Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease

  Diarrhoeal disease is the third leading cause of death in children under 5 years old and is responsible for killing around 443 832 children every year. […] Diarrhoeal disease is a leading cause of child mortality and morbidity in the world, and mostly results from contaminated food and water sources. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] Diarrhoea due to infection is widespread throughout developing countries. […] Diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faeces-contaminated water. […] Infection is more common when there is a shortage of adequate sanitation and hygiene and safe water for drinking, cooking and cleaning. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] WHO works with Member States and other partners to promote national policies and investments that support case management of diarrhoea and its complications as well as increasing access to safe drinking-water and sanitation in developing countries.

• #2 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Diarrheal diseases are among the most common causes of death, especially in children. […] In 2021, around 1.2 million people died from diarrheal diseases. […] Around 390,000 of these deaths were among children and adolescents. […] In recent decades, deaths from diarrheal diseases have fallen significantly across the world as a result of public health interventions. […] Diarrheal deaths are preventable because they are primarily caused by pathogens, whose spread can be easily controlled. […] By increasing global access to clean water and sanitation, oral rehydration treatment, and vaccination, this major cause of death can be reduced substantially. […] Diarrheal diseases are a leading cause of death among children. […] Its estimated that around 340,000 children died from diarrheal diseases globally in 2021.

• #3 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Deaths from diarrheal diseases have declined over time, but they still carry a substantial death toll today. […] This is because people in many countries still lack access to clean water and sanitation, adequate treatment and healthcare, and have low vaccination rates against pathogens that cause diarrheal disease. […] There are significant differences in diarrheal death rates across the world. […] Deaths from diarrheal disease are more common in poorer countries. […] Death rates in low-income countries are almost fifty times higher than in high-income countries. […] Diarrheal deaths remain a large problem in much of the world even today but they can be significantly reduced with greater public health efforts. […] Researchers now know that diarrheal disease deaths in children are primarily caused by pathogens, such as viruses, bacteria, and protists.

• #4 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Diarrheal diseases are among the most common causes of death, especially in children. […] In 2021, around 1.2 million people died from diarrheal diseases. […] Around 390,000 of these deaths were among children and adolescents. […] In recent decades, deaths from diarrheal diseases have fallen significantly across the world as a result of public health interventions. […] Diarrheal deaths are preventable because they are primarily caused by pathogens, whose spread can be easily controlled. […] By increasing global access to clean water and sanitation, oral rehydration treatment, and vaccination, this major cause of death can be reduced substantially. […] Diarrheal diseases are a leading cause of death among children. […] Its estimated that around 340,000 children died from diarrheal diseases globally in 2021.

• #5 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diarrhea-Epidemiology.aspx

  Diarrhea kills 1.8 million children under five in developing countries. This figure, however, is an improvement from 4.5 million deaths in last 20 years. […] Annual incidence of diarrheal disease episodes in children less than five years old in developing countries thus stands at 2 billion diarrheal episodes globally with a median incidence rate of 3.2 episodes per child. […] The incidence is highest among children under 5 years of age living in low- and middle-income countries.

• #6 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diarrhea-Epidemiology.aspx

  Diarrhea kills 1.8 million children under five in developing countries. This figure, however, is an improvement from 4.5 million deaths in last 20 years. […] Annual incidence of diarrheal disease episodes in children less than five years old in developing countries thus stands at 2 billion diarrheal episodes globally with a median incidence rate of 3.2 episodes per child. […] The incidence is highest among children under 5 years of age living in low- and middle-income countries.

• #7 Diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Diarrhea

  Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5 million deaths among children under the age of five. Greater than half of these were in Africa and South Asia. This is down from a death rate of 4.5 million in 1980 for gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after pneumonia (17%) in this age group. […] The majority of such cases occur in the developing world, with over half of the recorded cases of childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases, respectively, compared to only 480 million in the rest of the world. […] Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011 and 250 million lost school days. In the Americas, diarrheal disease accounts for a total of 10% of deaths among children aged 15 months while in South East Asia, it accounts for 31.3% of deaths. It is estimated that around 21% of child mortalities in developing countries are due to diarrheal disease. […] The World Health Organization has reported that „deaths due to diarrhoeal diseases have dropped by 45%, from sixth leading cause of death in 2000 to thirteenth in 2021.”

• #8 Diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Diarrhea

  Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5 million deaths among children under the age of five. Greater than half of these were in Africa and South Asia. This is down from a death rate of 4.5 million in 1980 for gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after pneumonia (17%) in this age group. […] The majority of such cases occur in the developing world, with over half of the recorded cases of childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases, respectively, compared to only 480 million in the rest of the world. […] Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011 and 250 million lost school days. In the Americas, diarrheal disease accounts for a total of 10% of deaths among children aged 15 months while in South East Asia, it accounts for 31.3% of deaths. It is estimated that around 21% of child mortalities in developing countries are due to diarrheal disease. […] The World Health Organization has reported that „deaths due to diarrhoeal diseases have dropped by 45%, from sixth leading cause of death in 2000 to thirteenth in 2021.”

• #9 Diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Diarrhea

  Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5 million deaths among children under the age of five. Greater than half of these were in Africa and South Asia. This is down from a death rate of 4.5 million in 1980 for gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after pneumonia (17%) in this age group. […] The majority of such cases occur in the developing world, with over half of the recorded cases of childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases, respectively, compared to only 480 million in the rest of the world. […] Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011 and 250 million lost school days. In the Americas, diarrheal disease accounts for a total of 10% of deaths among children aged 15 months while in South East Asia, it accounts for 31.3% of deaths. It is estimated that around 21% of child mortalities in developing countries are due to diarrheal disease. […] The World Health Organization has reported that „deaths due to diarrhoeal diseases have dropped by 45%, from sixth leading cause of death in 2000 to thirteenth in 2021.”

• #10 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diarrhea-Epidemiology.aspx

  Diarrhea kills 1.8 million children under five in developing countries. This figure, however, is an improvement from 4.5 million deaths in last 20 years. […] Annual incidence of diarrheal disease episodes in children less than five years old in developing countries thus stands at 2 billion diarrheal episodes globally with a median incidence rate of 3.2 episodes per child. […] The incidence is highest among children under 5 years of age living in low- and middle-income countries.

• #11 Epidemiology of Acute Diarrheal Diseases | PSM Made Easy

  https://ihatepsm.com/blog/epidemiology-acute-diarrheal-diseases

  Most common in children esp. b/w 6months 2 years age Highest incidence between 6 11 months age This may be due to: Declining maternal antibodies Introduction of complimentary feed Crawling More common in the bottle fed malnourished Malnutrition leading to diarrhea and vice versa forms a vicious cycle diarrhea and malnutrition-vicious cycle […] Seasonal patterns differ in geographical areas Tropical areas: Rotavirus occurs throughout the year but increase in winter and Bacterial diarrheas peak during the warmer rainy season Temperate climate: Bacterial diarrheas more frequent in warm season and Viral diarrheas in winters […] Most of the diarrheal agents are transmitted by the fecal-oral route Water borne Food borne Person to person transmission via finger or fomite Some viruses (such as rotavirus) can be transmitted through air Nosocomial transmission is possible

• #12 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Deaths from diarrheal diseases have declined over time, but they still carry a substantial death toll today. […] This is because people in many countries still lack access to clean water and sanitation, adequate treatment and healthcare, and have low vaccination rates against pathogens that cause diarrheal disease. […] There are significant differences in diarrheal death rates across the world. […] Deaths from diarrheal disease are more common in poorer countries. […] Death rates in low-income countries are almost fifty times higher than in high-income countries. […] Diarrheal deaths remain a large problem in much of the world even today but they can be significantly reduced with greater public health efforts. […] Researchers now know that diarrheal disease deaths in children are primarily caused by pathogens, such as viruses, bacteria, and protists.

• #13 Global Epidemiology and Management of Acute Diarrhea in Children from Developing Countries

  https://www.jscimedcentral.com/jounal-article-info/Annals-of-Pediatrics-and-Child-Health/Global-Epidemiology-and–Management-of-Acute–Diarrhea-in-Children-from–Developing-Countries-7974

  The biggest factors leading to deaths in children under the age of five in developing countries is the lack of clean water supply, unsanitary living conditions, and poor personal hygiene, which have been associated with 88% of deaths resulting from diarrhea worldwide. […] The major detriment in the prevention and management of children with diarrheal illness in developing countries is insufficient resources and unstable infrastructure to effectively help treat these patients. […] WHO recommends five methods for physicians to utilize to effectively prevent and treat diarrhea and its complications; these include the use of the rotavirus vaccine, ORS, zinc supplementation, proper personal hygiene with an emphasis on handwashing, and targeted antibiotic therapy for certain conditions. […] ORS, as stated by WHO and United Nations International Childrens Emergency Fund (UNICEF), has shown to effectively decrease the morbidity and mortality resulting from diarrheal illnesses in children. […] With a combined approach of proper education for caregivers, adequate sanitary living conditions, and prompt management of diarrheal illnesses, the rates of mortality due to diarrhea in children can drastically decline in developing countries as seen in the developed nations worldwide.

