Etiology, epidemiology and clinical characteristics of acute moderate-to-severe diarrhea in children under 5 years of age hospitalized in a referral pediatric hospital in Rabat, Morocco

Abstract

The objective of the study was to describe the etiology, epidemiology, and clinical characteristics of the principal causes of acute infectious diarrhea requiring hospitalization among children under 5 years of age in Rabat, Morocco. A prospective study was conducted from March 2011 to March 2012, designed to describe the main pathogens causing diarrhea in hospitalized children >2 months and less than 5 years of age. Among the 122 children included in the study, Enteroaggregative E. coli (EAEC) and rotavirus were the main etiologic causes of diarrhea detected. Twelve (9.8%) children were referred to the intensive care unit, while 2, presenting infection by EAEC and EAEC plus a Shigella sonnei respectively, developed a hemolytic uremic syndrome. Additionally, 6 (4.9%) deaths occurred with EAEC being isolated in four of these cases. Diarrheogenic E. coli and rotavirus play a significant role as the two main causes of severe diarrhea while other pathogens such as norovirus or parasites seem to have a minimal contribution. Surveillance and prevention programs to facilitate early recognition and improved management of potentially life-threatening diarrhea-episodes are needed.