Infantile diarrhoea: Breast and bottle feeding compared with special reference to their clinical role

This study was conducted to evaluate a clinical presentation of diarrhoea in infants under 2 years of age, in relation to their types of feeding. It was found that the duration of diarrhoea in bottle-fed infants was significantly longer than in breast-fed ones. It was 7.2 ± 0.46 days in bottle-fed, compared to 5.5 ± 0.17 days in breast-fed infants. The prevalence of acute Otitis media and Rhinopharyngitis in bottle-fed infants under 1 year of age was higher than in breast-fed infants.f!owever,it was not so after 1 year of age.

Infant feeding practices and risk of occurrence of diarrheal and respiratory infections in infancy-a hospital based study

Background: Breastfeeding is the most cost-effective intervention for protecting children against various childhood morbidities. Suboptimal breastfeeding has been linked with numerous adverse child health outcomes including increased incidence of diarrheal disease and pneumonia.Methods: A sample of 360 infants was surveyed during the period of one year (2013-2014). The socio-demographic characteristics and feeding modes were collected from the parents of the children during the interview.Results: A total of 228 (63.3%) were suffering from acute gastroenteritis and 132 (37.7%) were suffering from pneumonia. The risk of diarrhea and pneumonia was higher and statistically significant in partially breastfed and non- exclusive breast fed as compared to exclusive breast fed. Infants who were bottle fed had higher risk of morbidity. Infants who were breast fed for longer duration (more than 4 months) has lesser risk of morbidity as compare to counterparts who were fed for lesser duration.Conclusions: These results indicate that promoting exclusive breastfeeding will play an important role in reducing the risk of infantile diarrhoea and pneumonia. This observation is important given the growing concern of the modern society wherein breastfeeding is on the decline.

Low Lactose Milk (LLM) on Refeeding of Infantile Diarrhoea

Seventeen infants suffering from diarrhoea hospitalized in the Department of Child Health, Medical School University of Indonesia/Dr. Tjipto Mangunkusumo General Hospital from 10 to 31 August 1973 were refed with LLM, Almiron or SGM. LLM gives good to excellent results in refeeding of infants suffering from diarrhoea. Nine out of 17 cases were refed with LLM, where as the other 8 with Almiron or SGM as a control. Result of LLM in stopping diarrhoea was excellent in 5, good in 2, poor in 2 cases. Increase of body weight was excellent in 4 cases, good in none, poor in 5 cases. Results of Almiron or SGM in stopping diarrhoea was excellent in 1 case, good in one, poor in 6 cases. Increase of body weight was excellent in 1 case, good in none, poor in 7 cases. From these results it is recommended to give low lactose milk as refeeding on patients with infantile gastroenteritis.

Unusual rotavirus genotypes in humans and animals with acute diarrhoea in Northeast India

SUMMARYRotavirus (RV) infection causes acute infantile diarrhoea in humans and animals and remains a major concern for vaccine development. The close proximity of humans to animals may foster cross-species infection resulting in the emergence of novel/unusual strains by genetic reassortment. In this study, we characterized 500 diarrhoeal samples for group A rotaviruses (RVA) from children (n= 290), piglets (n= 95) and calves (n= 115) in Northeast India during 2012–2013. The data showed that 142/500 (28·4%) faecal samples were positive for RVA with the highest level of infection detected in piglets (57/142, 40·1%) followed by children (51/142, 35·9%) and calves (34/142, 23·9%). Sequence-based G- and P-typing showed G1P[8] (25%) and G1P[7] (35%) were the prevailing genotypes in both humans and animals. Single cases of unusual genotypes, i.e. G9P[8], G5P[8] in humans and G1P[13], G1P[23] and G3P[7] in animals were also identified. Cluster analyses of the sequences showed regional strains were genetically closer to their homologous strains. However, human G5P[8] and porcine G1P[8] strains showed homology to heterologous hosts of their prototype strains. The subsequent global spread of unusual RV strains may result in their establishment over time, presenting challenges to future vaccine evaluation programmes. More studies on emerging genotypes are required to elucidate how RVA strains evolve post-vaccination. This study supports the need for continuous surveillance of RVA infections after detecting from diverse hosts in a common setting.