• #14 Epidemiology of Acute Diarrheal Diseases | PSM Made Easy

  https://ihatepsm.com/blog/epidemiology-acute-diarrheal-diseases

  Most common in children esp. b/w 6months 2 years age Highest incidence between 6 11 months age This may be due to: Declining maternal antibodies Introduction of complimentary feed Crawling More common in the bottle fed malnourished Malnutrition leading to diarrhea and vice versa forms a vicious cycle diarrhea and malnutrition-vicious cycle […] Seasonal patterns differ in geographical areas Tropical areas: Rotavirus occurs throughout the year but increase in winter and Bacterial diarrheas peak during the warmer rainy season Temperate climate: Bacterial diarrheas more frequent in warm season and Viral diarrheas in winters […] Most of the diarrheal agents are transmitted by the fecal-oral route Water borne Food borne Person to person transmission via finger or fomite Some viruses (such as rotavirus) can be transmitted through air Nosocomial transmission is possible

• #15 Diarrhea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/928598-overview

  In the United States, one estimate before the introduction of specific antirotavirus immunization in 2006 assumed a cumulative incidence of 1 hospitalization for diarrhea per 23-27 children by age 5 years, with more than 50,000 hospitalizations. By these estimates, rotavirus was associated with 4-5% of all childhood hospitalizations and a cost of nearly $ 1 billion. Furthermore, acute diarrhea is responsible for 20% of physician referrals in children younger than 2 years and for 10% in children younger than 3 years. […] The impact of vaccination on rotavirus morbidity has been remarkable, with significant reduction of diarrhea-associated hospitalizations and visits to emergency departments in children in the years 2007-2008 compared with the prevaccine period. […] In developing countries, an average of 3 episodes per child per year in children younger than 5 years is reported; however, some areas report 6-8 episodes per year per child. In these settings, malnutrition is an important additional risk factor for diarrhea, and recurrent episodes of diarrhea lead to growth faltering and substantially increased mortality.

• #16

  https://journals.lww.com/10.1097/01.ede.0000239728.75215.86

  Our study shows important advantages of applying a dynamic analysis approach to longitudinal observational studies of diarrhea or other acute diseases and highlights the complex interrelationships of diarrhea determinants. […] Our results confirm the importance of sanitation as a major determinant of child health in urban settings of developing countries. […] We confirmed poor socioeconomic, neighborhood, and domestic sanitary conditions (presence of an open sewage nearby, absence of toilet in household, flooding of habitation) as well as some child- and care-related exposure variables (absence of prenatal examination) and presence of intestinal parasites as being the major risk factors for diarrhea incidence. […] The implication is that diarrhea rates in developing countries could be substantially decreased by interventions aimed to improve the sanitary and general living conditions of households.

• #17

  https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease

  Diarrhoeal disease is the third leading cause of death in children under 5 years old and is responsible for killing around 443 832 children every year. […] Diarrhoeal disease is a leading cause of child mortality and morbidity in the world, and mostly results from contaminated food and water sources. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] Diarrhoea due to infection is widespread throughout developing countries. […] Diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faeces-contaminated water. […] Infection is more common when there is a shortage of adequate sanitation and hygiene and safe water for drinking, cooking and cleaning. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] WHO works with Member States and other partners to promote national policies and investments that support case management of diarrhoea and its complications as well as increasing access to safe drinking-water and sanitation in developing countries.

• #18

  https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease

  Diarrhoeal disease is the third leading cause of death in children under 5 years old and is responsible for killing around 443 832 children every year. […] Diarrhoeal disease is a leading cause of child mortality and morbidity in the world, and mostly results from contaminated food and water sources. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] Diarrhoea due to infection is widespread throughout developing countries. […] Diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faeces-contaminated water. […] Infection is more common when there is a shortage of adequate sanitation and hygiene and safe water for drinking, cooking and cleaning. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] WHO works with Member States and other partners to promote national policies and investments that support case management of diarrhoea and its complications as well as increasing access to safe drinking-water and sanitation in developing countries.

• #19 Epidemiology of Acute Diarrheal Diseases | PSM Made Easy

  https://ihatepsm.com/blog/epidemiology-acute-diarrheal-diseases

  Major killer of under 5 children, even though the toll has reduced considerably 10% of under-5 deaths in India Reduction of mortality mainly due to rehydration tech including ORS Under 5 children are estimated to have 3 episodes per year Incidence hasnt changed much but mortality is reduced considerably Loss of considerable number of DALYs Leading cause of death during disasters and emergencies Displacement of population into temporary, overcrowded shelters and polluted water source, inadequate sanitation, contaminated food, lack of hygiene and malnutrition, all lead to spread and severity of diarrhea Heavy economic burden on: Health services and Nation […] Until recently the pathogen could be identified only 25% of diarrhea cases Currently, new techniques have enabled such identification in 75% cases

• #20 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions. […] We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. […] During 2017-2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7).

• #21 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516). […] Despite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality. […] This study used standardised surveillance, laboratory and analysis protocols to define the aetiology of hospitalised paediatric diarrhoea using quantitative molecular diagnostics from a large, globally representative set of low-income and middle-income countries.

• #22 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions. […] We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. […] During 2017-2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7).

• #23 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516). […] Despite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality. […] This study used standardised surveillance, laboratory and analysis protocols to define the aetiology of hospitalised paediatric diarrhoea using quantitative molecular diagnostics from a large, globally representative set of low-income and middle-income countries.

• #24 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions. […] We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. […] During 2017-2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7).

• #25 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516). […] Despite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality. […] This study used standardised surveillance, laboratory and analysis protocols to define the aetiology of hospitalised paediatric diarrhoea using quantitative molecular diagnostics from a large, globally representative set of low-income and middle-income countries.

• #26 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions. […] We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. […] During 2017-2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7).

• #27 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516). […] Despite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality. […] This study used standardised surveillance, laboratory and analysis protocols to define the aetiology of hospitalised paediatric diarrhoea using quantitative molecular diagnostics from a large, globally representative set of low-income and middle-income countries.

• #28 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  In total, ten pathogens are responsible for three-quarters of diarrheal deaths. […] These pathogens are transmitted between people through different routes, including contaminated water and food, respiratory droplets, and close contact. […] Several pathogens that cause diarrheal diseases are spread by contaminated water or food and unsafe sewage. […] This means clean water treatment, food safety measures, and sanitation can effectively kill them and reduce their disease burden. […] Improving access to safe drinking water and sanitation would help reduce diarrheal deaths and child mortality rates. […] By understanding the causes of diarrheal diseases, the world has managed to reduce their burden through public health measures. […] But, in many countries, only a small share of children receive oral rehydration therapy.

• #29 Epidemiology of Acute Diarrheal Diseases | PSM Made Easy

  https://ihatepsm.com/blog/epidemiology-acute-diarrheal-diseases

  Most common in children esp. b/w 6months 2 years age Highest incidence between 6 11 months age This may be due to: Declining maternal antibodies Introduction of complimentary feed Crawling More common in the bottle fed malnourished Malnutrition leading to diarrhea and vice versa forms a vicious cycle diarrhea and malnutrition-vicious cycle […] Seasonal patterns differ in geographical areas Tropical areas: Rotavirus occurs throughout the year but increase in winter and Bacterial diarrheas peak during the warmer rainy season Temperate climate: Bacterial diarrheas more frequent in warm season and Viral diarrheas in winters […] Most of the diarrheal agents are transmitted by the fecal-oral route Water borne Food borne Person to person transmission via finger or fomite Some viruses (such as rotavirus) can be transmitted through air Nosocomial transmission is possible

• #30 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD. […] In South Asia, for example, much higher TD attack rates are reported during the hot months preceding the monsoon. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #31 Epidemiology, aetiology and seasonality of infectious diarrhoea in adult outpatients through active surveillance in Shanghai, China, 2012–2016: a cross-sectional study | BMJ Open

  https://bmjopen.bmj.com/content/8/9/e019699

  Epidemiology, aetiology and seasonality of infectious diarrhoea in adult outpatients through active surveillance in Shanghai, China, 20122016: a cross-sectional study […] This study aimed to identify the epidemiology, clinical characteristics, aetiology and seasonality of sporadic infectious diarrhoea in adults in Shanghai. […] This study is the first study in Shanghai to identify the aetiology and epidemiology of adult infectious diarrhoea in sporadic outpatients from a continuous active diarrhoea surveillance enhanced with comprehensive laboratory testing for common enteric bacteria and virus. […] A seasonal distribution of infectious diarrhoea was observed with larger peaks in winter and smaller peaks in summer. […] Viral infections were predominant, and norovirus played a leading role. […] Our findings highlight the necessity for conducting an active, comprehensive surveillance in adults, to monitor changing dynamics in the epidemiology and aetiology of infectious diarrhoea.

• #32 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  Travelers diarrhea has a high incidence rate among deployed US military personnel and can hinder operational readiness. The Global Travelers Diarrhea study is a US Department of Defense-funded multisite surveillance effort to investigate the etiology and epidemiology of travelers diarrhea. […] This article describes the epidemiology of TD cases among US military populations and adult travelers during 2018-2023. […] Our investigation also identified Campylobacter, Salmonella, and norovirus as TD etiologies, although with lower proportions than observed for E. coli. […] Our study data suggest E. coli, specifically pathotypes ETEC, EAEC, and EPEC, are the leading causes of TD in Southern and Central Asia, Northern Africa, the Middle East, sub-Saharan Africa, and Central and South America.

• #33 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  The highest rates of Campylobacter and Salmonella associated with TD are found in Southeast and East Asia, and high rates are also found in Southern and Central Asia. […] Vaccines used prophylactically to prevent TD have the potential to reduce disease incidence and severity; however, no vaccines for E. coli, Campylobacter, or Shigella are currently licensed by the US Food and Drug Administration. […] Moving forward, we recommend the GTD study expand to include antimicrobial resistance (AMR) characterization of bacterial pathogens identified from TD cases by using antimicrobial susceptibility testing and next-generation sequencing technologies to identify genetic markers of AMR and virulence factors of enteric bacterial pathogens.

