INFECTIOUS AGENTS CAUSING ACUTE WATERY DIARRHEA IN INFANTS AND YOUNG-CHILDREN IN BANGLADESH AND THEIR PUBLIC-HEALTH IMPLICATIONS

We studied the age specific distribution of enteropathogens in young c hildren presenting at a large diarrhoeal diseases hospital in urban Ba ngladesh. A 5 per cent systematic sample was used to examine 1207 rect al swab specimens of children aged 1-35 months with acute watery diarr hoea. Variation in isolation rates of enteropathogens was observed in different age groups. Overall, rotavirus (26 per cent) and Campylobact er (26 per cent) were the most common pathogens followed by enterotoxi genic Escherichia coli (15 per cent), Vibrio cholerae 01 (7 per cent), other Vibrios (9 per cent), Shigella (4 per cent), and Salmonella (<1 per cent). In early infancy (1-5 months) more rectal swab specimens d id not yield any enteropathogen compared to older children of 24-35 mo nths old (44 v. 30 per cent). Rotavirus was most frequently detected ( 35 per cent) in children between 6 and 11 months old. Attendance of ch olera cases at the hospital was alarmingly high in the third year of l ife (29 per cent). The study provided useful information that, in gene ral, children under 2 years are predominantly infected with agents [ro tavirus, Campylobacter, and enterotoxigenic Escherichia coli (ETEC)] f or which antibiotic therapy is not usually indicated. These patients c an be managed effectively with oral rehydration therapy and proper fee ding. Knowledge of pathogens associated with more severe forms of diar rhoea may help in optimizing strategies for vaccination when suitable vaccines are available against enteric infections.