Etiology of Diarrhea in Pediatric Outpatient Settings

Denno, Donna M.; Stapp, Jennifer R.; Boster, Daniel R.; Qin, Xuan; Clausen, Carla R.; Beccaro, Kathryn H. Del; Swerdlow, David L.; Braden, Christopher R.; Tarr, Phillip I.

doi:10.1097/01.inf.0000151031.47761.6d

Cited by 65 publications

(51 citation statements)

References 13 publications

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“…In this study, a higher detection rate of astrovirus in cases of AG (4.3%) was observed, as compared to non-diarrheic patients (0.5%) (p < 0.05). This result is comparable to those from other studies where viral detection rates in cases of AG ranged from 1.5 to 20% (Mitchell et al 1999, Giordano et al 2001, Denno et al 2005. In contrast, results from children without gastroenteritis are lower than those observed in other studies where detection rates of 1.2 to 5.7% were yielded considering the same population (Pennap et al 2002, Riechmann et al 2004.…”

Section: Discussioncontrasting

confidence: 45%

Astrovirus infection in children living in the Central West region of Brazil

Santos¹,

Borges²,

Costa

et al. 2007

Mem. Inst. Oswaldo Cruz

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This study presents data regarding the circulation of astrovirus in Goiânia-GO and Brasília-DF. These viruses were detected in fecal samples from hospitalized children up to five years old with and without acute gastroenteritis. A total of 1244 fecal samples were collected in two periods, 1994 to 1996 (Brasília) and 1998, and were analyzed for viral RNA using the reverse transcription-polymerase chain reaction (RT-PCR)

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Section: Discussioncontrasting

confidence: 45%

Astrovirus infection in children living in the Central West region of Brazil

Santos¹,

Borges²,

Costa

et al. 2007

Mem. Inst. Oswaldo Cruz

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“…The effect of probiotics in management of acute diarrhea have been postulated and understood to be because of mechanism like immonological tolerance, producing bacterocins to act as local antibiotics, inhibiting pathogen growth by luminal pH, improving mucosal integrity by stimulating mucin production and by decreasing potent proinflammatory cytokines and enhancing the production of antiinflammatory cytokines. [2][3][4] In a published summary of 73 studies of children who sought care for diarrhea in 33 countries Rotavirus was the most frequently identified. 5,6 Optimal management of diarrhea patients including choice of therapy differs in invasive and noninvasive diarrhea.…”

Section: Discussionmentioning

confidence: 99%

“…Management of acute non bloody diarrhea includes fluids & supportive care in form of Zinc. 2,4 The management in the form of giving probiotics has long been advocated. Probiotics are by definition of WHO and FAO of United Nations are living microorganism which when administered in adequate amount confer a health benefit to the host.…”

Section: Introductionmentioning

confidence: 99%

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To compare the efficacy of two probiotics in acute non bloody diarrhea

Kumar¹,

Ahmed

Vohra

et al. 2016

Int J Contemp Pediatr

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Background: According to WHO watery diarrhea is defined as passage of 3 or more loose stools without blood during preceding 24 hrs. End point of diarrhea was defined as passage of 3 stools of formed consistency. The objective of this study was tocompare the efficacy of two groups of commercially available probiotics in treating children hospitalized with acute non-bloody diarrhea on the basis of duration of stay in hospital, frequency of stool per day and duration of requirement for intravenous fluid. And to compare the results of probiotics in Rotavirus antigen positive children.Methods: A prospective interventional study was conducted in Holy Family Hospital, New Delhi in children aged between 6 months - 5 years hospitalized with acute non bloody diarrhea with 30 children in each group.Results: Total 123 children (6 months - 5 years) admitted in hospital with acute diarrhea, out of which 6 turned out to be bloody, 5 could not be followed up and 3 went LAMA. Finally 109 children with 68 males (62%) with male:female ratio of 1.65. Total 109 children (68 males) were included - Group A (33), 48 in Group B (48) and 28 in Group C (28). In a lateral study, Group A (11), Group B (23) and Group C (10) were Rotavirus positive. 49 children (45%) admitted with stool frequency of 5-10 times per day. Majority of children presented with symptoms like vomiting (68%), fever (55%), decrease oral intake (45%), decrease urine output (25%). Majority of patients 92 children (84%) were between 6 months to 2 years. 44 children (40%) were Rotavirus antigen positive.Conclusions: There is no statistical significant advantage of adding probiotics for treating acute non bloody diarrhea including Rotaviral.