• #34 Approach to the adult with acute diarrhea in resource-abundant settings – UpToDate

  https://www.uptodate.com/contents/approach-to-the-adult-with-acute-diarrhea-in-resource-abundant-settings

  Diarrheal disease is a leading cause of death worldwide. Among adults in resource-abundant settings, diarrhea is often a „nuisance disease” in the healthy individual. Most cases of acute diarrhea in adults are of infectious etiology, and most cases resolve with symptomatic treatment alone. In the United States, expert guidelines on the diagnosis and management of acute diarrhea include guidelines from the Infectious Diseases Society of America and the American College of Gastroenterology. Updated information on outbreaks may be found on websites maintained by the United States Centers for Disease Control and Prevention and the US Food and Drug Administration. The United States Foodborne Diseases Active Surveillance Network (FoodNet) conducts active population-based surveillance for laboratory-diagnosed enteric infections; in 2022, FoodNet reported 25,479 cases, 5981 hospitalizations and 170 deaths from foodborne infection in the United States. Most cases of acute diarrhea are due to infections and are self-limited. The major causes of acute infectious diarrhea include viruses (norovirus, rotavirus, adenoviruses, astrovirus, and others), bacteria (Salmonella, Campylobacter, Shigella, enterotoxigenic Escherichia coli, Clostridioides difficile, and others), and protozoa (Cryptosporidium, Giardia, Cyclospora, Entamoeba, and others). Exact data on the frequency of different causes of acute diarrhea vary according to the definition used, the diagnostic technology available, and the population studied. Noninfectious etiologies become more common as the course of the diarrhea persists and becomes chronic.

• #35

  https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease

  Diarrhoeal disease is the third leading cause of death in children under 5 years old and is responsible for killing around 443 832 children every year. […] Diarrhoeal disease is a leading cause of child mortality and morbidity in the world, and mostly results from contaminated food and water sources. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] Diarrhoea due to infection is widespread throughout developing countries. […] Diarrhoea is a symptom of infections caused by a host of bacterial, viral and parasitic organisms, most of which are spread by faeces-contaminated water. […] Infection is more common when there is a shortage of adequate sanitation and hygiene and safe water for drinking, cooking and cleaning. […] Diarrhoea is a leading cause of malnutrition in children under 5 years old. […] WHO works with Member States and other partners to promote national policies and investments that support case management of diarrhoea and its complications as well as increasing access to safe drinking-water and sanitation in developing countries.

• #36 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Diarrhoea remains a leading cause of child morbidity and mortality. Systematically collected and analysed data on the aetiology of hospitalised diarrhoea in low-income and middle-income countries are needed to prioritise interventions. […] We established the Global Pediatric Diarrhea Surveillance network, in which children under 5 years hospitalised with diarrhoea were enrolled at 33 sentinel surveillance hospitals in 28 low-income and middle-income countries. […] During 2017-2018, 29 502 diarrhoea hospitalisations were enrolled, of which 5465 were randomly selected and tested. Rotavirus was the leading cause of diarrhoea requiring hospitalisation (attributable fraction (AF) 33.3%; 95% CI 27.7 to 40.3), followed by Shigella (9.7%; 95% CI 7.7 to 11.6), norovirus (6.5%; 95% CI 5.4 to 7.6) and adenovirus 40/41 (5.5%; 95% CI 4.4 to 6.7).

• #37 WHO Global Pediatric Diarrhea Surveillance 2017-2018 | GHDx

  https://ghdx.healthdata.org/record/who-global-pediatric-diarrhea-surveillance-2017-2018

  WHO Global Pediatric Diarrhea Surveillance (GPDS) 2017-2018 includes: (1) Sentinel hospital surveillance sites participating in the GPDS network and (2) weighted prevalence estimates derived from WHO GPDS data on diarrheal pathogens. […] Data type Epi surveillance.

• #38 Diarrhea Case Surveillance in the Enterics for Global Health Shigella Surveillance Study: Epidemiologic Methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10962728/

  Shigella is a leading cause of acute watery diarrhea, dysentery, and diarrhea-attributed linear growth faltering, a precursor to stunting and lifelong morbidity. […] The Enterics for Global Health (EFGH) Shigella surveillance study will employ facility-based enrollment of diarrhea cases aged 635 months with 3 months of follow-up to establish incidence rates and document clinical, anthropometric, and financial consequences of Shigella diarrhea at 7 country sites (Mali, Kenya, The Gambia, Malawi, Bangladesh, Pakistan, and Peru). […] This multicountry surveillance network will provide key incidence data needed to design Shigella vaccine trials and strengthen readiness for potential trial implementation. […] Diarrheal diseases are a leading cause of morbidity and mortality in children 5 years of age with an estimated 500 000 deaths annually, ranking third in the global disability-adjusted life-year burden.

• #39 Diarrhea Case Surveillance in the Enterics for Global Health Shigella Surveillance Study: Epidemiologic Methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10962728/

  Utilizing a hybrid surveillance approach, the Enterics for Global Health (EFGH) Shigella surveillance study will estimate serotype- and disease severity-specific incidence rates of Shigella diarrhea and document the health and economic consequences of Shigella diarrhea in 7 country sites in Africa, Asia, and South America. […] A key aim of EFGH is to estimate the incidence of Shigella diarrhea by various severity definitions, which include clinical measures such as dehydration and clinician decision to hospitalize. […] Ensuring the success of eventual Shigella vaccine field efficacy trials and promoting uptake and adoption of newly licensed Shigella vaccines by policy makers will require recent, country-specific data on the burden of Shigella diarrhea as well as the health and economic consequences of this important disease.

• #40 eCommons@AKU

  https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/1489/

  Shigella is a leading cause of acute watery diarrhea, dysentery, and diarrhea-attributed linear growth faltering, a precursor to stunting and lifelong morbidity. […] The Enterics for Global Health (EFGH) Shigella surveillance study will employ facility-based enrollment of diarrhea cases aged 6-35 months with 3 months of follow-up to establish incidence rates and document clinical, anthropometric, and financial consequences of Shigella diarrhea at 7 country sites (Mali, Kenya, The Gambia, Malawi, Bangladesh, Pakistan, and Peru). […] Over a 24-month period between 2022 and 2024, the EFGH study aims to enroll 9800 children (1400 per country site) between 6 and 35 months of age who present to local health facilities with diarrhea. […] This multicounty surveillance network will provide key incidence data needed to design Shigella vaccine trials and strengthen readiness for potential trial implementation. Data collected in EFGH will inform policy makers about the relative importance of this vaccine-preventable disease, accelerating the time to vaccine availability and uptake among children in high-burden settings.

• #41 Pacific Syndromic Surveillance System Weekly Bulletin / Système de Surveillance Syndromique dans le Pacifique – Bulletin Hebdomadaire: W17 2025 (Apr 21-Apr 27) [EN/FR] – Fiji | ReliefWeb

  https://reliefweb.int/report/fiji/pacific-syndromic-surveillance-system-weekly-bulletin-systeme-de-surveillance-syndromique-dans-le-pacifique-bulletin-hebdomadaire-w17-2025-apr-21-apr-27-enfr

  The Pacific Syndromic Surveillance System (PSSS) collects data on the following syndromes: acute fever and rash, diarrhea, influenza-like-illness, prolonged fever and dengue-like illness. […] PSSS serves as an invaluable early warning tool for common outbreak-prone diseases and a mechanism for regular contact between Pacific island countries and areas, WHO and other international agencies such as the Secretariat of the Pacific Community.

• #42 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  Travelers diarrhea has a high incidence rate among deployed US military personnel and can hinder operational readiness. The Global Travelers Diarrhea study is a US Department of Defense-funded multisite surveillance effort to investigate the etiology and epidemiology of travelers diarrhea. […] This article describes the epidemiology of TD cases among US military populations and adult travelers during 2018-2023. […] Our investigation also identified Campylobacter, Salmonella, and norovirus as TD etiologies, although with lower proportions than observed for E. coli. […] Our study data suggest E. coli, specifically pathotypes ETEC, EAEC, and EPEC, are the leading causes of TD in Southern and Central Asia, Northern Africa, the Middle East, sub-Saharan Africa, and Central and South America.

• #43 National Pediatric Diarrhea Surveillance Study | Slone Epidemiology Center

  https://www.bu.edu/slone/research/studies/npdss/

  To determine a) the prevalence of specific bacterial, viral and protozoal pathogens in the stools of 1000 healthy children between 6 months and 3 years of age who are representative of US children with respect to geography, family income, and race, b) the incidence of acute diarrheal illness occurring among these children (including illness not severe enough to require medical attention), and c) the incidence of infection with specific bacterial, viral and protozoal foodborne pathogens associated with clinical illness. […] To identify risk factors for diarrheal illness and infection with specific foodborne pathogens in these children. Risk factors to be studied include consumer practices related to food (and water) purchasing, handling, storage, and cooking in the home. […] This is a multi-center, prospective cohort study. Eligible healthy children are identified and enrolled by office-based primary care physicians from an established nationwide network.

• #44 National Pediatric Diarrhea Surveillance Study | National Agricultural Library

  https://www.nal.usda.gov/research-tools/food-safety-research-projects/national-pediatric-diarrhea-surveillance-study

  The major goals of this project are to gain a better understanding of the causes, risk factors, and outcomes of foodborne disease related diarrhea in children under the age of 3 in the United States. The first goal of this proposal is to determine a)the prevalence of specific bacterial, viral and protozoal pathogens in the stools of 1000 healthy children between 6 months and 3 years of age who are representative of U.S. children with respect to geography, family income, and ethnicity,b)the incidence of acute diarrheal illness occurring among these children and c)the incidence of infection with specific bacterial, viral, and protozoal foodborne pathogens associated with clinical illness. […] The second goal is to characterize the type of gastrointestinal illnesses that occur in these children, the duration, treatment, and sequelae occurring within two months of acute illness.

• #45 French GPs Sentinelles network > France > Public Health Surveillance

  https://www.sentiweb.fr/france/en/?page=maladies&mal=6

  Surveillance period: 1990 – active. […] Temporal resolution: Weekly surveillance. […] Publication frequency: Data are updated every Wednesday. […] Secular trends in incidence of acute gastroenteritis in general practice, France, 1991 to 2015. […] A method for selecting and monitoring medication sales for surveillance of gastroenteritis. […] Diarrhoea-related morbidity and rotavirus infection in France. […] Risk factors for winter outbreak of acute diarrhoea in France: case-control study. […] Sentinelle traces of an epidemic of acute gastroenteritis in France. […] Une anne de surveillance des diarrhes aigus par les mdecins sentinelles.

