Detection of Adenovirus, Astrovirus, Norwalk Virus and Rotavirus in Libyan Children with Diarrhea.

Detection of Adenovirus, Astrovirus, Norwalk Virus and Rotavirus in Libyan Children with Diarrhea.

Amal Rahouma, Ezzedin Franka, Zaineb Krema, Khalid Treesh, Omar Abusnena, John Klena and

Khalifa Sifaw GhengheshDepartments of Microbiology and Immunlogy and Family

and Community Health, Faculty of Medicine, Tripoli University, Al-Jala Children Hospital, Tripoli-Libya, and

NAMRU3, Cairo-Egypt

Amal Rahouma, Ezzedin Franka, Zaineb Krema, Khalid Treesh, Omar Abusnena, John Klena and

Khalifa Sifaw GhengheshDepartments of Microbiology and Immunlogy and Family

and Community Health, Faculty of Medicine, Tripoli University, Al-Jala Children Hospital, Tripoli-Libya, and

NAMRU3, Cairo-Egypt

IntroductionIntroduction

• Viral agents are an important cause of diarrhea worldwide, which accounts for several million deaths each year with children under five years of age in developing countries being most often affected.

• The World Health Organization estimated that diarrhea accounts for 1.6–2.5 million deaths annually and that each child in the developing world experiences an average of three episodes of diarrhea per year.

• Viral agents are an important cause of diarrhea worldwide, which accounts for several million deaths each year with children under five years of age in developing countries being most often affected.

• The World Health Organization estimated that diarrhea accounts for 1.6–2.5 million deaths annually and that each child in the developing world experiences an average of three episodes of diarrhea per year.

Common Viral Agents Associated with DiarrheaCommon Viral Agents Associated with Diarrhea

• Rotavirus– Double-stranded RNA virus.– Species: A, B, C, D, E, F & G– Leading single cause of severe diarrhoea among infants and

young children.– Nosocomial gastroenteritis

• Adenoviruses– Non-enveloped icosahedral viruses composed of a

nucleocapsid and a double-stranded linear DNA genome.– Over 52 different serotypes in humans. – Most infections with adenovirus result in infections of the

upper respiratory tract. – Adenoviruses can also cause gastroenteritis (stomach flu).

• Rotavirus– Double-stranded RNA virus.– Species: A, B, C, D, E, F & G– Leading single cause of severe diarrhoea among infants and

young children.– Nosocomial gastroenteritis

• Adenoviruses– Non-enveloped icosahedral viruses composed of a

nucleocapsid and a double-stranded linear DNA genome.– Over 52 different serotypes in humans. – Most infections with adenovirus result in infections of the

upper respiratory tract. – Adenoviruses can also cause gastroenteritis (stomach flu).

Viral Agents Associated with DiarrheaViral Agents Associated with Diarrhea

• Astrovirus– Non-enveloped single stranded RNA genome.– A newly recognized cause of gastroenteritis in children and

adults.– Several species that affect mammals with many serotypes

within human astrovirus species.

• Norovirus (formerly Norwalk virus)– Non-enveloped single stranded RNA viruses.– Highly infectious associated acute gastroenteritis (winter

vomiting diseases) and foodborne outbreaks.– Nosocomial gastroenteritis.

• Astrovirus– Non-enveloped single stranded RNA genome.– A newly recognized cause of gastroenteritis in children and

adults.– Several species that affect mammals with many serotypes

within human astrovirus species.

• Norovirus (formerly Norwalk virus)– Non-enveloped single stranded RNA viruses.– Highly infectious associated acute gastroenteritis (winter

vomiting diseases) and foodborne outbreaks.– Nosocomial gastroenteritis.

Adenovirus

Astrovirus

Rotavirus

Norovirus

Aim of the StudyAim of the Study

• To determine the prevalence of rotavirus, adenovirus, norovirus and astrovirus associated with children diarrhea in Tripoli, Libya.

• To determine the prevalence of rotavirus, adenovirus, norovirus and astrovirus associated with children diarrhea in Tripoli, Libya.

Materials and MethodsMaterials and Methods

• Study subjects:– Included in the study 88 children (38 females) aged a few

days to 5 years.– Diarrhea was defined as the occurrence of three or more

watery stools in a period of 24 hours.– Parents (or care-providers) of all patients were informed of

the purpose of the study and their consent was obtained before stool samples were collected.

• Stool samples were collected in sterile containers, and were frozen at -20 C. 1

• The study was carried out between February-June 2008.

• Study subjects:– Included in the study 88 children (38 females) aged a few

days to 5 years.– Diarrhea was defined as the occurrence of three or more

watery stools in a period of 24 hours.– Parents (or care-providers) of all patients were informed of

the purpose of the study and their consent was obtained before stool samples were collected.

• Stool samples were collected in sterile containers, and were frozen at -20 C. 1

• The study was carried out between February-June 2008.

Materials and MethodsMaterials and Methods

• Rotavirus, adenovirus, astrovirus and norovirus were detected in faecal samples by specific commercial enzyme-immunoassay [EIA] kits.

• The tests were performed according to the manufacturer recommendations.

• Rotavirus, adenovirus, astrovirus and norovirus were detected in faecal samples by specific commercial enzyme-immunoassay [EIA] kits.

• The tests were performed according to the manufacturer recommendations.

ResultsResults

• Of the 88 stool specimens examined enteric viruses were detected in 48.8% (43/88) of diarrheic children.

• The different enteric viruses detected in the present study are shown in Table.

• Gender and age had no significant influence on the detection rates of the examined enteric viruses in the population studied.

• Of the 88 stool specimens examined enteric viruses were detected in 48.8% (43/88) of diarrheic children.

• The different enteric viruses detected in the present study are shown in Table.

• Gender and age had no significant influence on the detection rates of the examined enteric viruses in the population studied.

Viral Agents of Children Diarrhea in Tripoli-Libya

Viral Agents of Children Diarrhea in Tripoli-Libya

Agent No. ( %) Positive (n=88)

-----------------------------------------------------------• Rotavirus 19 (21.6%)• Adenovirus 9 (10.2%)• Astrovirus 3 (3.4%)• Norowalk virus 12 (13.6%)-----------------------------------------------------------• Total 43 (48.8%)

Agent No. ( %) Positive (n=88)

-----------------------------------------------------------• Rotavirus 19 (21.6%)• Adenovirus 9 (10.2%)• Astrovirus 3 (3.4%)• Norowalk virus 12 (13.6%)-----------------------------------------------------------• Total 43 (48.8%)

ConclusionConclusion

• The present work has clearly demonstrated that adenovirus, Norwalk virus, rotavirus and, to a lesser extent, astrovirus are important causative agents of diarrhea in Libyan children.

• In the future, studies are needed on larger groups of patients from major cities in Libya to determine the exact role of these viruses in children diarrhea in the country.

• The present work has clearly demonstrated that adenovirus, Norwalk virus, rotavirus and, to a lesser extent, astrovirus are important causative agents of diarrhea in Libyan children.

• In the future, studies are needed on larger groups of patients from major cities in Libya to determine the exact role of these viruses in children diarrhea in the country.