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“…El promedio total del costo por episodio de diarrea en Estados Unidos es de US $289 (16). Teniendo en cuenta las limitaciones de recursos en salud, con la consiguiente necesidad de control de los mismos y su alto costo, se realizará un análisis de costo oportunidad que busca identificar la mejor forma de asignar los recursos teniendo en cuenta que una vez que se decide asignar recursos a un programa o actividad se pierde la oportunidad de asignarlos a otro; de esta forma se busca que los recursos sean asignados a la alternativa que produzca el mayor beneficio, que pueden ser medidos por los indicadores de calidad en salud.…”

Section: Introductionunclassified

Análisis de costo oportunidad del uso de coproscópico en diarrea aguda en menores de 5 años.

López-Barón

Jiménez

Morales³

2016

Rev. Med.

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RESUMENObjetivo: Analizar el uso de coproscópico de rutina, en menores de 5 años con diarrea aguda, en un Hospital de primer nivel de Bogotá y evaluar la mejor forma de asignar los recursos usados en esta intervención a una alternativa que produzca mayor beneficio.Métodos: Revisión de la literatura en diarrea aguda y utilidad del coproscópico. Recopilación de datos de consultas por diarrea en niños de 0-5 años y coproscópicos realizados entre octubre de 2011 y febrero de 2012 en Hospital de Bogotá, con selección de aquellos sugestivos de enfermedad enteroinvasiva, cálculo del costo de su uso y estimación del costo-oportunidad en realización de programas que reduzcan la morbimortalidad en menores de 5 años.Resultados: La principal etiología de la enfermedad diarreica es viral. Más de 5 leucos/campo tiene una sensibilidad y especificidad adecuada que no supera la valoración clínica. Se solicitó coproscópico en 44.8%; el 14.6% sugerían enfermedad enteroinvasiva. El 30.2% de los pacientes no requerían coproscópico y su costo corresponde a $5.266.400.Conclusiones: La utilidad del coproscópico es baja y no mejora la probabilidad pretest de diarrea enteroinvasiva, es necesario abordar la el análisis de costo-oportunidad para la distribución correcta de los recursos en intervenciones que reduzcan la morbimortalidad.Palabras claves: Diarrea, Leucocitos fecales, Coproscópico. 67 COST-OPPORTUNITY ANALYSIS OF THE USE OF FECAL SCREENING TEST IN ACUTE DIARRHEA IN CHILDREN UNDER 5 YEARS OLD ABSTRACTObjective : To analyze the use of routine fecal screening test in children under 5 years old, with acute diarrheal disease in a primary care level hospital in Bogotá and evaluate how best the resources used in this intervention can be allocated to an alternative one, that produces greater benefit .Methods: Review of the literature on acute diarrhea and utility of fecal screening test. Data collection of diarrhea consultations in children under 5 years old and fecal screening test done between October 2011 and February 2012 in a Bogota´s Hospital. Selecting those one, which diagnoses enteroinvasive diarrhea and costing of routine use, and estimated opportunity-cost in programs to reduce morbi-mortality in children under 5 years old. Results:The main etiology of diarrhea is viral. More than 5 WBCs / field has adequate sensitivity and specificity, but the clinical assessment is better on detection of enteroinvasive disease. Fecal screening test was requested in 44.8 %; 14.6 % was suggested enteroinvasive disease. The resources used in 30.2 % of patients did not require the test match to US$2.633. Conclusions:The utility of Fecal screening test is low and does not imprve the pretest probability of enteroinvasive diarrhea. Is necessary to address the cost-opportunity analysis for the proper distribution of resources in intervetions that reduce the morbi-mortality. Conclusões: A utilidade do teste de triagem Fecal é baixa e não melhora a probabilidade pré-teste de diarréia enteroinvasiva. É necessário abordar a análise custo-oportunidade ...

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Etiology of Diarrhea in Pediatric Outpatient Settings

Cited by 65 publications

References 13 publications

Astrovirus infection in children living in the Central West region of Brazil

Astrovirus infection in children living in the Central West region of Brazil

To compare the efficacy of two probiotics in acute non bloody diarrhea

Análisis de costo oportunidad del uso de coproscópico en diarrea aguda en menores de 5 años.

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