• #46 Sentinel Diarrhoeal Disease Surveillance: South Africa 2022 Insights

  https://www.phbsa.ac.za/diarrhoeal-disease-surveillance-2022/

  Diarrhoeal diseases refer to a group of illnesses that involve the passage of loose or watery stools, often accompanied by an increased frequency of bowel movements. […] The Diarrhoeal Diseases Syndromic Surveillance (DDSS) is a system that was set up in April 2009 to keep an eye on severe cases of diarrhoea, especially in children under 5 years old, after the introduction of the rotavirus vaccine. […] Diarrhoeal diseases are still a significant health issue in South Africa, and not everyone who gets sick with diarrhoea has their stool tested. […] This report details the monitoring and tracking of bacterial, viral, and parasitic agents that cause diarrhoeal diseases in South Africa during 2022. […] In 2022, diarrhoeal disease surveillance was conducted at sentinel sites in five provinces as part of the GERMS-SA surveillance. […] A total of 624 cases were enrolled from the eight surveillance sites, all of whom provided a stool specimen for screening.

• #47 Clostridium difficile–Associated Diarrhea Surveillance results: 2016-2017 | Institut national de santé publique du Québec

  https://www.inspq.qc.ca/en/nosocomial-infections/spin-cdad/surveillance-results-2016-2017

  From April 1st, 2016 to March 31st, 2017, 95 healthcare facilities participated in the Clostridium difficileassociated diarrhea (CDAD) surveillance program, for a combined total of 5,022,104 patient days. These participating facilities reported 2,330 healthcare-associated CDAD (HA-CDAD), either acquired during a current or previous hospitalization. The HA-CDAD incidence rate was 4.64 cases per 10,000 patient days. This incidence rate has declined for a third consecutive year and this decline was statistically and significantly lower than the 2015-2016 rate. The 10-day fatality rate was 6.3% while the 30-day fatality rate was 12.4%. In total, 14 (0.7%) colectomies were reported. […] In 2016-2017, the provincial incidence rate for HA-CDAD for all participating facilities is 4.64 cases per 10,000 patient days. Some healthcare facility characteristics are associated with higher incidence rates. Incidence rates are significantly higher in non-teaching facilities with 110 beds and more, and this is even stronger when the proportion of admitted patients aged 65 years and older is equal or greater than 45%. The incidence rate is greater among teaching facilities with 400 beds and more.

• #48 Clostridium difficile–Associated Diarrhea: surveillance 2015-2016 | Institut national de santé publique du Québec

  https://www.inspq.qc.ca/en/nosocomial-infections/spin-cdad/surveillance-results-2015-2016

  From April 1, 2015, to March 31, 2016, 95 healthcare facilities participated in the Clostridium difficileassociated diarrhea (CDAD) surveillance program, for a combined total of 5,048,411 inpatient days. These participating facilities reported 2,977 cases of healthcare-associated CDAD (HA-CDAD). The incidence rate of HA-CDAD was 5.9 cases per 10,000 patient days. The 2015-2016 incidence rate was significantly lower than the 2014-2015 rate. The 10-day fatality rate was 8.0% (n = 219) while the 30-day fatality rate was 14.0% (n = 381). […] In 2015-2016, the provincial incidence rate for HA-CDAD (cat. 1a and 1b) for all participating facilities was 5.9 cases per 10,000 patient days. Some healthcare facilities characteristics are associated with higher incidence rate. Incidence rate were significantly higher in non-teaching facilities with 110 beds and more, and when the proportion of admitted patients aged 65 years or older is equal or greater to 45%. The incidence rate is greater among teaching facilities with 400 beds and more.

• #49 Comparative study on epidemiological and etiological characteristics of patients with acute diarrhea with febrile or non-febrile symptoms in China | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-023-01108-w

  Acute diarrhea with fever can potentially represent a more severe form of the disease compared to non-febrile diarrhea. This study was to investigate the epidemiological characteristics and enteric pathogen composition of febrile-diarrheal patients, and to explore factors including pathogens associated with fever by age group. […] A nationwide surveillance study of acute diarrheal patients of all ages was conducted in 217 sentinel hospitals from 31 provinces (autonomous regions or municipalities) in China between 2011 and 2020. […] A total of 146,296 patients with acute diarrhea (18.6% with fever) were tested. […] The febrile-diarrheal patients were associated with a significantly higher prevalence of bacterial pathogens than afebrile-diarrheal patients (all P<0.01). [...] There are significant discrepancy of the infected enteric pathogens in patients with acute diarrhea with fever between age groups, and it is valuable for priority detection of NTS and rotavirus A in patients with children 5 years old and NTS and DEC in adult patients.

• #50 Travelers’ diarrhea: Epidemiology, microbiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/travelers-diarrhea-epidemiology-microbiology-clinical-manifestations-and-diagnosis

  Travelers’ diarrhea refers to development of unformed stools during or within 10 days of returning from travel; it commonly occurs in association with travel to a setting where sanitation and hygienic practices are poor and there is limited access to safe drinking water. Travelers’ diarrhea is typically self-diagnosed. […] For epidemiologic purposes, travelers’ diarrhea may be defined as passage of three or more unformed stools in a 24-hour period, accompanied by at least one of these other symptoms: nausea, vomiting, abdominal pain or cramps, fever, or blood in the stool. […] Frequency — Travelers’ diarrhea is the most common illness among individuals traveling to settings where sanitation and hygienic practices are poor and there is limited access to safe drinking water. The attack rate for travelers’ diarrhea ranges between 10 and 70 percent; estimates vary greatly between studies.

• #51 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD. […] In South Asia, for example, much higher TD attack rates are reported during the hot months preceding the monsoon. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #52 Diarrhea – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/diarrhea/

  Approximately 25% of all travelers develop traveler’s diarrhea. […] Enterotoxigenic E. coli (ETEC) is the most common cause of traveler’s diarrhea globally. […] Antibiotic treatment is not recommended in patients with mild traveler’s diarrhea. […] Bismuth subsalicylate is an antidiarrheal agent used to treat traveler’s diarrhea (caused by enterotoxigenic Escherichia coli).

• #53 Diarrhea – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/diarrhea/

  The WHO defines diarrhea as 3 loose or watery stools per day or more frequent passage than is normal for the individual. […] Though most patients with diarrhea have mild symptoms and can be managed as outpatients, some patients may present with severe and even life-threatening symptoms that require hospitalization. […] Recent travel: associated with traveler’s diarrhea. […] Recent hospitalization: associated with health care-associated infections (e.g., C. difficile infection). […] More than 700 medications can cause diarrhea and, therefore, the introduction of a new medication within 6-8 weeks of the onset of diarrhea should be considered as a potential cause. […] Chronic diarrhea is common after bariatric surgery. […] The highest rates occur after travel to Africa and South, Central, and West Asia.

• #54 Diarrhea – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/diarrhea/

  Approximately 25% of all travelers develop traveler’s diarrhea. […] Enterotoxigenic E. coli (ETEC) is the most common cause of traveler’s diarrhea globally. […] Antibiotic treatment is not recommended in patients with mild traveler’s diarrhea. […] Bismuth subsalicylate is an antidiarrheal agent used to treat traveler’s diarrhea (caused by enterotoxigenic Escherichia coli).

• #55 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD. […] In South Asia, for example, much higher TD attack rates are reported during the hot months preceding the monsoon. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #56 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  Travelers diarrhea has a high incidence rate among deployed US military personnel and can hinder operational readiness. The Global Travelers Diarrhea study is a US Department of Defense-funded multisite surveillance effort to investigate the etiology and epidemiology of travelers diarrhea. […] This article describes the epidemiology of TD cases among US military populations and adult travelers during 2018-2023. […] Our investigation also identified Campylobacter, Salmonella, and norovirus as TD etiologies, although with lower proportions than observed for E. coli. […] Our study data suggest E. coli, specifically pathotypes ETEC, EAEC, and EPEC, are the leading causes of TD in Southern and Central Asia, Northern Africa, the Middle East, sub-Saharan Africa, and Central and South America.

• #57 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD. […] In South Asia, for example, much higher TD attack rates are reported during the hot months preceding the monsoon. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #58 Travelers’ Diarrhea | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/preparing-international-travelers/travelers-diarrhea.html

  Travelers’ diarrhea (TD) is the most predictable travel-related illness. Attack rates range from 30% to 70% of travelers during a 2-week period, depending on the destination and season of travel. […] Poor hygiene practices in local restaurants and underlying hygiene and sanitation infrastructure deficiencies are likely the largest contributors to the risk for TD. […] Surveillance also points to Aeromonas spp., Plesiomonas spp., and newly recognized pathogens (Aliarcobacter, enterotoxigenic Bacteroides fragilis, Larobacter) as potential causes of TD. […] In South Asia, for example, much higher TD attack rates are reported during the hot months preceding the monsoon. […] Where provided, effective food-handling courses have been shown to decrease the risk for TD. […] However, even in high-income countries, food handling and preparation in restaurants has been linked to diarrhea caused by pathogens such as Shigella sonnei.

• #59 Epidemiology, aetiology and seasonality of infectious diarrhoea in adult outpatients through active surveillance in Shanghai, China, 2012–2016: a cross-sectional study | BMJ Open

  https://bmjopen.bmj.com/content/8/9/e019699

  Epidemiology, aetiology and seasonality of infectious diarrhoea in adult outpatients through active surveillance in Shanghai, China, 20122016: a cross-sectional study […] This study aimed to identify the epidemiology, clinical characteristics, aetiology and seasonality of sporadic infectious diarrhoea in adults in Shanghai. […] This study is the first study in Shanghai to identify the aetiology and epidemiology of adult infectious diarrhoea in sporadic outpatients from a continuous active diarrhoea surveillance enhanced with comprehensive laboratory testing for common enteric bacteria and virus. […] A seasonal distribution of infectious diarrhoea was observed with larger peaks in winter and smaller peaks in summer. […] Viral infections were predominant, and norovirus played a leading role. […] Our findings highlight the necessity for conducting an active, comprehensive surveillance in adults, to monitor changing dynamics in the epidemiology and aetiology of infectious diarrhoea.

