Arthur J D, Bodhidatta L, Echeverria P, Phuphaisan S, Paul S
Department of Bacteriology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.
Am J Epidemiol. 1992 Mar 1;135(5):541-51. doi: 10.1093/oxfordjournals.aje.a116321.
The etiology of acute diarrhea (less than or equal to 3 days duration) and persistent diarrhea (greater than or equal to 14 days duration) was determined in Cambodian children under age 5 years in a refugee camp on the Thai-Cambodian border between May and October 1989; potential risk factors associated with persistent diarrhea were examined in an age-matched case-control study. Specimens collected from children and environmental sources were examined by standard microbiologic methods; Escherichia coli isolates were examined for hybridization with specific DNA probes and in tissue culture adherence assays. The same bacterial, viral, or parasitic agents were identified in 79 children with persistent diarrhea and in 408 children with acute diarrhea. Only one of nine children with persistent diarrhea excreted the same organism, Cryptosporidium, for that extended period. The most important risk factors identified for developing persistent diarrhea were living with other young children (odds ratio (OR) = 2.0, 95% confidence interval (Cl) 1.2-3.4) and being undernourished (OR = 2.6, 95% Cl 1.2-5.7). Persistent diarrhea in children in this camp was associated with several different agents rather than persistent infections with a single organism.
1989年5月至10月间,在泰柬边境的一个难民营中,对5岁以下柬埔寨儿童急性腹泻(病程小于或等于3天)和持续性腹泻(病程大于或等于14天)的病因进行了确定;在一项年龄匹配的病例对照研究中,对与持续性腹泻相关的潜在危险因素进行了检查。采用标准微生物学方法对从儿童和环境样本中采集的标本进行检测;对大肠杆菌分离株进行特异性DNA探针杂交检测及组织培养黏附试验。在79例持续性腹泻儿童和408例急性腹泻儿童中,鉴定出相同的细菌、病毒或寄生虫病原体。9例持续性腹泻儿童中只有1例在较长时间内排出相同病原体——隐孢子虫。确定的发生持续性腹泻最重要的危险因素是与其他幼儿共同生活(比值比(OR)=2.0,95%置信区间(CI)1.2 - 3.4)和营养不良(OR = 2.6,95%CI 1.2 - 5.7)。该难民营儿童的持续性腹泻与多种不同病原体有关,而非单一病原体的持续感染。