Acute gastroenteritis is the major cause of morbidity and mortality among infants and children around the globe. Along with other enteropathogens, human adenovirus (HadV) is a major etiological agent associated with diarrhea in young children. However, information about the epidemiology of Adenoviruses in Pakistan is limited or has not been reported. A total of 1082 stool samples were collected from patients with acute gastroenteritis under the age of five years with symptoms of diarrhea, vomiting, nausea, and abdominal cramps who visited Benazir Bhutto Hospital Rawalpindi and Children’s hospital in Lahore of Punjab Province in Pakistan. Of this, 384 cases with no blood in their stool, negative for Rotavirus, and under the age of five years were recruited in this study. Human Adenoviruses were isolated in the human epithelial HEp-2 cell line. Furthermore, adenovirus antigen detection was carried out by an enzyme-linked immunosorbent assay (ELISA), and then all positive and negative samples were confirmed by nested PCR. After inoculating a clear stool supernatant on HEp-2 cell lines, we observed a positive cytopathic effect in 65 (16%) cases. Using an enzyme-linked immunosorbent assay, HAdV antigens were detected in 54 (14.06%) of the clear supernatant from gastroenteritis cases. However, HAdV hexon coding regions were amplified in 57 (14.80%) fecal samples, mainly from patients ≤24 months of age. The findings of this study suggest that adenovirus circulates significantly in the children population under the age of five years and may be the potential etiological factor of acute gastroenteritis in the mentioned cities. This study provides baseline data about the possible role of adenovirus in causing viral diarrhea in children. Further large-scale epidemiological surveys are recommended to better understand disease burden, etiological agents, and its clinical impact across the country.

Background: Acute gastroenteritis is the major cause of morbidity and mortality among infants and children around the globe. Along with other enteropathogens, human adenoviruses (HadV) are considered a major etiological agent associated with diarrhea in young children. However, information about the epidemiology of adenoviruses in Rawalpindi and Lahore, the two cities of Punjab province, Pakistan is not reported yet.Methods: A total of 384 fecal samples were negative for rotavirus, out of 1082 from a patient with acute gastroenteritis, under the age of five years with symptoms like watery diarrhea, visiting Benazir Bhutto hospital Rawalpindi and Children hospital Lahore were enrolled in this study. Human adenoviruses were tested for primary isolation in the human epithelial HEp-2 cell line. Furthermore, adenovirus antigen detection was carried out by enzyme-linked immunosorbent assay (ELISA), and then all the positive and negative samples were confirmed by nested PCR.Results: After inoculation stool, supernates on HEp-2 cell lines showed a positive cytopathic effect in 65 (16.) patients. Using an enzyme immunosorbent assay HAdV, antigens were detected in 54 (14.06%) samples. However, HAdV hexon coding regions were amplified in 57 (14.80%) fecal samples mostly from patients equal to or under 24 months of age.Conclusion: The findings of this study revealed that adenovirus is the etiological agent of gastroenteritis in the mentioned cities and provides the baseline data about the possible role of adenovirus in causing diarrhea in children. Further large-scale epidemiological surveys are required for a better understanding of disease burden and its clinical impact.