Aetiology of diarrhoea in children aged less than two years in central Java

Bacteria, parasitic agents and rotaviruses associated with acute diarrhoea in hospital in-patient Indonesian children

Faeces from children (aged from one month to 12 years) with acute diarrhoea admitted to hospital in Yogyakarta, Indonesia, from June 1978 to June 1979, were examined for the presence of enteric pathogens. One or more recognized enteropathogens were identified in 56% of children. Rotaviruses were identified in 38% of all children. Toxigenic coliforms (predominantly Escherichia coli) were isolated from 12% of children. Salmonella sp. (6%), Shigella sp. (4%) and enteropathogenic parasites (predominantly Trichuris trichiura) from 3.5% of children. Mixed infections with two or more enteric pathogens were found in 7.6% of children. The incidence rate of each pathogen was correlated with age of the child, socio-economic level of the family and duration of breast feeding. Toxigenic coliforms were equally common in all age groups from both well-to-do and poor families. Enteropathogenic parasites appeared in increasing frequency with age. They were more common in artificially fed children and in children from families of low socio-economic level. The occurrence of multiple infection with mixtures of enteric pathogens increased with increasing age. Mixtures of parasites and other enteric pathogens only occurred in children with acute diarrhoea. These results provide baseline data about the relative importance of different enteropathogens in Indonesian children.

Frequency of Escherichia coli strains producing heat-labile toxin or heat-stable toxin or both in children with and without diarrhea in São Paulo

Enterotoxigenic Escherichia coli strains were isolated from 32 (13.4%) of 245 children with diarrhea and from 11 (11.4%) of 96 children of the control group. Strains producing heat-labile toxin were found more frequently in normal children than in children with diarrhea. Strains producing heat-stable toxin and both heat-labile and heat-stable toxins were isolated only from children with diarrhea. Association of these strains with diarrhea was highly significant as shown by statistical analysis. The O:H types and the colonization factors of strains producing heat-stable toxin and both heat-labile and heat-stable toxins are presented.