A Trend of Seasonality of Enteric Adenoviral Gastroenteritis in Pediatric Patients Less than Five Years from Baghdad
Author(s): Batool Ali Ghalib Yassin, Saad Hasan Mohammed Ali, Huda Q Muhammad Abu AL-ess, Khalil Ismail A Mohammed, Mohammed arhood Al-Timimi, Muhi Kadhem Wannas Al-Janabi, Ghanim Ibrahim Ahmed Al-Wadi, Jenan Mehdi Mousa
Background: In developing countries, viral agents are the most commonly identifiable causes in children with gastroenteritis. Some of the viral infections have showed seasonal tendencies in relation to geographical regions. Enteric types of adenoviruses (Ad 40, Ad41) are among the most common and important etiological agents associated with sporadic cases and outbreaks of infantile acute gastroenteritis.
Objectives: The purpose of this study was to determine the prevalence and seasonal tendency as well as the diagnostic value of the related clinical and laboratory findings of Adenovirus- associated diarrhea in children up to five years of age.
Study Design: A prospective study along one–year period (February, 2013 till January, 2014) was carried out in the outpatient clinics of AL-Elweya Pediatric Teaching Hospital and Welfare Children Teaching Hospital at Baghdad. Stool samples from a total of 807 children (aged between 5-60 months) with acute gastroenteritis, were enrolled in this study. Stool samples were tested by immunochromatographic assay for enteric adenoviruses. This sample of children, and according to their age, was categorized into four groups: >12 months, 12->24 months, 24->36months and <36 months. Total monthly numbers among these age groups formed the basis for assessing seasonal tendency of adenovirus infections.
Results: Less than 5 years children with acute gastroenteritis tested for Adenovirus infection have a mean of 11.1±10.1 months and the males comprised 57.9% (467 out of 807) while females 42.1% (340 out of 807). Shedding of Adenovirus was detected in 14.6% of acute diarrheal stool samples, among them 58.5% were males with a male to female ratio of 1.4: 1. Children with acute Adenoviral diarrhea were younger than those without viral infection, yet the association was statistically not significant. Adenovirus-positive cases showed two ratal peaks; the highest one was during January (25 cases) and the second was during September (22 cases). During the hottest months in Iraq, July and August, the number of cases in each was dropped to three cases while two cases were reported during each of November and December.
Conclusions: The present data indicate that the infection rate was low in November and December (had peaked equally in Autumn and early Winter), while high in January.<