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Review
. 2023 Aug 23:2023:1906782.
doi: 10.1155/2023/1906782. eCollection 2023.

Gastrointestinal Infection in South African Children under the Age of 5 years: A Mini Review

Tshepo Mafokwane  1 , Appolinaire Djikeng  2   3 , Lucky T Nesengani  2 , John Dewar  1 , Olivia Mapholi  2
Affiliations
Review

Gastrointestinal Infection in South African Children under the Age of 5 years: A Mini Review

Tshepo Mafokwane et al. Gastroenterol Res Pract. .

Abstract

Objective: To estimate gastroenteritis disease and its etiological agents in children under the age of 5 years living in South Africa.

Methods: A mini literature review of pertinent articles published in ScienceDirect, PubMed, GoogleScholar, and Scopus was conducted using search terms: "Gastroenteritis in children," "Gastroenteritis in the world," Gastroenteritis in South Africa," "Prevalence of gastroenteritis," "Epidemiological surveillance of gastroenteritis in the world," and "Causes of gastroenteritis".

Results: A total of 174 published articles were included in this mini review. In the last 20 years, the mortality rate resulting from diarrhea in children under the age of 5 years has declined and this is influenced by improved hygiene practices, awareness programs, an improved water and sanitation supply, and the availability of vaccines. More modern genomic amplification techniques were used to re-analyze stool specimens collected from children in eight low-resource settings in Asia, South America, and Africa reported improved sensitivity of pathogen detection to about 65%, that viruses were the main etiological agents in patients with diarrhea aged from 0 to 11 months but that Shigella, followed by sapovirus and enterotoxigenic Escherichia coli had a high incidence in children aged 12-24 months. In addition, co-infections were noted in nearly 10% of diarrhea cases, with rotavirus and Shigella being the main co-infecting agents together with adenovirus, enteropathogenic E. coli, Clostridium jejuni, or Clostridium coli.

Conclusions: This mini review outlines the epidemiology and trends relating to parasitic, viral, and bacterial agents responsible for gastroenteritis in children in South Africa. An increase in sequence-independent diagnostic approaches will improve the identification of pathogens to resolve undiagnosed cases of gastroenteritis. Emerging state and national surveillance systems should focus on improving the identification of gastrointestinal pathogens in children and the development of further vaccines against gastrointestinal pathogens.

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Conflict of interest statement

The author(s) declare(s) that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Global and South African mortality rates from diarrheal disease according to patient age [25].
Figure 2
Figure 2
Risk factors associated with diarrheal deaths in African children [25].
See this image and copyright information in PMC

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