. Pathogen-specific reference tests providing highest diagnostic accuracy are described in greater detail.ResultsOver 30 pathogens may cause persistent digestive disorders. Bacteria, viruses and parasites are important aetiologic agents of acute and long-lasting symptomatologies. An integrated approach, consisting of stool culture, microscopy and/or specific immunological techniques for toxin, antigen and antibody detection, is required for accurate diagnosis of bacteria and parasites. Molecular techniques are essential for sensitive diagnosis of many viruses, bacteria and intestinal protozoa, and are increasingly utilised as adjuncts for helminth identification.ConclusionsDiagnosis of the broad spectrum of intestinal pathogens is often cumbersome. There is a need for rapid diagnostic tests that are simple and affordable for resource-constrained settings, so that the management of patients suffering from persistent digestive disorders can be improved.

【 授权许可】

Unknown   
© Becker et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.