Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004
Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004
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DOI：
10.4269/ajtmh.2006.74.1067
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
Ryan, Edward T.
中科院分区：
文献类型：
--
作者：
Schwartz, Brian S.;Harris, Jason B.;Ryan, Edward T.
我们检查了1988年、1998年和2004年在孟加拉国达卡的一家腹泻治疗医院就诊的与洪水相关的腹泻流行患者的人口统计学、微生物学和临床数据。与非洪水期相比，在洪水相关流行病期间出现的个体年龄更大，脱水更严重，社会经济地位更低。在与洪水相关的流行期间，霍乱弧菌是最常见的腹泻病因，也是唯一在每次流行中发病率与季节性匹配时期相比呈比例增加的腹泻病原体。轮状病毒是第二大最常见的与洪水相关的病原体，尽管在洪水期间由轮状病毒感染引起的病例比例与匹配时期相比有所下降。其他原因的腹泻没有成比例的变化，尽管在洪水期间每天有更多的患者出现与肠道毒素有关的大肠杆菌、志贺氏菌和沙门氏菌腹泻。我们的研究结果表明，霍乱是达卡洪水相关腹泻流行的主要原因，但通过粪-口途径传播的其他生物体也有贡献。
We examined demographic, microbiologic, and clinical data from patients presenting during 1988, 1998, and 2004 flood-associated diarrheal epidemics at a diarrhea treatment hospital in Dhaka, Bangladesh. Compared with non-flood periods, individuals presenting during flood-associated epidemics were older, more severely dehydrated, and of lower socioeconomic status. During flood-associated epidemics, Vibrio cholerae was the most commonly identified cause of diarrhea, and the only diarrheal pathogen whose incidence proportionally increased in each epidemic compared with seasonally matched periods. Rotavirus was the second most frequently identified flood-associated pathogen, although the proportion of cases caused by rotavirus infection decreased during floods compared with matched periods. Other causes of diarrhea did not proportionally change, although more patients per day presented with enterotoxigenic Escherichia coli, Shigella, and Salmonella species-associated diarrhea during floods compared with matched periods. Our findings suggest that cholera is the predominant cause of flood-associated diarrheal epidemics in Dhaka, but that other organisms spread by the fecal-oral route also contribute.