Clinical Symptoms of Human Rotavirus Infection Observed in Children in Sokoto, Nigeria

Rotavirus has been identified among the most important causes of infantile diarrhoea, especially in developing countries. The present study was undertaken to determine the occurrence and clinical symptoms of human rotavirus disease among children presenting with varying degree of diarrhoea in selected urban hospitals in Sokoto metropolis, Nigeria. Diarrhoea samples were collected from 200 diarrheic children younger than 5 years of age and tested using a commercially available DAKO Rotavirus ELISA kit which detects the presence of human group A rotaviruses. A questionnaire, based on WHO generic protocol, was completed for each child to generate the primary data. Of the total number of samples collected, 51 were found to be positive for human group A rotavirus indicating 25.5% prevalence of the disease in Sokoto state. The symptoms associated with the disease were analyzed and discussed.

An update on the microbiology and epidemiology of enteropathogenic Escherichia coli in England 2010–2012

Historically, enteropathogenic Escherichia coli (EPEC) are a well-known cause of outbreaks of infantile diarrhoea associated with morbidity and mortality in England. The aim of this study was to provide an update on the microbiology and epidemiology of strains of EPEC in England between 2010 and 2012. A wide range of E. coli serogroups were identified, with the most common being E. coli O145, O49 and O157. Few isolates (9 %) had additional virulence factors (specifically bfp, vtx2f and espT genes) and the majority were classified as atypical EPEC. The majority of cases (86 %) were among children. This included a significantly higher percentage (17.4 %) of cases aged 0–12 months when compared with cases of other common gastrointestinal pathogens (P<0.001). No outbreaks were reported during this period; however, the data indicated that EPEC are still an important cause of sporadic cases of infantile diarrhoea in England.

Full genomic analyses of two human G2P[4] rotavirus strains detected in 2005: identification of a caprine-like VP3 gene

Although G2P[4] rotaviruses are common causes of infantile diarrhoea, to date only the full genomes of the prototype (strain DS-1) and another old strain, TB-Chen, have been analysed. We report here the full genomic analyses of two Bangladeshi G2P[4] strains, MMC6 and MMC88, detected in 2005. Both the strains exhibited a DS-1-like genotype constellation. Excluding the VP4 and VP7 genes, and except for VP3 of MMC88, the MMC strains were genetically more closely related to the contemporary G2P[4] and several non-G2P[4] human strains than the prototype G2P[4] strain. However, by phylogenetic analyses, the VP2, VP3 (except MMC88), NSP1 and NSP3–5 genes of these strains appeared to share a common origin with those of the prototype strain, whilst their VP1, VP6 and NSP2 genes clustered near a caprine strain. The VP3 gene of MMC88 exhibited maximum relatedness to a local caprine strain, representing the first reported human G2P[4] strain with a gene of animal origin.

Antibiotic resistance patterns of intestinal Escherichia coli isolates from Nicaraguan children

In developing countries, diarrhoeal diseases are one of the major causes of death in children under 5 years of age. It is known that diarrhoeagenic Escherichia coli (DEC) is an important aetiological agent of infantile diarrhoea in Nicaragua. However, there are no recent studies on antimicrobial resistance among intestinal E. coli isolates in Nicaraguan children. The aim of the present study was to determine the antimicrobial resistance pattern in a collection of 727 intestinal E. coli isolates from the faeces of children in León, Nicaragua, between March 2005 and September 2006. All samples had been screened previously for the presence of DEC by multiplex PCR. Three hundred and ninety-five non-DEC isolates (270 from children with diarrhoea and 125 from children without diarrhoea) and 332 DEC isolates (241 from children with diarrhoea and 91 from children without diarrhoea) were analysed in this study. In general, antimicrobial resistance among the 727 intestinal E. coli isolates was high for ampicillin (60 %), trimethoprim–sulfamethoxazole (64 %) and chloramphenicol (11 %). Among individual E. coli categories, enteroaggregative E. coli isolates from children with and without diarrhoea exhibited significantly higher levels of resistance (P<0.05) to ampicillin and trimethoprim–sulfamethoxazole compared to the other E. coli categories. Resistance to ceftazidime and/or ceftriaxone and a pattern of multi-resistance was related to CTX-M-5- or CTX-M-15-producing E. coli isolates. The results suggest that E. coli isolates from Nicaraguan children have not reached the high levels of resistance to the most common antibiotics used for diarrhoea treatment as in other countries.