Enteroaggregative Escherichia coli and Salmonella associated with nondysenteric persistent diarrhea

A hospital-based case-control study including 92 children with diarrhea for longer than 14 days and 92 controls without gastrointestinal symptoms was performed to describe the association between the excretion of enteric pathogens and persistent diarrhea. In patients the most frequently isolated stool pathogens were enteroaggregative Escherichia coli (19.6%), nontyphoidal Salmonella spp. (17.4%), E. coli with diffuse adherence pattern (7.6%), G. lamblia (7.6%) and enterotoxigenic E. coli (5.4%). The excretion rates in patients were significantly greater than in controls only for nontyphoidal Salmonella spp. (P = 0.0006) and enteroaggregative E. coli (P = 0.016)

Treatment of acute diarrhoea with wide use of ORS packets or sugar salt solution in a rural community

An oral rehydration therapy program was introduced in a rural community in India. During the initial 20 months (phase 1), packeted oral rehydration solution (ORS) was promoted and made available through the dispensary and also through 5 village health workers for treatment of all diarrheal illness, regardless of the severity. In the subsequent 11 months (phase 2), the supply of ORS packets was restricted only to cases of obvious dehydration when treatment was sought at the local dispensary. Preparation and correct use of the sugar-salt solution for early treatment of diarrhea were explained to all of the mothers in the villages. The diarrheal episodes and use of ORS were monitored through household visits by data collectors throughout the 31-month period. In phase 1, ORS packets were used in 68.6% of the diarrheal episodes whereas in phase 2, sugar-salt solution was used for 79.3% of the episodes. The mean intake (in liters)/diarrheal episodes was higher (p0.05) for sugar-salt (1.9 +or- 1.6) as compared to the ORS solutions prepared from packets (1.2 +or- 0.7). The percentage of samples with sodium concentration 120mE q/1 was 4.9% with ORS packets and 20% with sugar and salt (0.05). The diarrheal deaths/100 episodes were 0.73 (ORS packets phase) and 0.50 (sugar-salt phase), respectively (p0.05). author's modified. B D Malhotra,K Ramachandran,M K Bhan,N K Arora,Nita Bhandari,O P Ghai,Vikram Khosho