尼日利亚西北部腹泻病患儿的腺病毒感染

Adenovirus infection in children with diarrhea disease in Northwestern Nigeria.

作者信息

Aminu M, Ahmad A A, Umoh J U, de Beer M C, Esona M D, Steele A D

机构信息

Department of Microbiology, Faculty of Science, Ahmadu Bello University, Zaria, Nigeria.

出版信息

Ann Afr Med. 2007 Dec;6(4):168-73. doi: 10.4103/1596-3519.55702.

DOI:10.4103/1596-3519.55702

PMID:18354941

Abstract

BACKGROUND

Adenoviruses, particularly enteric adenoviruses (EAds) type 40 (Ad40) and type 41(Ad41), can cause acute and severe diarrhea in young children worldwide. This study was conducted to delineate the epidemiological features of adenoviruses identified in children with gastroenteritis in Northwestern Nigeria.

METHODS

All 282 specimens comprising 248 diarrheic and 34 non-diarrheic stools were randomly selected from 1063 stools previously analyzed for rotaviruses. These specimens were collected between July 2002 and July 2004 from children < 5 years of age. The specimens were screened for the presence of adenoviruses using monoclonal antibody-based Enzyme Immuno Assay (EIA), (Adenovirus RIDASCREEN r-Biopharm, UK) and the positive specimens were further examined for Ad40 and Ad41 using Premier Adenoclone -Type 40/41 EIA (Meridian Biosciences, USA). Negative staining electron microscopy was performed on selected specimens to confirm the presence of adenovirus particles.

RESULTS

Adenovirus antigen was detected in 63/282 (23%) of the diarrheic diarrheic and in 6/34 (17.6%) of the non-diarrheic specimens. Adenoviruses were detected throughout the study period with most patients infected in the age group 25-36 months. The male-to-female ratio was 2.2:1 (43/20). Clinical features included fever (60%: 38/63), vomiting (56%: 35/63), mild dehydration (49%: 31/63), symptoms of upper respiratory tract infection (13%: 8/63) and abdominal pain (5%: 3/63). Analysis of stool specimen in adenovirus infected patients showed watery diarrhea in 87% (55/63), diarrhea with mucus in 19% (12/63) and diarrhea with mucus and blood in 3% (2/63). Ten (10) percent of the children were hospitalized due to gastroenteritis while 9 patients (14.3%) had co-infections with rotavirus. Human EAds were detected in 8% of specimens mainly in the dry season and among children older than 2 years. The principal symptoms were diarrhea (100%), dehydration (80%) and fever (80%).

CONCLUSION

The findings of this study suggest that adenoviruses are important etiologic agents of gastroenteritis in Northwestern Nigerian children.

摘要

背景

腺病毒，尤其是40型（Ad40）和41型（Ad41）肠道腺病毒（EAds），可在全球范围内导致幼儿急性重症腹泻。本研究旨在描述尼日利亚西北部患肠胃炎儿童中所鉴定出的腺病毒的流行病学特征。

方法

从之前检测过轮状病毒的1063份粪便样本中随机选取282份样本，其中包括248份腹泻粪便样本和34份非腹泻粪便样本。这些样本于2002年7月至2004年7月期间从5岁以下儿童中采集。使用基于单克隆抗体的酶免疫测定法（EIA）（腺病毒RIDASCREEN r - 德国宝灵曼公司，英国）对样本进行腺病毒筛查，对阳性样本使用腺病毒40/41型酶免疫测定试剂盒（Meridian Biosciences公司，美国）进一步检测Ad40和Ad41。对部分选定样本进行负染色电子显微镜检查以确认腺病毒颗粒的存在。

结果

在248份腹泻样本中有63份（23%）检测到腺病毒抗原，在34份非腹泻样本中有6份（17.6%）检测到腺病毒抗原。在整个研究期间均检测到腺病毒，大多数感染患者年龄在25 - 36个月。男女比例为2.2:1（43/20）。临床特征包括发热（60%：38/63）、呕吐（56%：35/63）、轻度脱水（49%：31/63）、上呼吸道感染症状（13%：8/63）和腹痛（5%：3/63）。对腺病毒感染患者的粪便样本分析显示，87%（55/63）为水样腹泻；19%（12/63）为黏液性腹泻；3%（2/63）为黏液血便。10%的儿童因肠胃炎住院，9名患者（14.3%）同时感染轮状病毒。在8%的样本中检测到人类肠道腺病毒，主要发生在旱季以及2岁以上儿童中。主要症状为腹泻（100%）、脱水（80%）和发热（80%）。