Acute infectious diarrhea (AcID) causes a significant health burden on the population of developed countries, and even a higher burden in the developing world. The only investigation into the causes of AcID in Winnipeg was conducted in the late 1970s. That study determined that 3%-5% of Children’s Hospital Emergency Room (CHER) visits were due to AcID, and about 50% of those were due to rotavirus infections. We conducted a prospective case-control study to reveal the current spectrum of viral pathogens associated with AcID and the distribution and frequency of their occurrence among the pediatric population of Winnipeg. In this study, nucleic acid detection (NAD) and genome sequence information confirmed the presence and identity of each pathogen, and established whether an etiological shift in the distribution of pathogens, both between families and strains of specific pathogens, occurred. Stool samples were collected from pediatric cases with AcID at the ER along with asymptomatic cases for control. A panel of viral nucleic acid detection (NAD) assays was established by the Viral Gastroenteritis Study Group for human astro, calici (Noro and Sapo), entro, polio, hepA, rota and reo viruses according to the published procedures. A new assay for Aichivirus was developed, and the VGSG has established a novel rotavirus assay which is capable of detecting rotavirus from at least 4 different host species (Human, bovine, porcine and simian). Amplified viral targets were sequenced and the information submitted to GeneBank to confirm the strain of each isolate. A total of 1128 patients visited WCHER and WC during the study period and among them 242 patients were enrolled. In 104 cases viruses were identified. A total number of 114 viruses were identified either by NAD or EM assay. Out of 114 viruses, prevalence of HAdV, NoV GI/II and HRV were 44%, 23% and 23% respectively. Mixed infections were found in 4% of cases.This knowledge of pathogen distribution will facilitate design of effective methods for prevention, treatment and intervention in the spread of AcID pathogens.

Acute infectious diarrhea (AcID) causes a significant health burden on the population of developed countries, and even a higher burden in the developing world. The only investigation into the causes of AcID in Winnipeg was conducted in the late 1970s. That study determined that 3%-5% of Children’s Hospital Emergency Room (CHER) visits were due to AcID, and about 50% of those were due to rotavirus infections. We conducted a prospective case-control study to reveal the current spectrum of viral pathogens associated with AcID and the distribution and frequency of their occurrence among the pediatric population of Winnipeg. In this study, nucleic acid detection (NAD) and genome sequence information confirmed the presence and identity of each pathogen, and established whether an etiological shift in the distribution of pathogens, both between families and strains of specific pathogens, occurred. Stool samples were collected from pediatric cases with AcID at the ER along with asymptomatic cases for control. A panel of viral nucleic acid detection (NAD) assays was established by the Viral Gastroenteritis Study Group for human astro, calici (Noro and Sapo), entro, polio, hepA, rota and reo viruses according to the published procedures. A new assay for Aichivirus was developed, and the VGSG has established a novel rotavirus assay which is capable of detecting rotavirus from at least 4 different host species (Human, bovine, porcine and simian). Amplified viral targets were sequenced and the information submitted to GeneBank to confirm the strain of each isolate. A total of 1128 patients visited WCHER and WC during the study period and among them 242 patients were enrolled. In 104 cases viruses were identified. A total number of 114 viruses were identified either by NAD or EM assay. Out of 114 viruses, prevalence of HAdV, NoV GI/II and HRV were 44%, 23% and 23% respectively. Mixed infections were found in 4% of cases.This knowledge of pathogen distribution will facilitate design of effective methods for prevention, treatment and intervention in the spread of AcID pathogens.

Thesis (M.D.) -- Dept. of Medicine, University of Adelaide, 1980. / Typescript (photocopy).

Thesis (M.D.)--University of Maryland, 1815. / Microform version available in the Readex Early American Imprints series.

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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand Johannesburg, in fulfillment of the requirements for the degree of Master of Medicine in the branch of Paediatrics Johannesburg, 2017 / Introduction: Diarrhoeal illness is a major contributor to morbidity and mortality in children under five years. Hypernatraemia is a serious electrolyte disturbance associated with diarrhoea. There is a paucity of data of the incidence and possible risk factors of hypernatraemia in acute gastroenteritis amongst the paediatric population in South Africa. Objective: To document the incidence of hypernatraemia in children admitted with diarrhoea and any associations between hypernatraemia and potential risk factors. Method: This study used a prospective cross - sectional convenience sample of children between the ages of one and 24 months, who were admitted for diarrhoea complicated by dehydration. Caregivers were interviewed and demographic, clinical and laboratory variables were obtained. Results: A total of a 125 children were included into the study. Fifty one of the 125 children (41%) had hypernatraemia. Their serum sodium levels ranged between 154 and 171 mmol/l. Age below one year (p< 0.001) and severe dehydration (p = 0.003) were risk factors for hypernatraemia in the univariate analysis but only infancy remained significant after the multivariate analysis (Odds ratio 10.6, 95% CI: 3.5 – 32.6, p<0.001). Three patients demised and all were part of the hypernatraemic group (6% vs. 0%, p = 0.24). Hypernatraemia was significantly associated with neurological deficits (14% vs. 0%, p = 0.013). Conclusion: This study illustrated a high incidence of paediatric hypernatraemic dehydration, which has not been reported in other studies. An age of less than one year old was a statistically significant risk factor. / MT2017

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