Non-bacterial etiologies of diarrheal diseases in Afghanistan

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2014-08, Vol.108 (8), p.461-465
• Main Authors: Elyan, Diaa, Wasfy, Momtaz, El Mohammady, Hanan, Hassan, Khaled, Monestersky, Jesse, Noormal, Bashir, Oyofo, Buhari
• Format: Article
• Language: English
• Subjects: Adenoviridae Infections - epidemiology; Afghanistan - epidemiology; Astroviridae Infections - epidemiology; Biological and medical sciences; Caliciviridae Infections - epidemiology; Child, Preschool; Cryptosporidiosis - epidemiology; Diarrhea - parasitology; Diarrhea - virology; Feces - parasitology; Feces - virology; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Giardiasis - epidemiology; Humans; Infant; Infant, Newborn; Male; Medical sciences; Other diseases. Semiology; Rotavirus Infections - epidemiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1093/trstmh/tru096

Background Microbial diarrheal diseases are one of the leading causes of child morbidity and mortality in developing countries. This study aimed to identify the main causes of non-bacterial diarrhea in Afghanistan. Methods A total of 699 stools were collected from children aged under 5 years who presented with diarrhea at Indira Gandhi and Kandahar hospitals. Frozen aliquots were preserved for screening against rotavirus, astrovirus, adenovirus, norovirus, Cryptosporidium and Giardia, when bacterial cultures tested negative. Tests were performed at the hospitals after laboratory staff were trained and provided with enzyme-immunoassays and equipment. Results were confirmed at the U.S. Naval Medical Research Unit No. 3, Cairo, Egypt. Results Of the samples tested, 71.9% (503/699) were infected with one or more pathogens. However, the majority (85.8%; 432/503) showed single infections: rotavirus (72.2%; 329/432), Cryptosporidium (14.1%; 61/432), Giardia (5.1%; 22/432), astrovirus (2.3%; 10/432), adenovirus (1.6%; 7/432) and norovirus (0.7%; 3/432). The remaining 14% (71/503) showed mixed infections of the tested pathogens. Conclusions Non-bacterial pathogens were identified that could enable health officials to adopt more effective treatment and control measures for diarrhea in Afghanistan.