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  • Title: The relative importance of various enteropathogens as a cause of diarrhoea in hospitalized children in Chiang Mai, Thailand.
    Author: Poocharoen L, Bruin CW, Sirisanthana V, Vannareumol P, Leechanachai P, Sukhavat K.
    Journal: J Diarrhoeal Dis Res; 1986 Mar; 4(1):10-5. PubMed ID: 3794260.
    Abstract:
    A study of 208 children aged under 15 hospitalized with diarrhea and 108 matched controls was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand from May 1983 to April 1984 to investigate the incidence, seasonal distribution, and causative agents of diarrhea. 1 or more enteropathogens were isolated from 121 (58%) diarrhea patients and from 32 (30%) controls. In diarrhea patients, Shigella spp. were most frequently isolated (22%) followed by enteropathogenic Escherichia coli (EPEC) (20%), rotavirus (18%), Campylobacter jejuni (7%), Salmonella (4%), Aeromonas (1%) and Plesiomonas shigelloides (1%). No Yersinia enterocolitica were found. Pathogens such as Norwalk agent, adenovirus, and enterotoxigenic E. coli (ETEC) were not sought. A concurrent study revealed ETEC in 3.2% of diarrheal children and 1.5% of controls. Parasites were identified in 11% of diarrhea patients; Giardia lamblia was most commonly found. In 32% of positive diarrhea and 19% of positive control cases more than 1 pathogen was isolated. Shigella was the least involved in cases with multiple infections. Only Shigella and rotavirus were found significantly more often in diarrhea cases than controls and their relation with age, season, and clinical presentation are reported. A high incidence of EPEC among control patients suggests common asymptomatic carriage. 2 diarrhea peaks occurred in the hot and cold seasons; the peak of Shigella diarrhea occurs in the summer, and may be related to the shortage of water at this time of year. Both shigellosis and rotavirus diarrhea patients had an acute onset of symptoms: cramps, convulsions, mucoid and bloody stools with high numbers of white and red blood cells were signficantly more common in shigellosis patients.
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