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. 2006 Jul 17;78(9):1198–1203. doi: 10.1002/jmv.20681

Identification of viral agents causing diarrhea among children in the Eastern Center of Tunisia

I Fodha 1,2, A Chouikha 2, I Peenze 3, M De Beer 3, J Dewar 3, A Geyer 3, F Messaadi 4, A Trabelsi 1,2,✉, N Boujaafar 1, MB Taylor 5, D Steele 3
PMCID: PMC7166705  PMID: 16847966

Abstract

Viral diarrhea remains a major cause of childhood morbidity and mortality worldwide. In Tunisia, no comprehensive studies of all viral agents related to diarrhea in children have yet been conducted. The present study was performed to investigate the role of enteric viruses in acute diarrhea in the country. Six hundred thirty‐eight stool samples were collected from children under 5 years of age seeking medical care for acute diarrhea between October 2003 and September 2005 in hospitals from the Eastern‐Center Tunisia. All samples were tested for rotavirus, astrovirus, and adenovirus using commercial antigen enzyme immunoassays (EIAs). Positive samples for rotavirus and astrovirus were confirmed by an “in‐house” reverse transcriptase‐polymerase chain reaction (RT‐PCR). Samples positive for adenovirus antigen were subjected to further EIA screening for species F enteric adenovirus types 40 and 41. At least one viral agent was found in 30% of the specimens. The frequency of rotavirus, astrovirus, and adenovirus was 20%, 7%, and 6%, respectively. Of the stool samples containing adenovirus, 57% (20/35) were found to be positive for species F adenovirus types 40/41. Dual infections were found in 9% (17/191) of the positive samples. Enteric viruses appear to play an important role in pediatric diarrhea in Tunisia. The introduction of affordable viral diagnosis in pediatric hospitals will improve patient care by reducing the unnecessary use of antibiotics. J. Med. Virol. 78:1198–1203, 2006. © 2006 Wiley‐Liss, Inc.

