Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance - 04/06/15

Doi : 10.1016/j.jinf.2015.03.001

Jianxing Yu ^a,^{^{o
Those authors contributed equally to this work.}}, Huaiqi Jing ^b,^{^{o
Those authors contributed equally to this work.}}, Shengjie Lai ^a,^{^{n
Current address: Department of Geography and Environment, University of Southampton, Southampton SO17 1BJ, UK.},}^{^{o
Those authors contributed equally to this work.}}, Wenbo Xu ^c, Mengfeng Li ^d, Jianguo Wu ^e, Wei Liu ^f, Zhenghong Yuan ^g, Yu Chen ^h, Shiwen Zhao ⁱ, Xinhua Wang ^j, Zhuo Zhao ^k, Lu Ran ^a, Shuyu Wu ^l,^m, John D. Klena ^l,^m, Luzhao Feng ^a, Fu Li ^e, Xianfei Ye ^h, Yanzi Qiu ^e, Xin Wang ^b, Hongjie Yu ^a, Zhongjie Li ^a,^⁎ , Weizhong Yang ^a,^⁎
^a Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
^b National Institute for Communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
^c National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
^d Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, China
^e State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, China
^f Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, China
^g Shanghai Public Health Clinical Center, Shanghai, China
^h State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
ⁱ Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
^j Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
^k Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
^l International Emerging Infections Program, US Centers for Disease Control and Prevention, Beijing, China
^m Global Disease Detection Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA

^∗Corresponding author. Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Changbai Rd. 155#, Changping District, Beijing 102206, China.^∗∗Corresponding author. Chinese Center for Disease Control and Prevention, Changbai Rd. 155#, Changping District, Beijing 102206, China.

Summary

Objectives

Diarrhea is a leading cause of morbidity and mortality for children, although sparse data is available on the etiology of diarrhea in China. This study was conducted to determine main causes that underlie childhood diarrhea and related diseases.

Method

Surveillance data for diarrhea was collected from 213 participating hospitals between 2009 and 2013. These stool specimens, from children aged 0–59 months, were then analyzed for a panel of etiological agents consisting of 5 viruses, 8 bacteria and 3 protozoa. The proportion of children who tested positive for each pathogen was calculated and seasonal patterns for major organisms were determined.

Results

Pathogens were identified in 44.6% of the 32,189 samples from children with diarrhea. The most commonly detected pathogens were rotavirus (29.7% of cases), norovirus (11.8%), Diarrheagenic Escherichia coli (DEC; 5.0%), adenovirus (4.8%), non-typhoidal Salmonella (NTS; 4.3%), and Shigella spp. (3.6%). A strong seasonal pattern was observed for these organisms, including rotavirus (winter), norovirus (autumn), and DEC, NTS, and Shigella (summer).

Conclusion

A wide range of enteropathogens were detected in this five-year surveillance study; rotavirus and norovirus were most common among children under the age five. These findings should serve as robust evidence for public health entities when planning and developing national intervention programs in China.

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Keywords : Etiology, Diarrhea, Outpatients, Children, Sentinel surveillance, China

Plan

Introduction

Materials and methods

Case recruitment

Collection and transport of specimens

Microbiological testing

Data analysis

Ethics

Results

Characteristics of case-patients

Prevalence of enteropathogens

Serotyping and genotyping

Conflict of interest statements

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Vol 71 - N° 1

P. 19-27 - juillet 2015 Retour au numéro

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Etiology of diarrhea among children under the age five in China: Results from a five-year surveillance - 04/06/15

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