Five-year Prevalence of Gastrointestinal Diseases and Disorders in Akure South, Nigeria

The burden of gastrointestinal diseases and disorders (GIDD) remains high in Nigeria and varies across regions. This study wa s therefore designed to examine the prevalence of gastrointestinal diseases and disorders over a period of 5-years from January 2014 to December 2018 in Akure South of Ondo state, Nigeria. Descriptive retrospective study was employed and the medical records of all patients diagnosed for GIDD in the two selected health facilities were reviewed within the study period. In total, 12,323 medical records of patients with GIDD were included in this study. The prevalence of GIDD were 44.9% in the year 2014 with the lowest prevalence of 6.7% occurring in the year 2018. Over the 5-years period, lower GIDD cases were 91% compared to upper GIDD that was 9%. Peptic ulcer had the highest prevalence (55%) of lower GIDD followed by gastroenteritis (30%). Hiatal hernia had the highest prevalence (84%) for upper GIDD followed by dyspepsia (11%) and Gastroesophageal reflux disease (5%). Over a 5-year period, the prevalence of gastrointestinal disease and disorders in Akure south in this study shows that lower GIDD is more prevalent in the study area with peptic ulcer as the most predominant GIDD among the study population.

A study of self-reported handwashing practices of caregivers in relation to acute respiratory infections and gastroenteritis in infants in a peri-urban community in KwaZulu-Natal Province, South Africa

Background. Handwashing is a recognised cost-effective intervention for the prevention of common childhoodinfections, including pneumonia and diarrhoeal disease. Globally, handwashing practices may be poor and little is known about handwashing practices in South Africa.Objectives. To describe and compare handwashing practises of caregivers whose infants are admitted with acute gastroenteritis and acute lower respiratory tract infection with those of healthy infants who are attending primary healthcare clinics for routine immunisation.Methods. A cross-sectional study of self-reported handwashing practices was conducted among caregivers of infants from the Vulindlela area,Pietermaritzburg. Respondents were interviewed regarding household structure, services and handwashing practices.Results. During the 3-month study period, 137 respondents were interviewed. Of these, 41 (30%) had infants with pneumonia, 41 (30%) with diarrhoea and 55 (40%) had healthy infants. A high rate of handwashing with soap and water (81.8%) was found in this study, with 58.4% of the respondents using running rather than stagnant water. Logistic regression identified some variables associated with higher odds of having a healthy infant, namely: a monthlyhousehold income >ZAR2 000 (odds ratio (OR) 4.74; 95% confidence interval (CI)1.99 - 11.25); washing hands with soap and running water (OR 3.88; 95% CI 1.55 - 9.76); washing hands before eating (OR 7.41; 95% CI 0.79 - 68.76), and washing hands after household chores (OR 9.24; 95% CI 1.85 - 46.25).Conclusion. A higher than anticipated number of participants washed their hands with soap and running water and at critical moments

Prevalence and genetic diversity of rotavirus infection in children with acute gastroenteritis in a hospital setting, Nairobi Kenya in post vaccination era: a cross-sectional study

Introduction: Rotavirus is the leading cause of severe diarrhoea among infants and young children. Each year more than 611 000 children die from rotavirus gastroenteritis, and two million are hospitalized, worldwide. In Kenya, the impact of recent rotavirus vaccinations on morbidities has not been estimated. The study aimed at determining the prevalence and identity of rotavirus strains isolated from rotavirus-associated diarrhoea in vaccinated children presenting with acute gastroenteritis.Methods: Two hundred and ninety eight specimen from children presented at Gertrude Childrens' Hospital from January to June 2012 were tested by EIA (Enzyme-linked Immunosorbent Assay) for rotavirus antigens. Molecular characterization was conducted on rotavirus-positive specimens. Extracted viral RNA was separated by polyacrylamide gel electrophoresis (PAGE) and the specific rotavirus VP4 (P-types) and VP7 (G-types) determined.Results: The prevalence rate of rotavirus was 31.5% (94/298). Of the rotavirus dsRNA, 57 (60.1%) gave visible RNA profiles, 38 (40.4%) assigned long electropherotypes while 19 (20.2%) were short electropherotypes. The strains among the vaccinated were G3P [4], G12P [6], G3P [6], G9P [4], G mixed G9/3P [4] and G1/3P [4]. Specifically, the G genotypes were G9/3 (5.3%), G9 (4.3%), G3 (4.3%), G12 (2.1%) and mixed G1/3 (1.1%). The P genotypes detected were P [4] (5.3%) and P [6] (5.3%).Conclusion: The present study demonstrates diversity in circulating genotypes with emergence of genotypes G3, G9, G12 and mixed genotypes G9/3 and recommends that vaccines should be formulated with a broad range of strains to include G9 and G12

