Ann Trop Paediatr. 1989 Dec; 9(4): 248-55.

Aetiological factors of infantile diarrhoea: a community-based study.

Loening WE, Coovadia YM, van den Ende J.

Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, South Africa.

A community-based study was undertaken to compare the organisms responsible for diarrhoea in children living in formal housing with indoor water supply and sanitation with those from a deprived environment. The role of "home remedies" was also assessed. Among 373 children with diarrhoea, rotavirus was detected in 15% (in 371 symptom-free controls, 9%), and proved to be the single most common causative agent. Bacterial pathogens were found in 20% of patients, with enteropathogenic Escherichia coli (EPEC) being isolated most frequently (9%; controls 3%), followed by Shigella species (4%; controls 1%), Campylobacter jejuni (4%; controls 1%), Salmonella species (2%; controls 1%) and enterotoxigenic E. coli (ETEC) (2%; controls 1%). Giardia lamblia and cryptosporidium were detected in 6% (controls 6%) and 3% (controls 1%) of patients, respectively; 7% (controls 1%) harboured more than one enteropathogen and no pathogens were detected in 58% (controls 78%). The vast majority (greater than 90%) of both patients and controls received some form of "home remedy" which included disinfectants and traditional herbs. The findings of this study therefore confirm the extremely complex nature of diarrhoea in developing communities and indicate that environmental factors are compounded by other issues.