Diarrheal Diseases

To describe knowledge and perceptions regarding the use of oral rehydration solution (ORS) for the management of diarrheal diseases among formal and informal health care providers and community caregivers in the Guatemalan department of Santa Rosa, and to recommend strategies to increase ORS use for management of diarrhea in children. From July to September 2008, in-depth, semi-structured interviews were conducted with formal health care providers; open-ended interviews were conducted with informal health care providers; and focus group discussions and pile sorting were carried out with community caregivers. The study participants attributed episodes of diarrhea in children to culturally recognized or folk ailments (empacho, cuajo, and varillas) that are primarily treated by traditional healers. There were knowledge deficits about 1) dehydration as a manifestation of diarrhea, and 2) management of dehydration, including the use of ORS and the need to continue feedings during diarrhe...

This essay contains two hypotheses: the first postulates that infectious and parasitic conditions in the first baby-carrying devices or “slings” selected for changes in juvenile hair distribution and immuno-resistance, and that a convergence of datable mutations and osteological changes indicate that infants in our lineage adapted to the microenvironment between 1.2 and 2.8 million years ago - with evidence converging towards the older end of that range. Such slings, which might have been first used to carry gleanings, would have surrounded offspring in dangerous pathogens and parasites. Babies whose fetal body baldness had not disappeared would have had an advantage over infants with previously normal body fur, because adults could clean them better – probably resulting in the neotenic extension of the fetal trait.
The microenvironment might have selected for the elimination of infectious pathways as well. The inactivation of the CMAH gene, which could have provided a pathway for pathogens associated with ungulate and proboscidean hides to infect infants with diarrhea, is explored as a candidate, and multiple ways of testing the hypothesis are described.
The related hypothesis, which is based partly on avian comparisons and milk chemistry, postulates that slings gradually forced adults to focus on the kind of nutrition needed by more slowly maturing infant brains by making their babies more altricial. This might have triggered more scavenging, hunting, and feedback mechanisms that slowly extended the new juvenile hair distribution to adults as part of a whole-body cooling system based on sweat and body baldness while contributing to speciation.

You can either download this article from Academia.edu or from my website, www.duncancaldwell.com, which offers more publications and information.

Objective: To explore the practice of management of diarrhea in under-5-year children at health facilities found in Hawassa town, and associated factors with malpractice in comparison. Methodology: Cross Sectional study was conducted in 2 hospitals, 2 health centers and 2 private clinics that are found in Hawassa city which is found in Southern Nations, Nationalities and peoples (SNNP), 275 KM to south from Addis Ababa, capital city of Ethiopia from august 2017-October 2017. Structured checklist was used to retrieve the required information from the patients on arrival and stay in pediatrics OPDs and wards. The data analysis carried out using SPSS version 20.0. Logistic regression was carried out to analyze the association between the independent
and dependent variables. Statistically significant associations were declared at p-values of less than or equal to 0.05. Results: Out of 420, about 397 (94.5%) children with diarrheal disease between the ages of 3 - 59 months were studied. The study subjects were from governmental hospitals (35.5%), health centers (34.5%) and private clinics (30%) that are found in Hawassa City. Sign of dehydration was 66 (17%) of which majority 59 (83%) of them were rehydrated. As to Zink supplementation, only 180 (45%) received it; antibiotics were the commonly (59.1%) prescribed drugs. Only 43.3% of children were appropriately managed. Hospitals had higher odds of inappropriate management of diarrhea with AOR = 1.61 (95% CI: 1.04 - 2.5) and children one year or younger were more inappropriately managed for diarrhea at the health facilities with AOR of 2.3 (95% CI: 1.57 - 4.41). Conclusions: In the current study the management of diarrhea at the health facilities is unsatisfactory as only less than half of children with diarrhea were properly managed. Treatment of diarrhea at hospital level and the patient’s age being less
than 1 year were found to significantly affect the level of mismanagement of the diarrheal disease. Therefore, orientation and trainings for health care providers especially GPs and Residents should be given to adhere to recommended zinc therapy, Oral Rehydration Salts (ORS) replacement therapy and rational antibiotics prescription.

