Showing papers by "International Centre for Diarrhoeal Disease Research, Bangladesh published in 1981"

Enterotoxigenic Escherichia coli diarrhoea: acquired immunity and transmission in an endemic area.

Abstract: Enterotoxigenic Escherichia coli (ETEC) are an important cause of diarrhoea in developing countries. Studies were made, in an endemic area of Bangladesh, of household contacts of patients with diarrhoea associated with E. coli producing heat-stable and heatlabile toxins (ST/LT) or heat-stable toxin (ST) only. It was found that 11% of contacts were infected in the 10-day study period, and that both the rate of infection and the proportion of infected persons with diarrhoea decreased with increasing age, suggesting the development of immunity. ETEC of the same serotype as that of the index patient were found in 9% of water sources used by index households, in a small number of food and drinking water specimens from the index homes, and in faeces from 3 healthy calves. The rate of infection of household members was highest in houses where there was contaminated food or water, which suggests that infection may take place in the home when contaminated water is brought in.

A prospective study of the risk of diarrheal diseases according to the nutritional status of children

Abstract: Prospective field data were employed to examined the effect of child malnutrition on the subsequent risk of diarrhea among preschool children in rural Bangladesh. A total of 2019 children aged 12-23 months were classified according to weight-for-age, weight-for-height, and height-for-age of the Harvard median standard. Over a 24-month prospective period, diarrheal hospitalization rates among the children were matched to the initial anthropometric assessment. No differences in diarrheal hospitalization rates were noted for the children according to initial nutritional status. Another group of 207 children under five years of age were classified according to weight-for-age and their diarrheal attack rate in the field was followed prospectively for one year after nutritional assessment. Again, no differences in field diarrheal attack rates were noted between children of varying nutritional status categories. The nutritional status of the 207 children was then defined as monthly growth velocity (kilogram change in body weight, per cent change of initial body weight, and per cent change in weight-for-age) and the diarrheal attack rate for the subsequent one month period was observed. No differences in attack rates were noted between nutritional groups. The study failed to demonstrate that nutritional status defined by anthropometry was associated with the subsequent risk of diarrheal diseases.

Glucose vs sucrose in oral rehydration solutions for infants and young children with rotavirus-associated diarrhea.

Abstract: The use of oral rehydration solutions containing essential electrolytes and either glucose or sucrose of equal osmolality was compared in a double-blind sequential trial of 784 children with rotavirus-associated diarrhea treated at a center in rural Bangladesh. The oral fluid failure rate was 11.5% for the sucrose-containing solution group and 7.3% for the glucose-containing group (P = NS). Vomiting was a significantly more common cause of failure for the group treated with sucrose-containing oral rehydration solution and was associated with an increased rate of intake of the sweeter sucrose-containing solution. The purging rate was not different for the two groups. The oral fluid failure rates for children in the most underweight category (less than 60% of expected weight for age) were not different from those for other groups, although, as assessed by purging rate and initial dehydration, the stool losses of members of this group constituted a greater proportion of their body weight. Glucose is the preferred carbohydrate for oral electrolyte solutions, although sucrose can be substituted with only minimum loss of efficacy.

Single-Dose Ampicillin Therapy for Severe Shigellosis in Bangladesh

Abstract: To evaluate a more economical regimen for severe shigella dysentery, treatment with single-dose (SD) ampicillin (100 mg/kg) was compared in a randomized trial with results obtained in a conventional five-day (100 mg/kg per 24 hr) multiple-dose (MD) course. Clinical relapse occurred in one of 23 SD children, no SD or MD adults, and none of 18 MD children. Bacteriologic failures were observed in six of 26 adults compared with one of 24 MD adults (P = 0.05). Four of 10 SD children younger than four years of age failed bacteriologically, compared with one MD child. In SD children, lower ampicillin levels were significantly associated with bacteriologic failure and younger age. Resistance of Escherichia coli to ampicillin, although transiently less in SD patients, was equal in MD and SD patients two weeks after therapy. Thus, in highly endemic areas SD ampicillin is clinically effective therapy for ampicillin-sensitive shigellosis in patients older than four years of age. In Bangladesh the treatment of choice for shigellosis is a five-day course of ampicillin because 95% of isolates of Shigella are sensitive to ampicillin, whereas the majority are resistant to tetracycline [1]. Conventional ampicillin therapy has been successful even for severe shigellosis in malnourished children.

The Relationship of Cholera to Water Source and Use in Rural Bangladesh

Abstract: The cholera experience of a sample of families in a rural area of Bangladesh is reported in relation to water supply and use. Tanks were the primary source for 65% of families, canals for 20% and the river for 14%. The highest attack rate was associated with access to canal water (13%). Attack rates did not vary markedly according to the purpose for which a source was used. The importance of cultural patterns in water use is identified.

Victims of childhood deaths.

Abstract: Out of 471 children studied in rural Bangladesh by anthropometry and feeding pattern, 28 expired. Records of dentition and kinds and dates of introduction of supplementary food by parents were maintained. The anthropometry of the deceased were compared with the age matched survivors from the same village. The average weight, height, arm circumference, number of erupted teeth between 10 and 15 months and income of the survivors were higher than those who died. These data suggest that children who die in infancy are less well nourished from their birth, grow at a slower rate and are mainly from poorest and 3rd and 2nd degree malnourished groups.

Brief Reports on All Topics

Abstract: S. typhi strains harboring R plasmids are a common finding in Mexico City hospitals. The predominant R plasmids share the following properties: they belong to the same incompatibility group (H1)’ have a molecular weight of 135 Mdal, carry a temperature sensitive transfer system, and code for the resistance to Cm, Sm, Su, Hg and Tc. The general organization of the resistance genes resembles that of RlOO, since homogenic derivatives which have lost the r-determinants, Tn1O or all the resistance genes can be isolated in vitro by several methods. Furthermore, naturally occurring a-plasmids deleted for the r-determinants or Tn1O have been found, although at low frequency. Complementation experiments indicated that the ts transfer system of the mexican plasmids is not related to that of Flac, Rl-19 or Col Ibdrd.