• #60 Diarrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448082/

  Diarrhea is categorized into acute or chronic and infectious or non-infectious based on the duration and type of symptoms. Acute diarrhea is defined as an episode lasting less than 2 weeks. Infection most commonly causes acute diarrhea. Most cases result from a viral infection, and the course is self-limited. Chronic diarrhea is defined as a duration lasting longer than 2 weeks and tends to be non-infectious. Common causes include malabsorption, inflammatory bowel disease, and medication side effects. […] Norovirus is associated with approximately one-fifth of all infectious diarrhea cases, with similar prevalence in children and adults. It is estimated to cause over 200,000 deaths annually in developing countries. Historically, rotavirus was the most common cause of severe disease in young children globally. Rotavirus vaccination programs have decreased the prevalence of diarrhea cases associated with rotavirus.

• #61

  https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/294

  Rotavirus is a major cause of severe diarrhea and dehydration in children worldwide. Data on the burden of disease in Indonesia is limited. […] To provide an epidemiological profile of rotavirus infection among children hospitalized for diarrhea in Mohammad Hoesin Hospital, Palembang. […] A total of 513 fecal specimens from 534 children were tested for rotavirus. Rotavirus was detected in 64% of the specimens, mostly of the G9 type (62.5%). Incidence of rotavirus diarrhea was highest in the 6 month to 2 years age group (60.4%). Children with rotavirus diarrhea were more likely to present with dehydration, compared to those with non-rotavirus diarrhea (94% vs 70%, respectively, P=0.03). […] Rotavirus was the most common pathogen found in children with diarrhea. Rotavirus was detected in 64% of pediatric diarrheal specimens tested in our study. This finding warrants the use of a large-scale program to prevent disease, such as vaccination against rotavirus.

• #62 Disease burden of rotavirus related diarrhea in children under 5 years in China: a meta-analysis | Scientific Reports

  https://www.nature.com/articles/s41598-025-00778-w

  Rotavirus (RV) is a leading cause of severe diarrhea among children under five years of age in China. […] The incidence of RV-related diarrhea ranged from 0.637 /1000 to 31.46/1000 persons. […] Given the dynamic nature of the incidence rate of RV-related diarrhea and the prevalence of the G9P[8] genotype, it is imperative to enhance surveillance efforts targeting incidence of RV-related diarrhea and the circulating genotypes of rotavirus. […] Pursuant to the Infectious Disease Prevention and Control Law of China, hospitals are required to report confirmed cases of rotavirus-related diarrhea to the National Notifiable Infectious Diseases Surveillance System (NNIDSS) within 24 h. […] However, RV-related diarrhea is not classified as a distinct notifiable infectious disease. […] It is challenging to accurately estimate the incidence rate of RV-related diarrhea from the NNIDSS.

• #63 Diarrhea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448082/

  Diarrhea is categorized into acute or chronic and infectious or non-infectious based on the duration and type of symptoms. Acute diarrhea is defined as an episode lasting less than 2 weeks. Infection most commonly causes acute diarrhea. Most cases result from a viral infection, and the course is self-limited. Chronic diarrhea is defined as a duration lasting longer than 2 weeks and tends to be non-infectious. Common causes include malabsorption, inflammatory bowel disease, and medication side effects. […] Norovirus is associated with approximately one-fifth of all infectious diarrhea cases, with similar prevalence in children and adults. It is estimated to cause over 200,000 deaths annually in developing countries. Historically, rotavirus was the most common cause of severe disease in young children globally. Rotavirus vaccination programs have decreased the prevalence of diarrhea cases associated with rotavirus.

• #64 Surveillance network tracks shift in cause of childhood diarrhea – VUMC News

  https://news.vumc.org/2013/03/28/surveillance-network-tracks-shift-in-cause-of-childhood-diarrhea/

  A national vaccine surveillance program that Vanderbilt University is a part of has identified a significant shift in the most common cause of childhood diarrhea. […] A study released March 21 in the New England Journal of Medicine (NEJM), finds that norovirus (sometimes called the Norwalk virus) is now the leading cause of childhood diarrhea. Rotavirus once caused 90 percent of cases of childhood diarrhea, but rates have steadily declined since a vaccine came into widespread use in 2006. […] It is important to note that even though the threat of rotavirus is greatly reduced, our study shows the intensity and burden of norovirus has remained unchanged, Edwards said. […] Norovirus was detected in 21 percent of cases, while rotavirus was identified in only 12 percent. Edwards acknowledged this study reinforces the great success of rotavirus vaccination programs.

• #65 Diarrhea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/928598-overview

  In the United States, one estimate before the introduction of specific antirotavirus immunization in 2006 assumed a cumulative incidence of 1 hospitalization for diarrhea per 23-27 children by age 5 years, with more than 50,000 hospitalizations. By these estimates, rotavirus was associated with 4-5% of all childhood hospitalizations and a cost of nearly $ 1 billion. Furthermore, acute diarrhea is responsible for 20% of physician referrals in children younger than 2 years and for 10% in children younger than 3 years. […] The impact of vaccination on rotavirus morbidity has been remarkable, with significant reduction of diarrhea-associated hospitalizations and visits to emergency departments in children in the years 2007-2008 compared with the prevaccine period. […] In developing countries, an average of 3 episodes per child per year in children younger than 5 years is reported; however, some areas report 6-8 episodes per year per child. In these settings, malnutrition is an important additional risk factor for diarrhea, and recurrent episodes of diarrhea lead to growth faltering and substantially increased mortality.

• #66 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Despite a substantial impact of rotavirus vaccination, rotavirus remained the leading cause of diarrhoea requiring hospitalisation. Shigella, norovirus and adenovirus 40/41 also had a high burden of disease, with some important geographic heterogeneity. […] Diarrhoea requiring hospitalisation represents a consistently severe phenotype of this highly morbid syndrome. […] Ongoing monitoring and surveillance of paediatric diarrhoea and its causes are needed to identify diarrhoea prevention and control strategies and guide the prioritisation and development of new vaccines for enteric pathogens. […] By incorporating quantitative molecular diagnostics and pathogen attribution modelling into a global network with standardised surveillance, sample collection and testing, this study provides direct estimates of the aetiology of diarrhoea requiring hospitalisation in children under 5 years of age in LMICs in 2017-2018.

• #67 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Despite a substantial impact of rotavirus vaccination, rotavirus remained the leading cause of diarrhoea requiring hospitalisation. Shigella, norovirus and adenovirus 40/41 also had a high burden of disease, with some important geographic heterogeneity. […] Diarrhoea requiring hospitalisation represents a consistently severe phenotype of this highly morbid syndrome. […] Ongoing monitoring and surveillance of paediatric diarrhoea and its causes are needed to identify diarrhoea prevention and control strategies and guide the prioritisation and development of new vaccines for enteric pathogens. […] By incorporating quantitative molecular diagnostics and pathogen attribution modelling into a global network with standardised surveillance, sample collection and testing, this study provides direct estimates of the aetiology of diarrhoea requiring hospitalisation in children under 5 years of age in LMICs in 2017-2018.

• #68 Comparative study on epidemiological and etiological characteristics of patients with acute diarrhea with febrile or non-febrile symptoms in China | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-023-01108-w

  Acute diarrhea with fever can potentially represent a more severe form of the disease compared to non-febrile diarrhea. This study was to investigate the epidemiological characteristics and enteric pathogen composition of febrile-diarrheal patients, and to explore factors including pathogens associated with fever by age group. […] A nationwide surveillance study of acute diarrheal patients of all ages was conducted in 217 sentinel hospitals from 31 provinces (autonomous regions or municipalities) in China between 2011 and 2020. […] A total of 146,296 patients with acute diarrhea (18.6% with fever) were tested. […] The febrile-diarrheal patients were associated with a significantly higher prevalence of bacterial pathogens than afebrile-diarrheal patients (all P<0.01). [...] There are significant discrepancy of the infected enteric pathogens in patients with acute diarrhea with fever between age groups, and it is valuable for priority detection of NTS and rotavirus A in patients with children 5 years old and NTS and DEC in adult patients.

• #69 Diarrhea Case Surveillance in the Enterics for Global Health Shigella Surveillance Study: Epidemiologic Methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10962728/

  The highest burden of diarrheal disease occurs in low- and middle-income countries (LMICs); approximately 20% of deaths among children aged 159 months in sub-Saharan Africa and South Asia are attributed to diarrhea. […] Shigella, a gram-negative bacillus, is a leading cause of acute watery diarrhea and the leading cause of dysentery, responsible for an estimated 90 000 deaths each year in children 5 years of age. […] Depending on the severity of diarrhea, the diagnostic test used, and the setting, Shigella-attributed acute diarrhea incidence rates can range from 0.4 to 105 cases per 100 child-years. […] Establishing incidence rates of Shigella diarrhea traditionally requires a closed population, such as in a cohort study, with prospective capture of incident diarrheal episodes and fecal testing for Shigella spp.

• #70

  https://journals.lww.com/md-journal/fulltext/2024/03010/epidemiology_of_pathogens_causing_acute_diarrhea.26.aspx

  Acute diarrhea is a prevalent disease worldwide and a cause of mortality in low and middle-income countries. In this study, we intend to determine the pathogenic agents responsible for acute diarrhea in patients presenting to the Emergency Departments of several Lebanese hospitals. A total of 100 stool samples were collected between June 2022 and June 2023 from patients presenting with acute diarrhea to the Emergency Departments. Pathogens were detected by multiplex polymerase chain reaction. Acute diarrhea epidemiology is understudied in Lebanon. This study is the first Lebanese data about acute diarrhea pathogens. Avoiding overuse of antibiotics in bacterial versus viral infections can be achieved while prevention campaigns can raise awareness about food and water safety at the community level. Data on the etiology of pathogens causing diarrhea in Lebanon are scarce, and recent events have led to the propagation of new organisms or the reemergence of old ones. In the present study, we analyzed the etiology of several cases of acute diarrhea in patients presenting to the Emergency Departments of hospitals in Lebanon. In total, 46 patients were admitted to the hospital (70%), among them 80% received IV antibiotics. The different types of pathogens detected are summarized in Table 1. Among 100 of stool samples, Campylobacter was the most common agent detected in 36%, followed by Rotavirus 19%, and Noroviruses 15%. The findings in the present study, as well as the trends seen in recent years and in the literature, all point to an increase in infectious diarrheal cases caused by pathogens that thrive in poor living conditions. In terms of pathogen epidemiology, Campylobacter was the most common bacterial cause of diarrheal cases in the present study. In our study, bacteria accounted for 49% of infections. However, 70% of the patients presenting with diarrhea were admitted to the hospital and the majority received intravenous antibiotics.

