Incidence and severity of rotavirus and Escherichia coli diarrhoea in rural Bangladesh. Implications for vaccine development

Abstract

In a 1 year study of diarrhoea in a village in rural Bangladesh, enterotoxigenic Escherichia coli (ETEC) were the most frequently detected enteropathogens; shigellae were the second most commonly detected enteropathogens and rotaviruses the third. ETEC and rotavirus were found in 31% of diarrhoea episodes experienced by children aged less than 2 years and in 70% of episodes associated with dehydration. Furthermore these two pathogens were identified in the stools of 77% of young children with life-threatening dehydration seen at a diarrhoea treatment centre. The association of ETEC and rotavirus with such a substantial proportion of cases of dehydrating diarrhoea suggests that immunoprophylaxis to reduce the high incidence of deaths from diarrhoea in developing countries may be feasible and that vaccine development should concentrate on these two enteropathogens.

PIP: In a 1 year study of diarrhea in a village in rural Bangladesh, (ETEC) enterotoxigenic Escherichia coli were the most frequently detected enteropathogenes; shigellae were 2nd and rotavirus 3rd. ETEC and rotavirus were found in 31% of the diarrhea episodes experienced by child 2 years old but in 70% of episodes associated with dehdyration. Furthermore, these 2 pathogens were identified in the stools of 77% of young children with life-threatening dehydration seen at a diarrhea treatment center. The association of 2 agents--ETEC and rotavirus--with such a substantial proportion of dehydrating diarrhea suggests that immunoprophylaxis may be a feasible approach in reducing the high incidence of diarrheal mortality in developing countries and that vaccine development should concentrate on these 2 enteropathogens.