Ramani Sasirekha, Kang Gagandeep
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Curr Opin Infect Dis. 2009 Oct;22(5):477-82. doi: 10.1097/QCO.0b013e328330662f.
Acute gastroenteritis is one of the leading causes of morbidity and mortality in children in the developing world. With improvements in hygiene and sanitation, the burden of disease due to bacterial and parasitic infections has decreased and an increasing proportion of diarrhoea hospitalizations are attributed to viruses. This review focuses on enteric viruses and their role in childhood diarrhoea in the developing world.
With the use of sensitive molecular techniques, it is evident that a significant proportion of childhood diarrhoea is attributable to enteric viruses, with at least one viral agent in nearly 43% of samples from childhood diarrhoea in developing countries. Rotaviruses remain the most common pathogens in children, followed by noroviruses in almost all countries. There is increasing evidence that both rotaviruses and caliciviruses spread beyond the gut in a large proportion of infections.
The review highlights the importance of viral agents of gastroenteritis in developing countries. Wider use of molecular techniques is resulting in rapid identification of new or emerging strains and in the detection of extra-intestinal spread. There is a need to better understand susceptibility and immune response to these agents to be able to design suitable interventions.
急性胃肠炎是发展中国家儿童发病和死亡的主要原因之一。随着卫生和环境卫生条件的改善，细菌和寄生虫感染导致的疾病负担有所下降，因病毒导致的腹泻住院病例所占比例日益增加。本综述重点关注肠道病毒及其在发展中国家儿童腹泻中的作用。
通过使用灵敏的分子技术，显而易见，相当一部分儿童腹泻可归因于肠道病毒，在发展中国家，近43%的儿童腹泻样本中至少有一种病毒病原体。轮状病毒仍然是儿童中最常见的病原体，在几乎所有国家中，其次是诺如病毒。越来越多的证据表明，在很大一部分感染中，轮状病毒和杯状病毒都会扩散到肠道以外。
本综述强调了发展中国家胃肠炎病毒病原体的重要性。分子技术的更广泛应用正在促使新的或正在出现的毒株得到快速鉴定，并能检测到肠道外传播情况。有必要更好地了解对这些病原体的易感性和免疫反应，以便能够设计出合适的干预措施。
