Prevalence of Gastrointestinal Pathogens in Developed and Developing Countries: Systematic Review and Meta-Analysis

Abstract

Diarrhoeal illness is a leading cause of child mortality and morbidity worldwide. There are no precise or current estimates of the types and prevalence of pathogens associated with diarrheal illnesses in developed and developing settings. This systematic review assessed data from 60 studies published in the English language from five developing regions and developed countries worldwide to provide regional estimates of enteric pathogens affecting children. The random-effect method was used to establish the weighted average prevalence of pathogens in adults and children for each region. Significantly more pathogens were reported by studies from developing regions compared with Organisation for Economic Co-operation and Development countries (P<0.016). The identification rates of pathogens from community based and hospital based studies were similar (58.5% and 58.1% respectively, P<0.619). The overall detection of enteric pathogens in developing countries was higher in adults (74.8%; 95% CI 63.1-83.8%) compared with children (56.7%; 95% CI 53.0-60.4%) (P<0.001). Rotavirus was the most frequently detected pathogen in all regions with the highest rate, 24.8% (95% CI 18.0-33.1%), detected in the developed countries. This systematic review is the first to provide an estimate of the prevalence of enteric pathogens associated with diarrhoeal illnesses in adults and children in developed and developing settings. While pathogen detection rate is greater in developing regions the consistently high prevalence of rotavirus in both developed and developing settings underscores the urgent need for access to rotavirus vaccines. Increased travel between developing and developed countries increases disease risk, and hence developed countries have a vested interest in supporting vaccine accessibility in developing settings.

Antibiotic resistance profiles of Campylobacter species in the South Africa private health care sector

“…This is comparable to results obtained by Samie et al, in Vhembe District, South-Africa, who found a higher rate of infection in children less than two years (30.4%) [19]. A recent review article by Fletcher et al, showed that Campylobacter gastroenteritis is particularly common between children less than 5 years old, with an isolation rate of approximately 58% in developing countries [30]. Another study conducted in New Delhi, India, showed a peak incidence of 19% in children below one year of age [31].…”

Selection Pressure in the Human Adenovirus Fiber Knob Drives Cell Specificity in Epidemic Keratoconjunctivitis

“…uman adenoviruses (HAdVs) are major causes of respiratory disease, gastroenteritis, and keratoconjunctivitis (1)(2)(3)(4). HAdV infections are also a major concern in immunocompromised hosts, with fatality rates as high as 55% (5).…”

Food safety in developing countries: an overview

“…The first systematic review of diarrhoeal pathogens in different world regions had similar findings: bacteria were relatively more important in developing countries and viruses less important (Fletcher et al, 2013 ++). Most studies (summarised in Belderock et al, 2011) find the Indian sub-continent has highest incidence of diarrhoea followed by Africa then other developing regions.…”

“… high levels of hazards are often reported in developing country food (Grace et al, 2010 ++);  high prevalences of potentially foodborne pathogens are found in hospital and community surveys of children and adults with diarrhoea (Fletcher et al, 2013 +++);  a lack of clean water for washing food and utensils is common (around 750 million people do not have access to clean water (WHO/UNICEF, 2014 +++); and  the use of human sewage or animal waste for horticulture production is common in developing countries.…”