Keywords: diarrhea, rotavirus, astrovirus, adenovirus

REFERENCES

  1. Akihara S, Phan TG, Nguyen TA, Hansman G, Okitsu S, Ushijima H. 2005. Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan. Arch Virol 150: 2061–2075. [DOI] [PubMed] [Google Scholar]
  2. Belliot G, Laveran H, Monroe SS. 1997. Detection and genetic differentiation of human astroviruses: Phylogenetic grouping varies by coding region. Arch Virol 142: 1323–1334. [DOI] [PubMed] [Google Scholar]
  3. Bern C, Martines J, de Zoysa I, Glass RI. 1992. The magnitude of the global problem of diarrhoeal disease: A 10‐year update. Bull World Health Organ 70: 705–714. [PMC free article] [PubMed] [Google Scholar]
  4. Bon F, Fascia P, Dauvergne M, Tenenbaum D, Planson H, Petion AM, Pothier P, Kohli E. 1999. Prevalence of group A rotavirus human calicivirus, astrovirus, and adenovirus type 40 and 41 infections among children with acute gastroenteritis in Dijon, France. J Clin Microbiol 37: 3055–3058. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Buesa J, Colomina J, Raja J, Villanueva A, Prat J. 1996. Evaluation of reverse transcription and polymerase chain reaction (RT‐PCR) for the detection of rotaviruses: Applications of the assay. Res Virol 147: 353–361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chikhi‐Brachet R, Bon F, Toubiana L, Pothier P, Nicolas JC, Flahault A, Kohli E. 2002. Virus diversity in a winter epidemic of acute diarrhea in France. J Clin Microbiol 40: 4266–4272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cunliffe NA, Dove W, Gondwe JS, Thindwa BDM, Greensill J, Holmes JL, Bresee JS, Monoroe SS, Glass RI, Broadhead RL, Molyneux ME, Hart CA. 2002. Detection and characterisation of human astroviruses in children with acute gastroenteritis in Blantyre, Malawi. J Med Virol 67: 563–566. [DOI] [PubMed] [Google Scholar]
  8. Giordano MO, Ferreyra LJ, Isa MB, Martinez LC, Yudowsky SI, Nates SV. 2001. The epidemiology of acute gastroenteritis in hospitalized children in Cordoba city Argentina: An insight of disease burden. Rev Inst Med Trop S Paulo 43: 193–197. [DOI] [PubMed] [Google Scholar]
  9. Glass RI, Kilgore PE, Holman S, Jin S, Smith JC, Woods PA, Clarke MJ, Ho MS, Gentsch JR. 1996. The epidemiology of rotavirus diarrhea in the United States surveillance and estimates of disease burden. J Infect Dis 174: S5–S11. [DOI] [PubMed] [Google Scholar]
  10. Gouvea V, Glass RI, Woods P, Taniguchi A, Clark HF, Forrester B, Fang ZY. 1990. Polymerase chain reaction amplification for typing of rotavirus nucleic acid from stool specimens. J Clin Microbiol 28: 276–282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Grimwood K, Carzino R, Barnes GL, Bishop RF. 1995. Patients with enteric adenovirus gastroenteritis admitted to an Australian pediatric teaching hospital from 1981 to 1992. J Clin Microbiol 33: 131–136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hafferjee JE. 1995. The epidemiology of rotavirus infections: A global perspective. J Paediatr Gastroenterol Nutr 20: 275–276. [DOI] [PubMed] [Google Scholar]
  13. Herrmann JE, Taylor DN, Echeverria P, Blacklow NR. 1991. Astrovirus as a cause of gastroenteritis in children. New Engl J Med 324: 1757–1760. [DOI] [PubMed] [Google Scholar]
  14. Inouye S, Yamashita K, Yamadera S, Yoshikawa M, Kato N, Okabe N. 2000. Surveillance of viral gastroenteritis in Japan: Pediatric cases and outbreak incidents. J Infect Dis 181: S270–S274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Koopmans M, Vinje J, de Wit M, Leenen I, van der Poel W, van Duynhoven Y. 2000. Molecular epidemiology of human enteric caliciviruses in The Netherlands. J Infect Dis 181: S262–S269. [DOI] [PubMed] [Google Scholar]
  16. Liu C, Grillner L, Jonsson K, Linde A, Shen K, Lindell AT, Wirgart BZ, Johansen K. 2005. Identification of viral agents associated with diarrhea in young children during a winter season in Beijing, China. J Clin Virol 35: 69–72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Mitchell DK, Monroe SS, Jiang XI, Matson DO, Glass RI, Pickering LK. 1995. Virologic features of an astrovirus diarrhea outbreak in a day care center revealed by reverse‐transcriptase‐polymerase chain reaction. J Infect Dis 172: 1437–1444. [DOI] [PubMed] [Google Scholar]
  18. Murray CJ, Lopez AD. 1997. Global mortality, disability, and the contribution of risk factors: Global burden of disease study. Lancet 349: 1436–1442. [DOI] [PubMed] [Google Scholar]
  19. Palombo EA, Bishop RF. 1996. Annual incidence, serotype distribution, and genetic diversity of human astrovirus isolates from hospitalized children in Melbourne, Australia. J Clin Microbiol 34: 1750–1753. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pang XL, Homma S, Nakata S, Vesikari T. 2000. Human calicivirus in acute gastroenteritis of young children in the community. J Infect Dis 181: S288–S294. [DOI] [PubMed] [Google Scholar]
  21. Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. 2003. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 9: 565–572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Parreño V, Bok K, Fernandez F, Gomez J. 2004. Molecular characterization of the first isolation of rotavirus in guanacos (Lama guanicoe). Arch Virol 149: 2465–2471. [DOI] [PubMed] [Google Scholar]
  23. Qiao H, Nilsson M, Abreu ER, Hedlund KO, Johansen K, Zaori G, Svensson L. 1999. Viral diarrhea in children in Beijing, China. J Med Virol 57: 390–396. [PubMed] [Google Scholar]
  24. Ratcliff RM, Doherty JC, Higgins GD. 2002. Sensitive detection of RNA viruses associated with gastroenteritis by a hanging‐drop single‐tube nested reverse transcription‐PCR method. J Clin Microbiol 40: 4091–4099. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Scott‐Taylor TH, Hammond GW. 1995. Local succession of adenovirus strains in pediatric gastroenteritis. J Med Virol 45: 331–338. [DOI] [PubMed] [Google Scholar]
  26. Simpson R, Aliyu S, Iturriza‐Gomara M, Desselberger U, Gray J. 2003. Infantile viral gastroenteritis: On the way to closing the diagnostic gap. J Med Virol 70: 258–262. [DOI] [PubMed] [Google Scholar]
  27. Soltani MS, Jebara H, Dahmani L, Garbouj M, Sidhom M, Bchir A. 1999. Surveillance sentinelle de la diarrhée à Ksar‐Hellal (Tunisie). Arch Pédiatr 6: 27–31. [DOI] [PubMed] [Google Scholar]
  28. Taylor MB, Marx FE, Grabow WOK. 1997. Rotavirus, astrovirus and adenovirus with an outbreak of gastroenteritis in a South African child care centre. Epidemiol Infect 119: 227–230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Trabelsi A, Peenze I, Pager C, Jeddi M, Steele D. 2000. Distribution of rotavirus VP7 serotypes and VP4 genotypes circulating in Sousse, Tunisia, from 1995 to 1999: Emergence of natural human reassortants. J Clin Microbiol 38: 3415–3419. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Traore O, Belliot G, Mollat, Piloquet H, Chamour C, Laveran H, Monroe SS, Billaudel S. 2000. RT‐PCR identification and typing of astroviruses and Norwalk‐like viruses in hospitalized patients with gastroenteritis: Evidence of nosocomial infections. J Clin Virol 17: 151–158. [DOI] [PubMed] [Google Scholar]
  31. Waters V, Ford‐Jones EL, Petric M, Fearon M, Corey P, Moineddein R. 2000. Etiology of community‐acquired pediatric viral diarrhea: A prospective longitudinal study in hospitals, emergency departments, pediatric practices and child care centers during the winter rotavirus outbreak, 1997 to 1998. Pediatr Infect Dis 19: 843–848. [DOI] [PubMed] [Google Scholar]
  32. Wilhelmi I, Roman E, Sanchez‐Fauquier A. 2003. Viruses causing gastroenteritis. Clin Microbiol Infect 9: 247–262. [DOI] [PMC free article] [PubMed] [Google Scholar]

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