Perspectives on acute gastroenteritis in black South African infants.

In developing countries, gastroenteritis is the major cause of infant mortality; however, owing to inadequate laboratory facilities and personnel, little is known about the status of enteropathogenic agents, especially rotavirus. Disease patterns differ between developed and developing communities, and rotavirus plays a markedly lesser role in the overall etiology of the disease in developing than in developed countries--where it is one of the major etiological agents. This may be due to extensive exposure to rotavirus in developing communities during and soon after the neonatal period, causing inapparent or mild clinical infection that could result in immunity during the significant target age of 6 to 24 months. This immunity may have important implications for immunization. However, immunoprophylaxis should be secondary to an improvement in socioeconomic conditions. The dramatic reduction in incidence and mortality of gastroenteritis seen in the Black urban populations of Johannesburg and Cape Town was a direct result of improvements in nutrition, housing, sanitation, etc.