Prevalence of gastrointestinal pathogens in sub-saharan africa: Systematic review and meta-analysis

Fletcher, SM; Stark, D; Ellis, J

Prevalence of gastrointestinal pathogens in sub-saharan africa: Systematic review and meta-analysis

Fletcher, SM

Stark, D Ellis, J

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Publication Type:: Journal Article
Citation:: Journal of Public Health in Africa, 2011, 2 (2), pp. 127 - 137
Issue Date:: 2011-01-01

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Field	Value	Language
dc.contributor.author	Fletcher, SM https://orcid.org/0000-0002-8897-2351	en_US
dc.contributor.author	Stark, D	en_US
dc.contributor.author	Ellis, J https://orcid.org/0000-0001-7328-4831	en_US
dc.date.available	2011-06-21	en_US
dc.date.issued	2011-01-01	en_US
dc.identifier.citation	Journal of Public Health in Africa, 2011, 2 (2), pp. 127 - 137	en_US
dc.identifier.issn	2038-9922	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18458
dc.description.abstract	© S.M. Fletcher et al., 2011. A significant proportion of vulnerable people in sub-Saharan Africa (SSA) remain at risk for contracting diarrhoeal diseases due to the presence of many risk factors facilitating their transmission. A systematic review of published articles from the SSA region was done to determine the prevalence and types of diarrhoeal pathogens in circulation, based on a search of databases, including EBSCO host, PubMed, Scopus, Science Direct, Google scholar and Web of Science was done between September 2009 and December 2010. Data were summarized from 27 studies, with pooled data analysed and reported. Pathogens were isolated from between 26.8-65.6% of cases, with an overall isolation rate of 55.7% (95% CI, 48.2-62.9%). Isolation rates were highest amongst adult cases followed by children, and the odds of isolating a pathogen was greater in diarrhoeal cases (Odds Ratio 4.93 (95% CI, 1.99 to 12.23), than in asymptomatic controls. Overall isolation ranged from 8% to 99%; and heterogeneity testing suggests differences between age groups (Q=5.806; df=2, P=0. 055). Mixed E. coli spp., (29.95%), Cryptosporidium (21.52%), Cyclospora (18%), Entamoeba. (13.8%), Shigella spp. (10.49%), Salmonella spp. (8.36%), and Campylobacter spp. (8.33%), were most commonly reported, and rotavirus was the most common virus isolated. This is the first review to look at the range of enteric pathogens circulating in SSA, and has confirmed high rates of isolation of pathogens from diarrhoeal cases. Public health practitioners can use this information to understanding the challenges related to diarrhoeal illness and set priorities for their prevention and control.	en_US
dc.relation.ispartof	Journal of Public Health in Africa	en_US
dc.relation.isbasedon	10.4081/jphia.2011.e30	en_US
dc.title	Prevalence of gastrointestinal pathogens in sub-saharan africa: Systematic review and meta-analysis	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.for	110802 Medical Infection Agents (incl. Prions)	en_US
utslib.for	060502 Infectious Agents	en_US
utslib.for	0605 Microbiology	en_US
utslib.for	070708 Veterinary Parasitology	en_US
utslib.for	110803 Medical Parasitology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	open_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	2	en_US

Abstract:

© S.M. Fletcher et al., 2011. A significant proportion of vulnerable people in sub-Saharan Africa (SSA) remain at risk for contracting diarrhoeal diseases due to the presence of many risk factors facilitating their transmission. A systematic review of published articles from the SSA region was done to determine the prevalence and types of diarrhoeal pathogens in circulation, based on a search of databases, including EBSCO host, PubMed, Scopus, Science Direct, Google scholar and Web of Science was done between September 2009 and December 2010. Data were summarized from 27 studies, with pooled data analysed and reported. Pathogens were isolated from between 26.8-65.6% of cases, with an overall isolation rate of 55.7% (95% CI, 48.2-62.9%). Isolation rates were highest amongst adult cases followed by children, and the odds of isolating a pathogen was greater in diarrhoeal cases (Odds Ratio 4.93 (95% CI, 1.99 to 12.23), than in asymptomatic controls. Overall isolation ranged from 8% to 99%; and heterogeneity testing suggests differences between age groups (Q=5.806; df=2, P=0. 055). Mixed E. coli spp., (29.95%), Cryptosporidium (21.52%), Cyclospora (18%), Entamoeba. (13.8%), Shigella spp. (10.49%), Salmonella spp. (8.36%), and Campylobacter spp. (8.33%), were most commonly reported, and rotavirus was the most common virus isolated. This is the first review to look at the range of enteric pathogens circulating in SSA, and has confirmed high rates of isolation of pathogens from diarrhoeal cases. Public health practitioners can use this information to understanding the challenges related to diarrhoeal illness and set priorities for their prevention and control.

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http://hdl.handle.net/10453/18458