Rotavirus Gastroenteritis Surveillance and Prevalence Assessment among Under Five Children in Rwanda

Rotavirus remains the most common cause of severe childhood diarrhea worldwide and of diarrheal mortality in developing countries. Despite the efforts made by the government of Rwanda and the stakeholders to reduce children mortality; the prevalence of rotavirus among under five children in Rwanda remains to be determined. We conducted a hospital-based cross-sectional study that aimed at determining the prevalence of rotavirus infection in under fie children presenting with gastroenteritis in eight hospitals in Rwanda. From June 2013 and August 2014 we collected and tested stool samples for the presence ofrotavirus using an enzyme immunoassay and a Real Time-Polymerase Chain Reaction for genotyping. In 969 stool samples; 232 (23.94 and 5.1) while the lowest one was observed in March (0.00). Muhima Hospital had the highest prevalence (33.33) whereas Kabgayi and Rwamagana Hospitals had the lowest (15.62 and 18.18; respectively). Male children were more affected than females (25.8 versus 21.5). We found that the prevalence was higher (31.10) in children aged between 12 and 24 months than in other age groups. For genotyping; G9 [P8] was the most prevalent genotype as G9 prevalence was 54.6 whereas [P8] prevalence was 73.9.In conclusion; the prevalence of rotavirus gastroenteritis was high among children aged less than 5 years; and it was different according to age groups and among different hospitals

Evaluation des dysnatremies au cours de la deshydratation aigue de l'enfant au Centre Hospitalier National d'Enfants Albert Royer (CHNEAR) de Dakar

INTRODUCTION : La deshydratation aigue represente une urgence pediatrique courante; generalement secondaire a la diarrhee aigue. L'objectif de cette etude etait d'apprecier; au cours de la deshydratation aigue; la prevalence des dysnatremies; leur impact sur la morbi-mortalite et les implications therapeutiques dans la prise en charge.MATERIEL ET METHODES : Il s'agissait d'une etude retrospective menee sur deux ans (2009 a 2010); au Centre National Hospitalier d'Enfants Albert Royer; incluant tous les enfants de 2 mois a 5 ans; souffrant de deshydratation aigue et ayant eu un ionogramme sanguin. Sur 310 cas de deshydratation recenses; 205 dossiers repondaient aux criteres d'inclusion et ont constitue notre population d'etude. Nous avons recueilli les donnees epidemiologiques; cliniques; biologiques; therapeutiques et evolutives. Nous avons retenu la classification de la deshydratation en legere; moderee et severe qui figurait dans le dossier. L'hyponatremie etait definie par une natremie strictement inferieure a 135 mmol/l; l'hypernatremie par une natremie superieure a 150 mmol/l. L'analyse a ete faite sur Epi info 3.5. Un p 0.05 etait considere comme significatif. RESULTATS : L'incidence de la deshydratation etait de 3;78%. L'age moyen etait de 12.2 mois (2 a 48 mois) et le sex ratio de 1;52 en faveur des garcons. Il y avait deux pics d'hospitalisation; en janvier-fevrier et en septembre. Un trouble digestif (diarrhee ou vomissements) etait present chez 202 enfants (98;5%) et la denutrition chez 35 enfants (17;1%). La gastroenterite aigue (159 cas) representait 77;5% des causes. La deshydratation etait jugee legere dans 20 cas (9;7 %); moderee dans 91 cas (44;4%) et severe [JK1] dans 94 cas (45;8%). [JK2] L'hyponatremie etait presente chez 105 enfants (51;2%) et elle etait severe; inferieure a 125 mmol/l; chez 28 (13;7%). L'hypernatremie etait notee chez 15 enfants (7;3%). Quatre-vingt pour cent des hypernatremies et 51;5% des hyponatremies etaient associees a une deshydratation severe (P

Acidified Infant Formula Explained

The development of effective methods to prevent acute gastroenteritis is an important goal for infant health. Exclusive breastfeeding and postponement of complementary foods until the age of six months is recommended for healthy infants. However; at times; infant formula is required. Various types are commercially available. Acidified cow's milk formula has been found to prevent the growth of pathogenic bacteria and concurring diarrhoeal disease

The use of prebiotics and probiotics in Infant Formula

Gastrointestinal flora influences health; but the composition of flora can be changed with prebiotics or probiotics. The addition of probiotics to powdered infant formula has not been demonstrated to be harmful to healthy term infants. However; evidence of clinical efficacy regarding their addition is insufficient to recommend the routine use of such formula. The administration of probiotic (single or in combination) supplementation in infant or follow-on formula; and given beyond early infancy; may be associated with some clinical benefits; such as a reduction in the risk of nonspecific gastrointestinal infections; a reduced risk of antibiotic use and a lower frequency of colic and irritability. Confirmatory well-designed clinical research studies are necessary

Probiotics in Infectious Diarrhoea : are they Indicated?

