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Helou M, Nasr J, Hajjar M, Bourji A, Feghaly R, Jabbour E, Abboud E, Abboud E, Mahdi A, Mina J, Asmar A, Husni R. Epidemiology of pathogens causing acute diarrhea in patients presenting to the emergency departments in 4 hospitals in Lebanon. Medicine (Baltimore) 2024; 103:e37316. [PMID: 38428867 PMCID: PMC10906651 DOI: 10.1097/md.0000000000037316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
Acute diarrhea is a prevalent disease worldwide and a cause of mortality in low and middle-income countries. In previous studies, the causative enteropathogen is found in 38% to 58% of patients, leaving a considerable diagnostic gap. In this study, we intend to determine the pathogenic agents responsible for acute diarrhea in patients presenting to the Emergency Departments of several Lebanese hospitals. A total of 100 stool samples were collected between June 2022 and June 2023 from patients presenting with acute diarrhea to the Emergency Departments. Pathogens were detected by multiplex polymerase chain reaction. The average age for the patients was 53 years old. All patients presented with diarrhea, 15 of them had fever associated. In total, 46 patients were admitted to the hospital (70%), among them 80% received Intravenous antibiotics. Campylobacter was the most common agent detected in 36%, followed by Rotavirus 19%, and Noroviruses 15%. The rest was detected at lower percentages. Bacteria accounted for 49% of cases, viruses for 39%, and parasitic infection 6%. Acute diarrhea epidemiology is understudied in Lebanon. This study is the first Lebanese data about acute diarrhea pathogens. Avoiding overuse of antibiotics in bacterial versus viral infections can be achieved while prevention campaigns can raise awareness about food and water safety at the community level.
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Affiliation(s)
- Mariana Helou
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Janane Nasr
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | | | - Alaa Bourji
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rita Feghaly
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Elsy Jabbour
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Edmond Abboud
- Laboratory Department, The Middle East Institute of Health University Hospital, Mount Lebanon, Lebanon
| | - Emma Abboud
- Laboratory department, Mount Liban Hospital, Lebanon
| | - Ahmad Mahdi
- Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Lebanese American University, School of Medicine, Beirut, Lebanon
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY
| | - Alain Asmar
- Division of Emergency Medicine, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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Damtie D. Review of Medicinal Plants Traditionally Used to Treat Diarrhea by the People in the Amhara Region of Ethiopia. Evid Based Complement Alternat Med 2023; 2023:8173543. [PMID: 38044982 PMCID: PMC10693470 DOI: 10.1155/2023/8173543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/05/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Background Diarrheal illness is the second-most common cause of death in under-five children. Worldwide, it results in about 1.7 billion illnesses and 525,000 deaths among under-five children annually. It is the leading cause of malnutrition among under-five children. Different people use medicinal plants to treat diarrhea. The present study aimed to review the medicinal plants used to treat diarrhea by the people in the Amhara region and to diagnose whether the antidiarrheal activities of the medicinal plants have been confirmed by studies using animal models. Methods The author searched 21 articles from worldwide databases up to December 2022 using Boolean operators ("AND" and "OR") and the terms "ethnobotanical studies," "ethnobiology," "traditional medicine," "ethnobotanical knowledge," and "Amhara region." Results From the 21 studies reviewed, 50 plant species grouped into 28 families were reported to treat diarrhea by the people in the Amhara region. The top most used families were Lamiaceae (12%), Fabaceae (8%), Asteraceae, Cucurbitaceae, Euphorbiaceae, and Poaceae (6% each). The modes of administration of the plant parts were orally 98.88% and topically 1.12%. The different extracts of 18 (or 36%) of the medicinal plants traditionally used to treat diarrhea by the people in the Amhara region have been proven experimentally in animal models. Conclusions The people in the Amhara region use different medicinal plants to treat diarrhea. Most of them take the medicinal plants orally. The traditional claim that 60% of medicinal plants are antidiarrheal has been confirmed in in vitro studies.
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Affiliation(s)
- Destaw Damtie
- Department of Biology, College of Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Asgedom AA, Abirha BT, Tesfay AG, Gebreyowhannes KK, Abraha HB, Hailu GB, Abrha MB, Tsadik M, Gebrehiwet TG, Gebreyesus A, Desalew T, Alemayehu Y, Mulugeta A. Unimproved water and sanitation contributes to childhood diarrhoea during the war in Tigray, Ethiopia: a community based assessment. Sci Rep 2023; 13:7800. [PMID: 37179380 PMCID: PMC10182988 DOI: 10.1038/s41598-023-35026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was to investigate the sources of drinking water, sanitation and hygiene practices, and the incidence of diarrhoeal diseases among children during the war in Tigray, Ethiopia. A cross-sectional study was conducted to collect data on selected WASH indicators in six zones of Tigray from August 4-20, 2021. Data were collected from a total of 4381 sample households selected by lottery. Descriptive analysis was performed and the analysed data are presented in tables, figures and explanatory notes. Binary logistic regression was performed to examine the relationship between independent and dependent variables. A total of 4381 households from 52 woredas participated in the study. Approximately 67.7% of the study participants reported that they relied on an improved source of drinking water during the war. Coverage of sanitation, hand washing, and menstrual hygiene during the war was reported as 43.9%, 14.5%, and 22.1%, respectively. The prevalence of diarrhoeal diseases among children was 25.5% during the war. Water source, latrine type, solid waste disposal and health extension worker visits were the significant predictors of the likelihood of diarrhoea in children (p < 0.05). The results of the study show that a decrease in services from WASH is associated with a higher prevalence of diarrhoeal disease among children during the war in Tigray. To prevent the high prevalence of diarrhoeal disease among children in war-torn Tigray, Ethiopia, improved access to water and sanitation is recommended. In addition, collaborative efforts are needed to engage health extension workers to provide appropriate promotion and prevention services to war-affected communities in Tigray, Ethiopia. Further comprehensive surveys of households with children over one year of age are recommended to assess access to WASH and the burden of WASH associated diseases.
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Affiliation(s)
- Akeza Awealom Asgedom
- Department of Environmental Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | | | - Askual Girmay Tesfay
- Department of Hygiene and Environmental Health, Tigray Health Bureau, Mekelle, Ethiopia
| | | | | | - Gessessew Bugssa Hailu
- Department of Medical Parasitology and Entomology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mesele Bahre Abrha
- Department of Environmental Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mache Tsadik
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | | | - Aregawi Gebreyesus
- Department of Epidemiology, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tilahun Desalew
- OXFAM Emergency Response - Tigray Field Office, Mekelle, Ethiopia
| | | | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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