Henry F J, Udoy A S, Wanke C A, Aziz K M
International Centre for Diarrheal Disease Research, Bangladesh.
Acta Paediatr Suppl. 1992 Sep;381:27-31. doi: 10.1111/j.1651-2227.1992.tb12368.x.
To determine the epidemiology and etiologic agents of persistent diarrhea we carried out an intensive diarrhea surveillance on children less than six years old in rural Bangladesh. From March 1987 to February 1989 we examined 363 children through diarrhea recall interviews and analyzed stool samples of all diarrhea cases for potential pathogens. Results showed that children had an average of two episodes per year and the incidence rate of diarrheal episodes defined as acute (< 14 d) and persistent (> or = 14 d) varied similarly with age. The peak incidence (episodes/child/year) of acute diarrhea (2.8) and persistent diarrhea (0.8) occurred in the 6-11 months age group. The data showed that an episode tended to be prolonged if the stool was loose/mucoid or bloody at onset. Aggregative adherent Escherichia coli was found significantly more often at onset in persistent than in acute episodes, whereas Shigella, Aeromonas, Giardia and toxigenic E. coli were isolated with less frequency in persistent than acute episodes. This suggests that other factors might be more important in the development of persistent diarrhea than specific pathogens.
为了确定持续性腹泻的流行病学特征和病因，我们在孟加拉国农村地区对6岁以下儿童开展了一项密集的腹泻监测。从1987年3月至1989年2月，我们通过腹泻回顾访谈对363名儿童进行了检查，并对所有腹泻病例的粪便样本进行分析以寻找潜在病原体。结果显示，儿童每年平均发生两次腹泻，急性腹泻（<14天）和持续性腹泻（≥14天）的发病率随年龄变化趋势相似。急性腹泻（2.8次/儿童/年）和持续性腹泻（0.8次/儿童/年）的发病率高峰出现在6-11月龄组。数据表明，如果腹泻起病时粪便呈稀便/黏液样便或血便，则病程往往会延长。持续性腹泻起病时聚集性黏附大肠杆菌的检出率显著高于急性腹泻，而志贺菌、气单胞菌、贾第虫和产毒素大肠杆菌在持续性腹泻中的分离率低于急性腹泻。这表明，在持续性腹泻的发生过程中，其他因素可能比特定病原体更为重要。