• #71 Pathogenic Surveillance of Foodborne Illness-Related Diarrhea — Beijing Municipality, China, 2013–2023

  https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.111

  Surveillance data indicated that Norovirus and DEC were the predominant pathogens, individuals between 19 and 30 years old had the highest infection rates, and patients with Salmonella infections were more likely to experience fever symptoms. […] The study provides a summary and comparison of the epidemiological characteristics of pathogens over time. A high percentage of patients, 28.38% (2,971/10,469), are aged 19-30 years. […] The detection rates of all five pathogens decreased in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. […] The most common clinical symptoms were nausea, vomiting, and abdominal cramps. Patients infected with Salmonella were more likely to have a fever. […] Given the atypical clinical manifestations of various pathogens, differentiating them from non-infectious diarrhea remains challenging. Therefore, there is an urgent need to establish rapid pathogen monitoring methods to enable targeted treatment strategies when patients seek medical care.

• #72 Diarrhea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/928598-overview

  Because the single most common cause of infectious diarrhea worldwide is rotavirus, and because a vaccine has been in use for over 3 years now, a reduction in the overall frequency of diarrheal episodes is hoped for in the near future. […] A study by Lbbert et al found the incidence of Clostridium difficile infection in Germany in 2012 to be 83 cases per 100,000 population. The chance of recurrence increased with each relapse; an initial recurrence of the infection was found in 18.2% of patients with index events, with 28.4% of these patients having a second recurrence and 30.2% of second-recurrence patients having a third recurrence.

• #73 Diarrhea | Knowledge Repository

  https://knowledgerepository.syndromicsurveillance.org/tags/diarrhea

  Disease surveillance is an epidemiological practice by which the spread of disease is mentioned in order to establish patterns of progression. […] Surveillance of priority communicable diseases started with a view to build up an early warning system for certain important public health important diseases in Bangladesh, namely: (1) Diarrheal disease (acute watery diarrhea and bloody dysentery); […] The objective of this study was to evaluate the potential for improved detection of enteric disease epidemics using a classification category based on variations of diarrhea appearing in the chief complaints from emergency department and urgent care facility visits. […] Nearly all (99%, 378) reported diarrhea.

• #74 Monitoring Acute Diarrhea via an Electronic Surveillance System in the Peruvian Navy | Knowledge Repository

  https://knowledgerepository.syndromicsurveillance.org/monitoring-acute-diarrhea-electronic-surveillance-system-peruvian-navy

  Syndromic surveillance can supplement diagnosis-based surveillance in resource-limited settings with limited laboratory infrastructure. […] Monitoring and disease diagnosis can be strengthened using pre-diagnostic data and statistical algorithms to detect morbidity trends. […] Alerta (2002-11) and Vigila (2011-present) are sequentially implemented electronic disease surveillance systems created by the Peruvian Navy to improve the detection, prevention, and control of disease outbreaks. […] Acute diarrheal disease, respiratory infections, and pneumonias are reported weekly, whereas specific notifiable diseases such as malaria, dengue, and tuberculosis are reported immediately after case detection. […] To use data from the Peruvian Navys electronic syndromic surveillance systems to estimate the baseline incidence of acute diarrheal disease (ADD) and detect outbreaks among individuals accessing military medical facilities from 2009-13.

• #75 Monitoring Acute Diarrhea via an Electronic Surveillance System in the Peruvian Navy | Knowledge Repository

  https://knowledgerepository.syndromicsurveillance.org/monitoring-acute-diarrhea-electronic-surveillance-system-peruvian-navy

  Syndromic surveillance can supplement diagnosis-based surveillance in resource-limited settings with limited laboratory infrastructure. […] Monitoring and disease diagnosis can be strengthened using pre-diagnostic data and statistical algorithms to detect morbidity trends. […] Alerta (2002-11) and Vigila (2011-present) are sequentially implemented electronic disease surveillance systems created by the Peruvian Navy to improve the detection, prevention, and control of disease outbreaks. […] Acute diarrheal disease, respiratory infections, and pneumonias are reported weekly, whereas specific notifiable diseases such as malaria, dengue, and tuberculosis are reported immediately after case detection. […] To use data from the Peruvian Navys electronic syndromic surveillance systems to estimate the baseline incidence of acute diarrheal disease (ADD) and detect outbreaks among individuals accessing military medical facilities from 2009-13.

• #76 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Globally, we estimated 208 009 annual rotavirus-attributable deaths (95% CI 169 561 to 259 216), 62 853 Shigella-attributable deaths (95% CI 48 656 to 78 805), 36 922 adenovirus 40/41-attributable deaths (95% CI 28 469 to 46 672) and 35 914 norovirus-attributable deaths (95% CI 27 258 to 46 516). […] Despite the substantial impact of rotavirus vaccine introduction, rotavirus remained the leading cause of paediatric diarrhoea hospitalisations. Improving the efficacy and coverage of rotavirus vaccination and prioritising interventions against Shigella, norovirus and adenovirus could further reduce diarrhoea morbidity and mortality. […] This study used standardised surveillance, laboratory and analysis protocols to define the aetiology of hospitalised paediatric diarrhoea using quantitative molecular diagnostics from a large, globally representative set of low-income and middle-income countries.

• #77 Predicting the incidence of infectious diarrhea with symptom surveillance data using a stacking-based ensembled model | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09138-x

  Infectious diarrhea remains a major public health problem worldwide. This study used stacking ensemble to developed a predictive model for the incidence of infectious diarrhea, aiming to achieve better prediction performance. […] Based on the surveillance data of infectious diarrhea cases, relevant symptoms and meteorological factors of Guangzhou from 2016 to 2021, we developed four base prediction models using artificial neural networks (ANN), Long Short-Term Memory networks (LSTM), support vector regression (SVR) and extreme gradient boosting regression trees (XGBoost), which were then ensembled using stacking to obtain the final prediction model. […] The incorporation of symptom surveillance data could improve the predictive accuracy of infectious diarrhea prediction models, and symptom surveillance data was more effective than meteorological data in enhancing model performance.

• #78 Predicting the incidence of infectious diarrhea with symptom surveillance data using a stacking-based ensembled model | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09138-x

  Infectious diarrhea remains a major public health problem worldwide and is a leading cause of death in children. […] Prediction can support the prevention and control of infectious diarrhea. Based on the surveillance data, prediction models can be developed to help implement better measures to reduce the burden of disease. […] In recent years, in addition to conventional infectious disease surveillance, symptom surveillance has been increasingly used internationally as a complementary method of disease surveillance. […] Therefore, it is beneficial to include symptom surveillance data as a part of multi-source data. […] The stacking model currently has few applications in the field of infectious disease prediction. […] The conclusions of this study could provide valuable references.

• #79

  https://link.springer.com/article/10.1007/BF02751121

  This study was conducted in children under the age of four years for a period of one year. By domiciliary visits the diarrheal episodes were recorded, analysed and presented. The findings are based on the diarrheal experience of 4860 children. The attack rate was 2.6/child/year. […] Attack rate was more in June-August and December-February than the other quarters. […] Case fatality was 0.6%.

• #80 Surveillance of norovirus among children with diarrhea in four major hospitals in Bhutan: Replacement of GII.21 by GII.3 as a dominant genotype | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184826

  Diarrhea is a major cause of morbidity and mortality among Bhutanese children. […] Establishing an etiology is crucial toward generating evidence that will contribute to policy discussions on a diarrheal disease control program. […] Our previous study, during 2010-2012, revealed that norovirus (NoV) is an important cause of diarrhea among Bhutanese children, and that GII.21 was the major genotype circulating at that time. […] In this update report, we provide new prevalence data to describe the progression of the transformation and distribution of the NoV genotype among Bhutanese children. […] The proportion of NoV-positive stool samples was 23.6% (147/623), of which 76.9% were NoV GII and the remainders were NoV GI. […] NoV remains an important cause of diarrhea among Bhutanese children. Genotype GII.3 from a single ancestor strain has spread, replacing the previously circulating GII.21.

• #81 Surveillance of norovirus among children with diarrhea in four major hospitals in Bhutan: Replacement of GII.21 by GII.3 as a dominant genotype | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184826

  Current NoV genotypes are similar to the strains circulating worldwide but are primarily related to those in neighboring countries. […] To develop a NoV infection control policy, further studies are needed. […] The present study was conducted from June 2013 through May 2014 as an update to determine whether there have been changes in the genotype distribution of NoV among the children of Bhutan. […] The present study revealed that GII.3 replaced GII.21 in our study population. […] The prevalence of NoV (23.6%) at this time remains remarkably similar to during the previous study (23.7%), which is similar to other countries and to children hospitalized with diarrhea in other parts of the world. […] The present study has also confirmed our previous observation that the diarrheal peak in the colder months is caused by NoV GII. […] Further surveillance is needed to determine the factors that trigger the dynamics of NoV genotype changes in Bhutanese children. This will help formulate informed policy to control this serious diarrheal disease.

