clove and Dysentery--Bacillary

Diarrheal disease remains a leading cause of death in children in low-income countries. We investigated the etiology, risk factors and effects on nutritional status of severe diarrhea in children from two districts in Madagascar.. We performed a matched case-control study in 2011 to 2014, on children under the age of five years from Moramanga and Antananarivo. The cases were children hospitalized for severe diarrhea and the controls were children without diarrhea selected at random from the community. Stool samples were collected from both groups. Anthropometric measurements were made during follow-up visits about one and two months after enrolment.. We enrolled 199 cases and 199 controls. Rotavirus infection was the most frequently detected cause of diarrhea. It was strongly associated with severe diarrhea (OR: 58.3; 95% CI: 7.7-439.9), accounting for 42.4% (95% CI: 37.6-43.1) of severe diarrhea cases. At the household level, possession of cattle (OR = 0.3; 95% CI: 0.1-0.6) and living in a house with electricity (OR = 0.4; 95% CI: 0.2-0.8) were protective factors. The presence of garbage around the house was a risk factor for severe diarrhea (OR = 3.2; 95% CI: 1.9-5.4). We found no significant association between severe diarrhea and the nutritional status of the children at follow-up visits, but evident wasting at enrolment was associated with a higher risk of severe diarrhea (OR = 9; 95% CI: 4.5-17.9).. Severe childhood diarrhea is mostly caused by rotavirus infection. An anti-rotavirus vaccine has already been introduced in Madagascar and should be promoted more widely. However, post-licensing surveillance is required. Interventions to improve the nutritional status of children, preventive measures focused on household and personal hygiene and nutritional rehabilitation during severe diarrheal disease should be reinforced.

Topics: Animals; Campylobacter; Campylobacter Infections; Case-Control Studies; Cattle; Child, Preschool; Diarrhea; Dysentery, Bacillary; Enteropathogenic Escherichia coli; Escherichia coli Infections; Female; Garbage; Humans; Infant; Madagascar; Male; Nutritional Status; Risk Factors; Rotavirus; Rotavirus Infections; Shigella

Topics: Acidosis; Acute Kidney Injury; Aged; Animals; Biopsy; Cattle; Dysentery, Bacillary; Food Microbiology; Humans; Intestinal Mucosa; Madagascar; Male; Meat; Megacolon, Toxic; Microbial Sensitivity Tests; Travel

Topics: 4-Quinolones; Anti-Infective Agents; Child; Child, Preschool; Disease Outbreaks; Drug Resistance, Multiple; Dysentery, Bacillary; Fluoroquinolones; Humans; Infant; Madagascar; Pefloxacin; Quinolones; Shigella dysenteriae

From November 1988 to March 1989, stools from 804 Malagasy children were examined, thirty-seven strains of Shigella were isolated, from which 5 S. dysenteriae serotype 1 (= Shiga bacillus) strains were found to be resistant to ampicillin, carbenicillin, streptomycin, chloramphenicol, tetracycline, sulphonamide and even to trimethoprim. Resistance to trimethoprim has appeared only recently in Madagascar.

Topics: Adolescent; Child; Child, Preschool; Diarrhea; Drug Resistance, Microbial; Dysentery, Bacillary; Humans; Infant; Infant, Newborn; Madagascar; Shigella dysenteriae; Shigella flexneri; Trimethoprim Resistance

Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Dysentery, Bacillary; Humans; Madagascar; Microbial Sensitivity Tests; Shigella