Pëllumb S. PİPERO, Majlinda M DHİMOLEA, Dhimiter V. KRAJA, Suela Y. SALLAVACİ, Silva F. BİNO, Gentian P. STRONİ

A Study on the Epidemiology and Aetiology of Acute Gastroenteritis in Adult Patients Presenting at the Infectious Diseases Hospital in Tirana, Albania

Background: Acute gastroenteritis remains a common cause of hospital emergency room visits in Albania. However, the aetiology of severe gastroenteritis leading to hospitalization in adults frequently remains unclear. Aims: Our objective was to study the epidemiology and causes of community-acquired, acute gastroenteritis in adult patients presenting to hospital. Study Design: Cross sectional study. Methods: A prospective study was conducted from January 2010 to January 2012, among patients >=15 years old with community-acquired gastroenteritis presenting to the emergency room of the University Hospital "Mother Theresa" in Tirana, Albania. Stool samples and rectal swabs were collected from the patients for microbiological testing. Results: The median age of the study patients was 33 (15-88) years and 577 (58%) were females. The median age of males was 35 (15-87) years. The vast majority of cases occurred in urban area (849, 85%), p

PDF

___

World Health Organization. The Global Burden of Disease: 2004 up- date. Geneva, Switzerland: World Health Organization, 2008. Available from: http://www.who.int/healthinfo/global burden disease/GBD report 2004update full. pdf. Accessed 3 March 2013
World Health Organization. Water Sanitation and Health. Geneva, Swit- zerland: World Health Organization, 2004. Available from: http://www. who.int/water sanitation health/monitoring/jmpfinal. pdf. Accessed 25 February 2013
World Health Organization. The treatment of diarrhoea, a manual for physicians and other senior health workers. - 4th revision. Geneva, Switzerland: World Health Organization, 2005. Available from: http:// whqlibdoc.who.int/publications/2005/9241593180.pdf. Accessed 20 February 2013
World Health Organization. Guidelines for the control of shigellosis, in- cluding epidemics due to Shigella dysenteriae type 1. Geneva, Switzer- land: World Health Organization, 2005. Available from: http://whqlibdoc. who.int/publications/2005/9241592330.pdf. Accessed 20 February 2013
World Health Organization. Cholera outbreak: Assessing the outbreak response and improving preparedness. Geneva, Switzerland: World Health Organization, 2004. Available from: https://icvanetwork.org/sys- tem/files/versions/doc00003922.pdf. 20 February 2013
Walker CL, Black RE. Diarrhoea morbidity and mortality in older children, adolescents, and adults. Epidemiol Infect 2010;138:1215-26. [CrossRef]
Greco D, Luizzi I, Sallabanda A, Dibra A, Kakarricy E, Shapo L. Chol- era in the Mediterranean: Outbreak in Albania. Euro Surveill 1995;1-2.
World Health Organization. Diarrhea. WHO. Available from: http:// www.who.int/topics/diarrhoea/en/
Forsberg BC, Petzold MG, Tomsona G, Allebeck P. Diarrhoea case man- agement in low - and middle-income countries - an unfinished agenda. Bull World Health Organ 2007;85:42-8. [CrossRef]
Jamison DT, Breman JG, Measham AR, et al., editors. Disease control priorities in developing countries. 2nd edition. Washington (DC): World Bank; 2006.
Dupont HL. Guidelines on acute infectious diarrhea in adults. The Prac- tice Parameters Committee of the American College of Gastroenterolo- gy. Guidelines on acute infectious diarrhea in adults. Am J Gastroenterol 1997;92:1962-75.
Cheng AC, McDonald JR, Thielman NM. Infectious diarrhea in developed and developing countries. J Clin Gastroenterol 2005;39:757-73. [CrossRef]
Thielman NM, Guerrant RL. Clinical practice. Acute infectious diar- rhea. N Engl J Med 2004;350:38-47. [CrossRef]
World Gastroenterology Organization practice guideline: Acute diarrhea March 2008. Available from: http://www.worldgastroenterology.org/as- sets/downloads/en/pdf/guidelines/01_acute_diar rhea.pdf
Svenungsson B, Lagergren A, Ekwall E, Evengård B, Hedlund KO, Kär- nell A, et al. Enteropathogens in adult patients with diarrhea and healthy control subjects: A 1-year prospective study in a Swedish clinic for in- fectious diseases. Clin Infect Dis 2000;30:770-8. [CrossRef]
Andreas J, Klaus S, Jan K, Eckart S, Ralf I, Oliver L, et al. Aetiology of community-acquired, acute gastroenteritis in hospitalised adults: A prospective cohort study. BMC Infect Dis 2008;8:143. [CrossRef]
Bresee JS, Marcus R, Venezia RA, Keene WE, Morse D, Thanassi M, et al. US Acute Gastroenteritis Etiology Study Team. J Infect Dis 2012;205:1374-81. [CrossRef]
de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Vinjé J, van Duynhoven YT. Etiology of gastroenteritis in sentinel general prac- tices in the netherlands. Clin Infect Dis 2001;33:280-8. [CrossRef]
Lopman B, Vennema H, Kohli E, Pothier P, Sanchez A, Negredo A, et al. Increase in viral gastroenteritis outbreaks in Europe and epidemic spread of new norovirus variant. Lancet 2004, 363:682-8. [CrossRef]
Maraki S, Georgiladakis A, Tselentis Y, Samonis G. A 5-year study of bacterial pathogens associated with acute diarrhoea on the island of Crete, Greece, and their resistance to antibiotics. Eur J Epidemiol 2003;18:85-90. [CrossRef]
Galanis E, Wong DMALF, Patrick ME, Binsztein N, Cieslik A, Chal- ermchaikit T, et al. Web-based Surveillance and Global Salmonella Dis- tribution, 2000-2002. Emerg Infect Dis 2006;12:381-8. [CrossRef]
Chan SS, Ng KC, Lyon DJ, Cheung WL, Cheng AF, Rainer TH. Acute bacterial gastroenteritis: a study of adult patients with posi- tive stool cultures treated in the emergency department. Emerg Med J 2003;20:335-8. [CrossRef]
Munk Petersen A, Vinther Nielsen S, Meyer D, Ganer P, Ladefoged K. Bacterial gastroenteritis among hospitalized patients in a Danish county, 1991-93. Scand J Gastroenterol 1996;31:906-11. [CrossRef]
Hines J, Nachamkin I. Effective use of the clinical microbiology labora- tory for diagnosing diarrheal diseases. Clin Infect Dis 1996;23:1292- 301. [CrossRef]
Park S, Giannella R. Approach to the adult patient with acute diarrhea. Gastroenterol Clin North Am 1993;22:483-97.
Casburn-Jones AC, Farthing MJG. Management of infectious diarrhea. Gut 2004;53:296-305. [CrossRef]
Presterl E, Nadrchal R, Wolf D, Rotter M, Hirschl AM. Enteroaggrega- tive and enterotoxigenic Escherichia coli among isolates from patients with diarrhea in Austria. Eur J Clin Microbiol Infect Dis 1999;18:209-12. [CrossRef]
Svanteson B, Thorén A, Castor B, Barkenius G, Bergdahl U, Tufvesson B, et al. Acute diarrhoea in adults: aetiology, clinical appearance and therapeutic aspects. Scand J Infect Dis 1988;20:303-14. [CrossRef]