Incidence and etiology of infectious diarrhea from a facility-based surveillance system in Guatemala, 2008–2012

Details

• Alternative Title:
  BMC Public Health
• Personal Author:
  Arvelo, Wences ; Hall, Aron J. ; Henao, Olga ; Lopez, Beatriz ; Bernart, Chris ; Moir, Juan C. ; Reyes, Lissette ; Montgomery, Susan P. ; Morgan, Oliver ; Estevez, Alejandra ; Parsons, Michele B. ; Lopez, Maria R. ; Gomez, Gerry ; Vinje, Jan ; Gregoricus, Nicole ; Parashar, Umesh ; Mintz, Eric D. ; McCracken, John ; Bryan, Joe P. ; Lindblade, Kim A.
• Description:
  Background
  
  Diarrhea is a major cause of morbidity and mortality, yet incidence and etiology data are limited. We conducted laboratory-based diarrhea surveillance in Guatemala.
  
  Methods
  
  A diarrhea case was defined as ≥3 loose stools in a 24-h period in a person presenting to the surveillance facilities. Epidemiologic data and stool specimens were collected. Specimens were tested for bacterial, parasitic, and viral pathogens. Yearly incidence was adjusted for healthcare seeking behaviors determined from a household survey conducted in the surveillance catchment area.
  
  Results
  
  From November 2008 to December 2012, the surveillance system captured 5331 diarrhea cases; among these 1381 (26%) had specimens tested for all enteric pathogens of interest. The adjusted incidence averaged 659 diarrhea cases per 10,000 persons per year, and was highest among children aged < 5 years, averaging 1584 cases per 10,000 children per year. Among 1381 (26%) specimens tested for all the pathogens of interest, 235 (17%) had a viral etiology, 275 (20%) had a bacterial, 50 (4%) had parasites, and 86 (6%) had co-infections. Among 827 (60%) specimens from children aged < 5 years, a virus was identified in 196 (23%) patients; 165 (20%) had norovirus and 99 (12%) rotavirus, including co-infections. Among 554 patients aged ≥5 years, 103 (19%) had a bacterial etiology, including diarrheagenic Escherichia coli in 94 (17%) cases, Shigella spp. in 31 (6%), Campylobacter spp. in 5 (1%), and Salmonella spp. in 4 (1%) cases. Detection of Giardia and Cryptosporidium was infrequent (73 cases; 5%).
  
  Conclusions
  
  There was a substantial burden of viral and bacterial diarrheal diseases in Guatemala, highlighting the importance of strengthening laboratory capacity for rapid detection and control and for evaluation of public health interventions.
  
  
• Subjects:
  Adolescent Adult Child Child, Preschool Dysentery Feces Female Humans Incidence Infant Laboratories Male Middle Aged Public Health Surveillance Young Adult

  More +
• Source:
  BMC Public Health. 19
• Pubmed ID:
  31640646
• Pubmed Central ID:
  PMC6805345
• Document Type:
  Journal Article
• Funding:
  Supported in part by Cooperative Agreement UO1 GH000028-02/US Centers for Disease Control and Prevention/
• Place as Subject:
  Guatemala
• Volume:
  19
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:671241c0d2672b411844c59b311ea6df5f96fbbde802d80bf39161ce45441f15
• Download URL:
  https://stacks.cdc.gov/view/cdc/89734/cdc_89734_DS1.pdf
• File Type:
  [PDF - 2.16 MB ]