Prevalence, risk factors and seasonal variations of different Enteropathogens in Lebanese hospitalized children with acute gastroenteritis

Abstract

Background Acute gastroenteritis (AGE) is a major cause of pediatric morbidity and mortality around the world. It remains a frequent reason for infection-related admissions to emergency units among all age groups. Following the Syrian refugee crisis and insufficient clean water in our region, we sought to assess the etiological and epidemiological factors pertaining to AGE in South Lebanon. Methods In this multi-center cross sectional clinical study, we analyzed the demographic, clinical and laboratory data of 619 Lebanese children from the age of 1 month to 5 years old who were admitted with AGE to pediatrics departments of three tertiary care centers in South Lebanon. Results Our results revealed that males had a higher incidence of AGE (57.3%) than females. Enteropathogens were identified in 332/619 (53.6%) patients. Single pathogens were found in 294/619 (47.5%) patients, distributed as follows: Entamoeba histolytica in 172/619 (27.8%) patients, rotavirus in 84/619 (13.6%), and adenovirus in 38/619 (6.1%). Mixed co-pathogens were identified in 38/619 (6.1%) patients. Analyzing the clinical manifestations indicated that E. histolytica caused the most severe AGE. In addition, children who received rotavirus vaccine were significantly less prone to rotavirus infection. Conclusions Our findings alluded to the high prevalence of E. histolytica and other unidentified enteropathogens as major potential causes of pediatric AGE in hospitalized Lebanese children. This should drive us to widen our diagnostic panel by adopting new diagnostic techniques other than the routinely used ones (particularly specific for the pathogenic amoeba E. histolytica and for the unidentified enteropathogens), and to improve health services in this unfortunate area of the world where insanitary water supplies and lack of personal hygiene represent a major problem.

Prevalence, Laboratory Findings and Clinical Characteristics of Campylobacteriosis Agents among Hospitalized Children with Acute Gastroenteritis in Lebanon

“…In accordance, Shim et al [ 27 ] reported that bacterial gastroenteritis is associated with more episodes of diarrhea and longer-lasting diarrhea than common viral infections. Consequently, our data resulted in a higher VSS score for Campylobacter -positive patients, showing a severe profile of acute gastroenteritis compared to a moderate profile for Campylobacter -negative patients, which is consistent with our previous results on rotavirus and adenovirus cases showing a lower severity of acute gastroenteritis in children when compared to other enteropathogens [ 17 ].…”

“…Acute gastroenteritis is the second major cause of pediatric morbidity and mortality following acute lower respiratory tract infections in Lebanon and other developing countries [ 17 ]. Identifying specific enteropathogens responsible for acute gastroenteritis is essential for the application of appropriate and suitable clinical measures to manage the disease.…”

“…We previously reported causative enteropathogens for acute gastroenteritis that are routinely tested in children [ 17 19 20 ], and showed that E. histolytica , rotavirus, and adenovirus are the main agents. The present study shows an additional diagnostic tool for the detection of Campylobacter , which is not routinely performed in gastroenteritis cases in Lebanese hospitals.…”

Prevalence, risk factors, and clinical characteristics of rotavirus and adenovirus among Lebanese hospitalized children with acute gastroenteritis

“…Among those, 135 (43.8%) were females and 173 (56.2%) were males. Patients were divided into seven age groups between 1 month and 12 years (1-3, 4-11, 12-23, 24-35, 36-47, 48-59 and !60) as previously described [1,19]. The mean family size of patients was 4.21; 61.3% of patients were breastfed; and 35.6% of patients have been previously vaccinated with rotavirus vaccine (Table 1).…”

“…Acute gastroenteritis is one of the most common infectious diseases facing all age groups worldwide, especially the pediatric population [1]. It represents a major health problem particularly in developing countries.…”