During diarrhea, a patient will have a frequent abnormal passage of loose, liquid or watery stools and causes depletion of body fluids, resulting in profound dehydration. Acute diarrhea refers to the episodes of infectious diarrhea, which have a rapid onset and lasts for about 3 to 7 days but may last up to 10 to 14 days. When two or more people in a community or geographical area have a similar illness or proven infection due to common exposure then it is termed as an outbreak. Variations in weather and climate conditions will influence the intensity of disease outbreaks and thus understanding the influence of the seasons on the infectious disease outbreaks is very important for public health monitoring. The objective of this study is to understand the seasonal variations of the acute diarrheal disease (ADD) outbreaks in India. We analyzed the weekly ADD outbreaks data from 2010 till 2018 that is published as a part of the Integrated Disease Surveillance Programme by National Centre for Disease Control, Directorate General of Health Services. The results of the analysis show that in India, ADD outbreaks will be more during the month of May (peak summer) but predominantly maximum during the month of July (when monsoon prevails).

This paper has reviewed researches that obtained from peer-reviewed literatures on Salmonellosis and Shigellosis. Foodborne diseases related to unhygienic food handling practices remain a major public health problem across the globe. The problem is severe in developing countries due to limitations in securing optimal hygienic food handling practices. Data shows that an estimated 70 % of cases of diarrheal diseases are associated with the consumption of foods contaminated with pathogenic microorganisms. Among these microorganisms Salmonella and Shigella are the major ones. In this review, it is noted that these potentially pathogens are still public health problems. Therefore, there needs to be frequent monitory and evaluation system so as to plan intervention strategies for at risk population in the area of water sanitation and hygienic food handling practice to minimize the burden posed by the diseases associated with Salmonellosis and Shigellosis.

This essay contains two hypotheses: the first postulates that infectious and parasitic conditions in the first baby-carrying devices or "slings" selected for changes in juvenile hair distribution and immuno-resistance, and that a convergence of datable mutations and osteological changes indicate that infants in our lineage adapted to the microenvironment between 1.2 and 2.8 million years ago – with evidence converging towards the older end of that range. Such slings, which might have been first used to carry gleanings, would have surrounded offspring in dangerous pathogens and parasites. Babies whose foetal body baldness had not disappeared would have had an advantage over infants with previously normal body fur, because adults could clean them better – probably resulting in the neotenic extension of the foetal trait. The microenvironment might have selected for the elimination of infectious pathways as well. The inactivation of the CMAH gene, which could have provided a p...

This article has reviewed researches that obtained from peer-reviewed literatures on Salmonellosis and Shigellosis in different parts of Ethiopia. The prevalence of Salmonella and Shigella, the causative agent for Salmonellosis and Shigellosis, respectively, their antibiogram and growth potential were the main objectives of this review. Foodborne diseases related to unhygienic food handling practices remain a major public health problem across the globe. The problem is severe in developing countries due to limitations in securing optimal hygienic food handling practices. Data shows that an estimated 70 % of cases of diarrheal diseases are associated with the consumption of foods contaminated with pathogenic microorganisms. Among these microorganisms Salmonella and Shigella are the major ones. In most studies of Antibiograms tests, Salmonella and Shigella spp. showed high resistance to the commonly used antibiotics which indicate serious problems in antimicrobial therapy globally, es...

This paper has reviewed researches that obtained from peer-reviewed literatures on Salmonellosis and Shigellosis. Foodborne diseases related to unhygienic food handling practices remain a major public health problem across the globe. The problem is severe in developing countries due to limitations in securing optimal hygienic food handling practices. Data shows that an estimated 70 % of cases of diarrheal diseases are associated with the consumption of foods contaminated with pathogenic microorganisms. Among these microorganisms Salmonella and Shigella are the major ones. In this review, it is noted that these potentially pathogens are still public health problems. Therefore, there needs to be frequent monitory and evaluation system so as to plan intervention strategies for at risk population in the area of water sanitation and hygienic food handling practice to minimize the burden posed by the diseases associated with Salmonellosis and Shigellosis.

Asian freshwater clams (Corbicula fluminea) were exposed for 24 hr in 38 liters of water contaminated with 1.0 x 10(5) Cyclospora cayetanensis oocysts (2.6 x 10(3) oocysts/L). The hemolyph and gill smears of 30 clams were examined by acid-fast stain on days 1, 3, 5, 7, 10, 13, and 18 postexposure (PE). Since no oocysts were detected in the water 24 hr after contamination by the membrane filter-dissolution method, the oocyst retention rate was 4.6 X 10(2) oocysts/clam. The prevalence of oocyst-positive clams significantly decreased (P < 0.01) from 93% to 47% during 13 days PE. None of the clams contained oocysts on day 18 PE; no oocysts were detected in the clam feces. The numbers of oocysts recovered from six clam size classes varied and significantly decreased with smaller clam size (P < 0.01). The lowest prevalence values of oocyst-positive clams, 45% and 34%, were observed in the two lowest size classes: 12.1-14.0 mm and 14.1-16.0 mm, respectively. The prevalence values in ...

