Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon.
Department of Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
BMC Pediatr. 2019 Apr 30;19(1):137. doi: 10.1186/s12887-019-1513-8.
Acute gastroenteritis (AGE) is a major cause of pediatric morbidity and mortality around the world. It remains a frequent reason for infection-related admissions to emergency units among all age groups. Following the Syrian refugee crisis and insufficient clean water in our region, we sought to assess the etiological and epidemiological factors pertaining to AGE in South Lebanon.
In this multi-center cross sectional clinical study, we analyzed the demographic, clinical and laboratory data of 619 Lebanese children from the age of 1 month to 5 years old who were admitted with AGE to pediatrics departments of three tertiary care centers in South Lebanon.
Our results revealed that males had a higher incidence of AGE (57.3%) than females. Enteropathogens were identified in 332/619 (53.6%) patients. Single pathogens were found in 294/619 (47.5%) patients, distributed as follows: Entamoeba histolytica in 172/619 (27.8%) patients, rotavirus in 84/619 (13.6%), and adenovirus in 38/619 (6.1%). Mixed co-pathogens were identified in 38/619 (6.1%) patients. Analyzing the clinical manifestations indicated that E. histolytica caused the most severe AGE. In addition, children who received rotavirus vaccine were significantly less prone to rotavirus infection.
Our findings alluded to the high prevalence of E. histolytica and other unidentified enteropathogens as major potential causes of pediatric AGE in hospitalized Lebanese children. This should drive us to widen our diagnostic panel by adopting new diagnostic techniques other than the routinely used ones (particularly specific for the pathogenic amoeba E. histolytica and for the unidentified enteropathogens), and to improve health services in this unfortunate area of the world where insanitary water supplies and lack of personal hygiene represent a major problem.
急性肠胃炎（AGE）是全世界儿童发病率和死亡率的主要原因。它仍然是所有年龄段因感染相关而入住急诊病房的常见原因。在叙利亚难民危机和我们地区缺乏清洁水之后，我们试图评估黎巴嫩南部 AGE 的病因和流行病学因素。
在这项多中心横断面临床研究中，我们分析了来自黎巴嫩南部 3 个三级保健中心儿科部门的 619 名 1 个月至 5 岁的患有 AGE 的黎巴嫩儿童的人口统计学、临床和实验室数据。
我们的结果表明，男性 AGE 发病率（57.3%）高于女性。在 619 名患者中，有 332 名（53.6%）确定了病原体。在 619 名患者中，有 294 名（47.5%）发现了单一病原体，分布如下：溶组织内阿米巴在 172 名（27.8%）患者中，轮状病毒在 84 名（13.6%）患者中，腺病毒在 38 名（6.1%）患者中。在 38 名（6.1%）患者中发现了混合共病原体。分析临床表现表明，溶组织内阿米巴引起的 AGE 最严重。此外，接种轮状病毒疫苗的儿童感染轮状病毒的风险明显降低。
我们的研究结果表明，溶组织内阿米巴和其他未识别的肠道病原体是黎巴嫩住院儿童儿科 AGE 的主要潜在原因。这应该促使我们通过采用新的诊断技术（特别是针对致病性阿米巴原虫溶组织内阿米巴和未识别的肠道病原体）来扩大我们的诊断小组，并改善这个不幸地区的卫生服务，在这个地区，不卫生的供水和缺乏个人卫生是一个主要问题。
