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A millennium update on pediatric diarrheal illness in the developing world.
Abstract
More than one billion diarrhea episodes occur every year among children younger than 5 years of age in socioeconomically developing countries causing 2 to 2.5 million deaths. More than twenty viral, bacterial, and parasitic enteropathogens are currently associated with acute diarrhea. Rotavirus and diarrheagenic Escherichia coli are the most common pathogens responsible for acute diarrhea episodes in children; Shigella spp., Salmonella spp, Campylobacter jejuni/coli, Vibrio cholerae, Aeromonas spp, and Plesiomonas spp. occur more commonly in poorer areas and infections caused by protozoa and helminthes occur mainly in areas where environmental sanitation is significantly deteriorated. Initial clinical assessment of a child with diarrhea should focus on obtaining an accurate evaluation of hydration and nutritional status. Assessment of stool characteristics (e.g., liquid non-bloody stools vs. dysenteric or bloody stools) is a key feature in determining potential pathogens causing an acute diarrhea episode. Diagnostic guidelines are discussed in the article. The major therapeutic intervention for all individuals with diarrhea consists of fluid and electrolyte therapy. When antimicrobial therapy is appropriate, selection of a specific agent should be made based upon susceptibility patterns of the pathogen or information on local susceptibility patterns. Current guidelines for administering appropriate antimicrobial treatment are provided in the article. Preventive measures include careful personal hygiene, especially promotion of hand washing. Immunizations currently or soon to be available for Salmonella serotype Typhi, cholera prevention, and rotavirus are discussed.
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“This approach is supported by the evidence that most non-bloody diarrheal episodes in children under 5 years of age in low-income settings are self-limiting and are caused by viral pathogens (rotavirus, norovirus, astrovirus, and enteric adenovirus) or pathogens for which antibiotics are likely of limited efficacy or even dangerous (e.g. Salmonellae and Campylobacter) 24.”
From Antibiotic treatment of acute gastroenteritis in children (2018) · cites this paper as [24]
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Metadata
- Authors
- O’Ryan, M., Prado, V., & Pickering, L. K.
- Affiliations
- University of Chile (CL)
- Centers for Disease Control and Prevention (US)
- Corresponding author
- O’Ryan, Miguel
- ORCID
- O’Ryan, Miguel
- Venue
- Seminars in Pediatric Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2005-04
- Volume
- 16
- Issue
- 2
- Pages
- 125-136
- ISSN
- 1045-1870 (ISSN-L)
- OpenAlex
- W2033517112
- Cited by
- 283
- References
- 138
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 5 · 2023: 13 · 2022: 9 · 2021: 7 · 2020: 6 · 2019: 7 · 2018: 13 · 2017: 10 · 2016: 15 · 2015: 23 · 2014: 21 · 2013: 25 · 2012: 22
- FWCI
- 8.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Pediatric Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- childhood diarrhea, acute diarrhea, enteric pathogens, rotavirus, diarrheagenic Escherichia coli, Shigella, Salmonella, Campylobacter, Vibrio cholerae, Aeromonas, Plesiomonas, helminths, protozoa, dehydration, nutritional status, stool characteristics, stool examination, fluid and electrolyte therapy, antimicrobial therapy, hand washing, hygiene, rotavirus vaccine, cholera vaccine, developing countries
- MeSH terms
- Acute Disease, Animals, Child, Preschool, Developing Countries, Diarrhea, Escherichia coli, Humans, Hygiene, Immunization, Infant, Rotavirus, Sanitation, Skin Care, Eukaryota
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