Prevalence of viral, bacterial and parasitic enteropathogens among young children with acute diarrhoea in Jeddah, Saudi Arabia

Abstract

The prevalence of viral, bacterial and parasitic pathogens among children of Jeddah, Saudi Arabia, was investigated. During December 1995-October 1996, 576 faecal samples were collected from children (0-5 year(s) old) suffering from acute diarrhoea and attending hospitals and outpatient clinics in Jeddah. One or more enteropathogen(s) were identified in 45.6% of the stool specimens. Mixed infections were detected in 12.2% of the diarrhoeal cases. Rotavirus was detected in 34.6% of the specimens of the hospitalized patients and in 5.9% of the specimens of the outpatients. Fifty-one percent of the rotavirus-positive specimens were long electropherotype, 26% were short electropherotype, and 23% could not be electropherotyped specifically. Among those of the long electropherotype, there were six patterns; and of the short electropherotypes, there were four patterns. Serotyping of these specimens revealed a distribution of 39.6%, 4.2%, 6.3%, and 15.6% for rotavirus serotype 1, 2, 3, and 4 respectively. Mixed serotypes were found in 3.1%, and 31.3% of the specimens were untypeable. Other aetiologic agents recognized included Escherichia coli (13%), of which 3.8% were enteropathogenic E. coli (EPEC) and 1.9% enterohaemorrhagic E. coli. Among the E. coli (EPEC) serotypes, O111:K58:B4, O55:K59:B11, and 0127:K63:B8 were found in 31.8%, 18.2%, and 13.6% of the cases respectively. Serotype 026:K60:B6, 0124:K72:B17, and 0112:K66:B11 each was found in 9.1% of the EPEC cases. 0128:K67:B12 and 0125:K70:B13 each was found in one case only. Other detected pathogens were: Klebsiella pneumoniae (4%), Giardia lamblia (3.1%), Salmonella sp. (3%), Shigella flexneri (2.6%), Entamoeba histolytica (2.2%), Trichuris trichiura, Hymenolepis nana, and Ascaris lumbricoides (0.7% each), and Candida albicans (0.5%). Based on the results of this study, it is concluded that the high prevalence of the various enteropathogens among young children is a significant public health problem.