"Infectious gastroenteritis continues to be a leading cause of mortality and morbidity worldwide and while ROTA-vaccination will certainly reduce prevalence; it is unlikely to impact significantly in this condition. The cornerstone of treatment remains replacement of water and electrolyte losses with oral rehydration solution. In areas with low vitamin A status; supplementation of the latter may be of benefit and in the future; the addition of zinc may become routine. A few years ago; probiotics were discussed primarily in the context of alternative medicine. Probiotics are now entering mainstream medical practice since they have been shown to decrease the severity and shorten the duration of infectious gastroenteritis by approximately 24 hours and are therefore a potent add-on therapy. Curtailing the duration of diarrhoea as well as reducing hospital stay; suggests a relevant social and economic benefit of probiotic treatment in adjunction to ORS in acute infectious gastroenteritis in children. Evidence in viral gastroenteritis is more convincing than in bacterial or parasitic infection. Mechanisms of action are strain specific and only those probiotic strains for which there is evidence of clinical efficacy should be recommended. In acute gastroenteritis; there is evidence of efficacy for some strains of lactobacilli (Lactobacillus (L) caseii GG and L. reuteri) and for Saccharomyces boulardii. Although probiotics are ""generally regarded as safe""; side effects such as septicemia have very rarely been reported."

Prevalence des antigenes d'adenovirus chez les enfants atteints de diarrhee aigue

Les diarrhees virales constituent une cause majeure de morbidite et de mortalite infantiles dans le monde entier. Les virus impliques sont; d'apres la litterature; les rotavirus; les astrovirus; les adenovirus enteriques et les calicivirus. Une etude epidemiologique retrospective a ete menee dans le centre-est tunisien : six-cent trente-huit selles ont ete prelevees a partir d'enfants de moins de 5 ans se presentant dans un service de soins hospitaliers du centre-est tunisien pour diarrhee aigue entre octobre 2002 et septembre 2005. Tous les prelevements ont ete testes par technique immunoenzymatique commercialise pour la detection d'antigenes specifiques des adenovirus. Les prelevements positifs en antigenes d'adenovirus ont par la suite ete testes par une technique ELISA permettant la mise en evidence specifique des adenovirus enteriques de l'espece F appartenant aux types 40 et 41. Les adenovirus ont ete detectes dans 6des selles testees par ELISA. Parmi les selles positives en adenovirus; 57(20/35) etaient positives en adenovirus F types 40/41. Parallelement a la diarrhee; les signes cliniques les plus frequemment retrouves chez les enfants hospitalises positifs en adenovirus etaient les vomissements (89) et la fievre (53); associes dans 32des cas a des signes respiratoires. Les adenovirus enteriques semblent jouer un role non negligeable dans les diarrhees infantiles en Tunisie. La mise a disposition de methodes de diagnostic simples et efficaces dans les laboratoires hospitaliers pourrait ameliorer la prise en charge des malades en reduisant l'instauration d'antibiotherapies inutiles

Gastroenteritis in young children

Acute diarrhoea is due to intestinal infection. The patient ingests the pathogen which has contaminated water; food; drink; toys or anything that can be placed in the mouth. An inadequate and unsafe water supply; and poor application and practice of hygiene leads to faecal contamination. The most important complication is dehydration; with a poor correlation between the clinical features and actual dehydration. The management of the dehydrated patient depends on a careful assessment of the state of the circulation and the need for resuscitation. In most instances; oral rehydration is appropriate and fully effective if the solution is offered in small quantities at a time. Normally nourished infants do not require modi fication of their feeds beyond adapting the quantity offered as tolerated; but if diarrhoea persists; there is a risk of intestinal mucosal damage with malabsorption and nutritional consequences

Contribution a l'etude chimique et microbiologique de Nauclea latifolia sm. (Rubiaceae) : possibilite d'utilisation des feuilles comme succedane des racines dans le traitement traditionnel de gastro-enterites