Asian freshwater clams, Corbicula fluminea, exposed for 24 h to 38 liters of water contaminated with infectious Cryptosporidium parvum oocysts (1.00 x 10(6) oocysts/liter; approximately 1.9 x 10(5) oocysts/clam) were examined (hemolymph, gills, gastrointestinal [GI] tract, and feces) on days 1, 2, 3, 7, and 14 postexposure (PE). No oocysts were detected in the water 24 h after the contamination event. The percentage of oocyst-containing clams varied from 20 to 100%, depending on the type of tissue examined and the technique used--acid-fast stain (AFS) or immunofluorescent antibody (IFA). The oocysts were found in clam tissues and feces on days 1 through 14 PE; the oocysts extracted from the tissues on day 7 PE were infectious for neonatal BALB/c mice. Overall, the highest number of positive samples was obtained when gills and GI tracts were processed with IFA (prevalence, 97.5%). A comparison of the relative oocyst numbers indicated that overall, 58.3% of the oocysts were found in c...

A total of 490 stool specimens were collected from patients with diarrhea and healthy controls without diarrhea to investigate the incidence of Bacillus cereus and its enterotoxins. B. cereus was found more significant in stools of persons with diarrhea than without diarrhea (9.5% versus 1.8%, P < 0.05), and was also detected more frequent but not significant in individuals aged > or =1 year and in adults than in children aged <1 year (11% and 8% versus 7.8%, P > 0.05). The hemolytic enterotoxin HBL genes of B. cereus isolates (hblA, hblC, hblD) were detected in 58%, 58%, and 68%, respectively, whereas the nonhemolytic enterotoxin NHE genes (nheA, nheB, nheC) were detected more frequent in 71.%, 84%, and 90% of the isolates, respectively. This study suggests that B. cereus isolates harboring 1 or more enterotoxin gene(s) can be a potential cause of diarrhea in Jordanian population.

BACKGROUND:
The emergence of drug resistant typhoid fever is a major public health problem, especially in Asia. An oral single dose typhoid vaccine would have major advantages. M01ZH09 is a live oral single dose candidate typhoid vaccine containing Salmonella enterica serovar Typhi (Ty2 aroC(-)ssaV(-)) ZH9 with two independently attenuating deletions. Studies in healthy adults demonstrated immunogenicity and an acceptable safety profile.
OBJECTIVES:
We conducted a randomised placebo controlled, single-blind trial to evaluate the safety and immunogenicity of M01ZH09 in healthy Vietnamese children aged 5 to 14 years.
METHODS:
Subjects were randomly assigned to receive either a nominal dose of 5x10(9) CFU of M01ZH09 or placebo and were followed up for 28 days. The primary safety outcome was the proportion of subjects with any adverse event attributed to M01ZH09. The primary immunogenicity endpoint was the proportion of subjects who showed a positive immune response to M01ZH09 in the Salmonella Typhi lipopolysaccharide (LPS) specific serum IgA and IgG ELISA.
PRINCIPAL FINDINGS:
One hundred and fifty-one children were enrolled, 101 subjects received M01ZH09 and 50 subjects received placebo. An intention to treat analysis was conducted. There were no serious adverse events and no bacteraemias. In the M01ZH09 group, 26 (26%; 95% CI, 18-5%) of 101 subjects experienced adverse events compared to 11 (22%; 95% CI, 12-36%) of 50 subjects in the placebo group (odds ratio (OR) [95%CI] = 1.23 [0.550-2.747]; p = 0.691). Faecal shedding of S. Typhi (Ty2 aroC(-)ssaV(-)) ZH9 was detected in 51 (51%; 95% CI, 41-61%) of 100 M01ZH09 subjects. No shedding was detected beyond day 3. A positive immune response, defined as 70% increase (1.7 fold change) in LPS specific serum IgG (day 14 or 28) and/or 50% increase (1.5 fold change) in LPS specific serum IgA (day 7 or 14) from baseline was detected in 98 (97%; 95% CI, 92-99%) of 101 M01ZH09 recipients and 8 (16%; 95% CI, 7-29%) of 50 placebo recipients. Twenty-eight (100%; 95% CI, 88-100%) of 28 vaccine recipients who were evaluated in the LPS specific IgA ELISPOT assay showed a positive response compared to none of the 14 placebo recipients tested.
CONCLUSIONS:
This was the first phase II trial of a novel oral candidate typhoid vaccine in children in an endemic country. M01ZH09 had an appropriate safety profile and was immunogenic in children.
TRIAL REGISTRATION:
Controlled-trials.com ISRCTN91111837.