• #82 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  The highest rates of Campylobacter and Salmonella associated with TD are found in Southeast and East Asia, and high rates are also found in Southern and Central Asia. […] Vaccines used prophylactically to prevent TD have the potential to reduce disease incidence and severity; however, no vaccines for E. coli, Campylobacter, or Shigella are currently licensed by the US Food and Drug Administration. […] Moving forward, we recommend the GTD study expand to include antimicrobial resistance (AMR) characterization of bacterial pathogens identified from TD cases by using antimicrobial susceptibility testing and next-generation sequencing technologies to identify genetic markers of AMR and virulence factors of enteric bacterial pathogens.

• #83 Pathogenic Surveillance of Foodborne Illness-Related Diarrhea — Beijing Municipality, China, 2013–2023

  https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.111

  Surveillance data indicated that Norovirus and DEC were the predominant pathogens, individuals between 19 and 30 years old had the highest infection rates, and patients with Salmonella infections were more likely to experience fever symptoms. […] The study provides a summary and comparison of the epidemiological characteristics of pathogens over time. A high percentage of patients, 28.38% (2,971/10,469), are aged 19-30 years. […] The detection rates of all five pathogens decreased in 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. […] The most common clinical symptoms were nausea, vomiting, and abdominal cramps. Patients infected with Salmonella were more likely to have a fever. […] Given the atypical clinical manifestations of various pathogens, differentiating them from non-infectious diarrhea remains challenging. Therefore, there is an urgent need to establish rapid pathogen monitoring methods to enable targeted treatment strategies when patients seek medical care.

• #84 Surveillance of norovirus among children with diarrhea in four major hospitals in Bhutan: Replacement of GII.21 by GII.3 as a dominant genotype | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184826

  Current NoV genotypes are similar to the strains circulating worldwide but are primarily related to those in neighboring countries. […] To develop a NoV infection control policy, further studies are needed. […] The present study was conducted from June 2013 through May 2014 as an update to determine whether there have been changes in the genotype distribution of NoV among the children of Bhutan. […] The present study revealed that GII.3 replaced GII.21 in our study population. […] The prevalence of NoV (23.6%) at this time remains remarkably similar to during the previous study (23.7%), which is similar to other countries and to children hospitalized with diarrhea in other parts of the world. […] The present study has also confirmed our previous observation that the diarrheal peak in the colder months is caused by NoV GII. […] Further surveillance is needed to determine the factors that trigger the dynamics of NoV genotype changes in Bhutanese children. This will help formulate informed policy to control this serious diarrheal disease.

• #85 Treatment-seeking practices of caregivers for children aged less than five years old with diarrhoea in low- and middle-income countries: a systematic review and meta-analysis — JOGH

  https://jogh.org/2025/jogh-15-04080/

  Diarrhoeal diseases in children aged <5 years require immediate medical attention. However, previous studies conducted on treatment-seeking practices of caregivers for children aged <5 years with diarrhoea in low- and middle-income countries (LMICs) were inconsistent and inconclusive. We aimed to estimate the pooled treatment-seeking practice of caregivers for children aged <5 years with diarrhoea in LMICs. [...] Treatment-seeking practice for diarrhoea among children aged <5 years in LMICs remained low. There was no statistically significant difference in treatment-seeking practice for children with diarrhoea by the country’s income classification. We recommend further studies to identify factors affecting treatment-seeking practices for diarrhoea among children aged <5 years in LMICs and to act on findings and recommendations.

• #86 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Despite a substantial impact of rotavirus vaccination, rotavirus remained the leading cause of diarrhoea requiring hospitalisation. Shigella, norovirus and adenovirus 40/41 also had a high burden of disease, with some important geographic heterogeneity. […] Diarrhoea requiring hospitalisation represents a consistently severe phenotype of this highly morbid syndrome. […] Ongoing monitoring and surveillance of paediatric diarrhoea and its causes are needed to identify diarrhoea prevention and control strategies and guide the prioritisation and development of new vaccines for enteric pathogens. […] By incorporating quantitative molecular diagnostics and pathogen attribution modelling into a global network with standardised surveillance, sample collection and testing, this study provides direct estimates of the aetiology of diarrhoea requiring hospitalisation in children under 5 years of age in LMICs in 2017-2018.

• #87 Diarrhea Case Surveillance in the Enterics for Global Health Shigella Surveillance Study: Epidemiologic Methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10962728/

  Utilizing a hybrid surveillance approach, the Enterics for Global Health (EFGH) Shigella surveillance study will estimate serotype- and disease severity-specific incidence rates of Shigella diarrhea and document the health and economic consequences of Shigella diarrhea in 7 country sites in Africa, Asia, and South America. […] A key aim of EFGH is to estimate the incidence of Shigella diarrhea by various severity definitions, which include clinical measures such as dehydration and clinician decision to hospitalize. […] Ensuring the success of eventual Shigella vaccine field efficacy trials and promoting uptake and adoption of newly licensed Shigella vaccines by policy makers will require recent, country-specific data on the burden of Shigella diarrhea as well as the health and economic consequences of this important disease.

• #88 Diarrhea treatment center (DTC) based diarrheal disease surveillance in settlements in the wake of the mass influx of forcibly displaced Myanmar national (FDMN) in Cox’s Bazar, Bangladesh, 2018 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254473

  In August 2017, after a large influx of forcibly displaced Myanmar nationals (FDMN) in Coxs Bazar, Bangladesh diarrhea treatment centers (DTCs) were deployed. This study aims to report the clinical, epidemiological, and laboratory characteristics of the hospitalized patients. Of the total 1792 admissions in 5 DTCs, 729 (41%) were from FDMN settlements; children 5 years contributed the most (n = 981; 55%). FDMN admissions within 24h were low compared to host hospitalization (n = 172, 24% vs. n = 330, 31%; p0.001). Seventy-two percent (n = 1295) had watery diarrhea; more common among host population than FDMN (n = 802; 75% vs. n = 493; 68%; p0.001). FDMN often used public taps (n = 263; 36%), deep tube-well (n = 243; 33%), and shallow tube well (n = 188; 26%) as the source of drinking water. Nearly 96% (n = 698) of the admitted FDMN used pit latrines as opposed to 79% (n = 842) from the host community (p0.001). FDMN children were often malnourished. None of the FDMN reported cholera. No diarrhea outbreak was detected, but preparedness for surges and response readiness are warranted in this emergency and crisis setting.

• #89 Diarrhea treatment center (DTC) based diarrheal disease surveillance in settlements in the wake of the mass influx of forcibly displaced Myanmar national (FDMN) in Cox’s Bazar, Bangladesh, 2018 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254473

  The study aimed to report results from our ongoing diarrheal disease surveillance efforts in Ukhiya and Teknaf sub-districts of Coxs Bazar, specifically on patients who were hospitalized in the newly deployed icddr,b operated DTCs serving FDMN and the host community populations during April-December, 2018. […] The findings of this study have public health importance and may be useful for the health system of Bangladesh for preparedness in situations with risks from public health perspectives such as cause-specific diarrhea surges in both the host and displaced population. […] With effective DTC networking, laboratory-based disease surveillance, and OCV campaigns in the present emergency and crisis settings, no cholera or acute watery diarrhea outbreak was observed during the study period. Preparedness for surges as well as response readiness is warranted in this emergency and crisis settings.

• #90 Diarrhea treatment center (DTC) based diarrheal disease surveillance in settlements in the wake of the mass influx of forcibly displaced Myanmar national (FDMN) in Cox’s Bazar, Bangladesh, 2018 | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254473

  The study aimed to report results from our ongoing diarrheal disease surveillance efforts in Ukhiya and Teknaf sub-districts of Coxs Bazar, specifically on patients who were hospitalized in the newly deployed icddr,b operated DTCs serving FDMN and the host community populations during April-December, 2018. […] The findings of this study have public health importance and may be useful for the health system of Bangladesh for preparedness in situations with risks from public health perspectives such as cause-specific diarrhea surges in both the host and displaced population. […] With effective DTC networking, laboratory-based disease surveillance, and OCV campaigns in the present emergency and crisis settings, no cholera or acute watery diarrhea outbreak was observed during the study period. Preparedness for surges as well as response readiness is warranted in this emergency and crisis settings.

• #91 Diarrhea Case Surveillance in the Enterics for Global Health Shigella Surveillance Study: Epidemiologic Methods

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10962728/

  Utilizing a hybrid surveillance approach, the Enterics for Global Health (EFGH) Shigella surveillance study will estimate serotype- and disease severity-specific incidence rates of Shigella diarrhea and document the health and economic consequences of Shigella diarrhea in 7 country sites in Africa, Asia, and South America. […] A key aim of EFGH is to estimate the incidence of Shigella diarrhea by various severity definitions, which include clinical measures such as dehydration and clinician decision to hospitalize. […] Ensuring the success of eventual Shigella vaccine field efficacy trials and promoting uptake and adoption of newly licensed Shigella vaccines by policy makers will require recent, country-specific data on the burden of Shigella diarrhea as well as the health and economic consequences of this important disease.

• #92 Aetiology and incidence of diarrhoea requiring hospitalisation in children under 5 years of age in 28 low-income and middle-income countries: findings from the Global Pediatric Diarrhea Surveillance network | BMJ Global Health

  https://gh.bmj.com/content/7/9/e009548

  Despite a substantial impact of rotavirus vaccination, rotavirus remained the leading cause of diarrhoea requiring hospitalisation. Shigella, norovirus and adenovirus 40/41 also had a high burden of disease, with some important geographic heterogeneity. […] Diarrhoea requiring hospitalisation represents a consistently severe phenotype of this highly morbid syndrome. […] Ongoing monitoring and surveillance of paediatric diarrhoea and its causes are needed to identify diarrhoea prevention and control strategies and guide the prioritisation and development of new vaccines for enteric pathogens. […] By incorporating quantitative molecular diagnostics and pathogen attribution modelling into a global network with standardised surveillance, sample collection and testing, this study provides direct estimates of the aetiology of diarrhoea requiring hospitalisation in children under 5 years of age in LMICs in 2017-2018.