Nauclea latifolia Sm. est une Rubiaceae medicinale tres utilisee dans la therapeutique medico-traditionnelle au Burkina-Faso. Elle est preconisee dans le traitement d'un certain nombre d'affections et plus particulierement les gastro-enterites infantiles. Ce travail presente les resultats d'une etude sur la mise en evidence d'une activite antibacterienne des extraits hydro-alcooliques et alcaloidiques (feuilles et ecorces de racines) vis-a-vis de quatre germes pathogenes testes in vitro. L'effet antimicrobien engendre par les extraits des feuilles de la drogue offre une opportunite de proposer l'utilisation des feuilles comme substitut aux racines. Cette substitution des feuilles aux racines contribue a la sauvegarde de cette plante dont l'exploitation traditionnelle des racines compromet la survie

Analysis of Infectious Diseases in Rural Tropical Areas

A study of 256 annual reports from 17 rural tropical hospitals in 4 African countries over a period of 16 years showed an absolute increase in the number of patients admitted with infectious diseases. Admissions were highest for malaria; followed by pneumonia and gastroenteritis. Admissions for immunisable diseases are decreasing in all countries. Fever remains the most important indicator of infectious diseases. Analysis of fever patients in rural tropical hospitals relies on knowledge of the epidemiology of diseases; plus expertise in physical examination. In this study; a detailed analysis of 900 fever patients indicated that 4showed no infection; 21of infections could be diagnosed by physical examination; 35were diagnosed with the help of additional laboratory tests and 40of patients were diagnosed as FUO (fever of unknown origin). 17of FUO patients had a short; self limiting fever; but the remaining 23were severely ill; suggesting bacterial sepsis; as was indicated by earlier studies. Undiagnosed fevers with resulting over-treatment and high resistance are costly and dangerous. These effects stress the need for better and more laboratory facilities; including possibilities for bacterial cultures. At present; patients are generally over-treated with antimalarials and antibiotics; since further diagnostic facilities are not available. Resistance is high for antimalatials ( Malaria) and for Amoxycillin; Cotrimoxazole and Gentamicin (Gram-bacteria from urine and blood)

Isolation of enteric pathogens and caliform bacteria from infant feeding bottle content in Addis Ababa; Ethiopia

Gastro-enteritis causing bacterial pathogens were studied in infant feeding bottle-contents collected from 24 feeding bottles which were brought to 5 clinics and 2 hospitals from January to November 1989 in Addis Ababa; Ethiopia. The most frequent bacterial isolates were coliform which included Enterobacter spp.; klebsiella spp.; faecal E. coli and cotrobacter spp. Enteric pathogens like entero-pathogenic E. Coli (EPEC); Shigella spp.; and Staph. aureus; constituted respectively 9 (3. per cent); 1 (0.01 per cent); 9 (2.2 per cent) of the total isolates. Although the percent of isolation of enteric pathogens in this study is low; the frequent isolation of Coliform from samples of bottle-contents suggests that the bottle-feeding serves as vehicle in transmission of the enteric pathogens in the studied population. Bottle-feeding mothers should be constantly taught on proper handling of feeding utensils and feeds. Above all the superior quality of breast milk needs to be emphasized to nursing mothers. Moreover; further and well controlled studies are also recommended to reduce diarrhoeal diseases in infant and young children

Epidemiological survey of an outbreak of gastroenteritis in rural community in Oyo State

This report documents the investigation and the control of an outbreak of gastro-enteritis in Lagun; Oyo State; Nigeria. In 1981 cholera was suspected in various parts of Nigeria. The investigations carried out included personal interviews of patients and their contacts; laboratory investigations of faecal specimens and analysis of water samples obtained from the village wells and stream. Available evidence indicates that the infection was probably introduced by one of the many visitors who had thronged the village for a festival. A community environmental sanitation programme was also carried out; and recommendations have been made

Mise en evidence d'une activite antibacterienne de nauclea latifolia Sm. (Rubiaceae); vis-a-vis d'enterobacteries responsables de gastro-enterites infantiles au Burkina-Faso

L'extrait hydroalcoolique de maceration de la poudre d'ecorces de racines de nauclea latifolia Sm. (Rubiaceae) de meme que la solution hydroalcoolique du totum alcaloidique des ecorces de racines ont montre une action inhibitrice sur la croissance des souches microbiennes isolees de produits pathologiques au Centre Hospitalier National de Ouagadougou et testees au cours de cette etude. Cette propriete antibacterienne mise en evidence in-vitro; justifierait l'utilisation de nauclea latifolia en medecine traditionnelle locale; notamment dans le traitement d'un grand groupe d'affections dont les gastro-enterites infantiles constituent l'une des plus frequentes