• #93 Etiology and Epidemiology of Travelers’ Diarrhea among US Military and Adult Travelers, 2018–2023 – Volume 30, Supplement—October 2024 – Emerging Infectious Diseases journal – CDC

  https://wwwnc.cdc.gov/eid/article/30/14/24-0308_article

  The highest rates of Campylobacter and Salmonella associated with TD are found in Southeast and East Asia, and high rates are also found in Southern and Central Asia. […] Vaccines used prophylactically to prevent TD have the potential to reduce disease incidence and severity; however, no vaccines for E. coli, Campylobacter, or Shigella are currently licensed by the US Food and Drug Administration. […] Moving forward, we recommend the GTD study expand to include antimicrobial resistance (AMR) characterization of bacterial pathogens identified from TD cases by using antimicrobial susceptibility testing and next-generation sequencing technologies to identify genetic markers of AMR and virulence factors of enteric bacterial pathogens.

• #94 Diarrhea: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/928598-overview

  In the United States, one estimate before the introduction of specific antirotavirus immunization in 2006 assumed a cumulative incidence of 1 hospitalization for diarrhea per 23-27 children by age 5 years, with more than 50,000 hospitalizations. By these estimates, rotavirus was associated with 4-5% of all childhood hospitalizations and a cost of nearly $ 1 billion. Furthermore, acute diarrhea is responsible for 20% of physician referrals in children younger than 2 years and for 10% in children younger than 3 years. […] The impact of vaccination on rotavirus morbidity has been remarkable, with significant reduction of diarrhea-associated hospitalizations and visits to emergency departments in children in the years 2007-2008 compared with the prevaccine period. […] In developing countries, an average of 3 episodes per child per year in children younger than 5 years is reported; however, some areas report 6-8 episodes per year per child. In these settings, malnutrition is an important additional risk factor for diarrhea, and recurrent episodes of diarrhea lead to growth faltering and substantially increased mortality.

• #95 Global Epidemiology and Management of Acute Diarrhea in Children from Developing Countries

  https://www.jscimedcentral.com/jounal-article-info/Annals-of-Pediatrics-and-Child-Health/Global-Epidemiology-and–Management-of-Acute–Diarrhea-in-Children-from–Developing-Countries-7974

  The biggest factors leading to deaths in children under the age of five in developing countries is the lack of clean water supply, unsanitary living conditions, and poor personal hygiene, which have been associated with 88% of deaths resulting from diarrhea worldwide. […] The major detriment in the prevention and management of children with diarrheal illness in developing countries is insufficient resources and unstable infrastructure to effectively help treat these patients. […] WHO recommends five methods for physicians to utilize to effectively prevent and treat diarrhea and its complications; these include the use of the rotavirus vaccine, ORS, zinc supplementation, proper personal hygiene with an emphasis on handwashing, and targeted antibiotic therapy for certain conditions. […] ORS, as stated by WHO and United Nations International Childrens Emergency Fund (UNICEF), has shown to effectively decrease the morbidity and mortality resulting from diarrheal illnesses in children. […] With a combined approach of proper education for caregivers, adequate sanitary living conditions, and prompt management of diarrheal illnesses, the rates of mortality due to diarrhea in children can drastically decline in developing countries as seen in the developed nations worldwide.

• #96 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  In total, ten pathogens are responsible for three-quarters of diarrheal deaths. […] These pathogens are transmitted between people through different routes, including contaminated water and food, respiratory droplets, and close contact. […] Several pathogens that cause diarrheal diseases are spread by contaminated water or food and unsafe sewage. […] This means clean water treatment, food safety measures, and sanitation can effectively kill them and reduce their disease burden. […] Improving access to safe drinking water and sanitation would help reduce diarrheal deaths and child mortality rates. […] By understanding the causes of diarrheal diseases, the world has managed to reduce their burden through public health measures. […] But, in many countries, only a small share of children receive oral rehydration therapy.

• #97 Global Epidemiology and Management of Acute Diarrhea in Children from Developing Countries

  https://www.jscimedcentral.com/jounal-article-info/Annals-of-Pediatrics-and-Child-Health/Global-Epidemiology-and–Management-of-Acute–Diarrhea-in-Children-from–Developing-Countries-7974

  The biggest factors leading to deaths in children under the age of five in developing countries is the lack of clean water supply, unsanitary living conditions, and poor personal hygiene, which have been associated with 88% of deaths resulting from diarrhea worldwide. […] The major detriment in the prevention and management of children with diarrheal illness in developing countries is insufficient resources and unstable infrastructure to effectively help treat these patients. […] WHO recommends five methods for physicians to utilize to effectively prevent and treat diarrhea and its complications; these include the use of the rotavirus vaccine, ORS, zinc supplementation, proper personal hygiene with an emphasis on handwashing, and targeted antibiotic therapy for certain conditions. […] ORS, as stated by WHO and United Nations International Childrens Emergency Fund (UNICEF), has shown to effectively decrease the morbidity and mortality resulting from diarrheal illnesses in children. […] With a combined approach of proper education for caregivers, adequate sanitary living conditions, and prompt management of diarrheal illnesses, the rates of mortality due to diarrhea in children can drastically decline in developing countries as seen in the developed nations worldwide.

• #98 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Diarrheal diseases are among the most common causes of death, especially in children. […] In 2021, around 1.2 million people died from diarrheal diseases. […] Around 390,000 of these deaths were among children and adolescents. […] In recent decades, deaths from diarrheal diseases have fallen significantly across the world as a result of public health interventions. […] Diarrheal deaths are preventable because they are primarily caused by pathogens, whose spread can be easily controlled. […] By increasing global access to clean water and sanitation, oral rehydration treatment, and vaccination, this major cause of death can be reduced substantially. […] Diarrheal diseases are a leading cause of death among children. […] Its estimated that around 340,000 children died from diarrheal diseases globally in 2021.

• #99 Diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Diarrhea

  Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5 million deaths among children under the age of five. Greater than half of these were in Africa and South Asia. This is down from a death rate of 4.5 million in 1980 for gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after pneumonia (17%) in this age group. […] The majority of such cases occur in the developing world, with over half of the recorded cases of childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases, respectively, compared to only 480 million in the rest of the world. […] Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011 and 250 million lost school days. In the Americas, diarrheal disease accounts for a total of 10% of deaths among children aged 15 months while in South East Asia, it accounts for 31.3% of deaths. It is estimated that around 21% of child mortalities in developing countries are due to diarrheal disease. […] The World Health Organization has reported that „deaths due to diarrhoeal diseases have dropped by 45%, from sixth leading cause of death in 2000 to thirteenth in 2021.”

• #100 Diarrhea – Wikipedia

  https://en.wikipedia.org/wiki/Diarrhea

  Worldwide in 2004, approximately 2.5 billion cases of diarrhea occurred, which resulted in 1.5 million deaths among children under the age of five. Greater than half of these were in Africa and South Asia. This is down from a death rate of 4.5 million in 1980 for gastroenteritis. Diarrhea remains the second leading cause of infant mortality (16%) after pneumonia (17%) in this age group. […] The majority of such cases occur in the developing world, with over half of the recorded cases of childhood diarrhea occurring in Africa and Asia, with 696 million and 1.2 billion cases, respectively, compared to only 480 million in the rest of the world. […] Infectious diarrhea resulted in about 0.7 million deaths in children under five years old in 2011 and 250 million lost school days. In the Americas, diarrheal disease accounts for a total of 10% of deaths among children aged 15 months while in South East Asia, it accounts for 31.3% of deaths. It is estimated that around 21% of child mortalities in developing countries are due to diarrheal disease. […] The World Health Organization has reported that „deaths due to diarrhoeal diseases have dropped by 45%, from sixth leading cause of death in 2000 to thirteenth in 2021.”

• #101 Diarrheal Diseases – Our World in Data

  https://ourworldindata.org/diarrheal-diseases

  Diarrheal diseases are among the most common causes of death, especially in children. […] In 2021, around 1.2 million people died from diarrheal diseases. […] Around 390,000 of these deaths were among children and adolescents. […] In recent decades, deaths from diarrheal diseases have fallen significantly across the world as a result of public health interventions. […] Diarrheal deaths are preventable because they are primarily caused by pathogens, whose spread can be easily controlled. […] By increasing global access to clean water and sanitation, oral rehydration treatment, and vaccination, this major cause of death can be reduced substantially. […] Diarrheal diseases are a leading cause of death among children. […] Its estimated that around 340,000 children died from diarrheal diseases globally in 2021.

• #102 Acute Diarrhea in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0201/p180.html

  The first step to treating acute diarrhea is rehydration, preferably oral rehydration. […] Good hygiene, hand washing, safe food preparation, and access to clean water are key factors in preventing diarrheal illness. Public health interventions to promote hand washing alone can reduce the incidence of diarrhea by about one-third. […] Vaccine development remains a high priority for disease prevention, particularly for those in the developing world. Effective and safe vaccines exist for rotavirus, typhoid fever, and cholera, and are under investigation for Campylobacter, enterotoxigenic E. coli, and Shigella infections. To contain disease outbreaks, designated diseases should be reported to public health authorities. In the United States, reportable diarrheal illnesses include those caused by Vibrio cholerae, Cryptosporidium, Giardia, Salmonella, Shigella, and Shiga toxinproducing E. coli.

• #103 Acute Diarrhea in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0201/p180.html

  The first step to treating acute diarrhea is rehydration, preferably oral rehydration. […] Good hygiene, hand washing, safe food preparation, and access to clean water are key factors in preventing diarrheal illness. Public health interventions to promote hand washing alone can reduce the incidence of diarrhea by about one-third. […] Vaccine development remains a high priority for disease prevention, particularly for those in the developing world. Effective and safe vaccines exist for rotavirus, typhoid fever, and cholera, and are under investigation for Campylobacter, enterotoxigenic E. coli, and Shigella infections. To contain disease outbreaks, designated diseases should be reported to public health authorities. In the United States, reportable diarrheal illnesses include those caused by Vibrio cholerae, Cryptosporidium, Giardia, Salmonella, Shigella, and Shiga toxinproducing E. coli.

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