Comparative study on epidemiological and etiological characteristics of patients with acute diarrhea with febrile or non-febrile symptoms in China  

作　　者：Tao Wang Gang Wang Chun-Xi Shan Yan-Qun Sun Xiang Ren Lin-Jie Yu Yi-Fei Wang Sheng-Hong Lin Xiao-Ai Zhang Hao Li Cui-Hong Zhang Meng-Jie Geng Wei-Zhong Yang Li-Ping Wang Wei Liu Li-Qun Fang 

机构地区：[1]Department of Epidemiology and Biostatistics,School of Public Health,Wuhan University,Wuhan,Hubei,People’s Republic of China [2]State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,20 Dong-Da Street,Fengtai District,Beijing,100071,People’s Republic of China [3]Nanjing Center for Disease Control and Prevention,Nanjing,People’s Republic of China [4]Division of Infectious Disease,Key Laboratory of Surveillance and Early-Warning On Infectious Disease,Chinese Center for Disease Control and Prevention,No.155 Changbai Road,Changping District,Beijing,102206,People’s Republic of China [5]Chinese Center for Disease Control and Prevention,Beijing,People’s Republic of China

出　　处：《Infectious Diseases of Poverty》2023年第4期17-28,共12页贫困所致传染病（英文）

基　　金：National Science Fund for Distinguished Young Scholars(No. 81825019);National Mega Project on Major Infectious Disease Prevention(No. 2018ZX10713002, 2018ZX10101003)。

摘　　要：Background Acute diarrhea with fever can potentially represent a more severe form of the disease compared to non-febrile diarrhea. This study was to investigate the epidemiological characteristics and enteric pathogen composition of febrile-diarrheal patients, and to explore factors including pathogens associated with fever by age group.Methods A nationwide surveillance study of acute diarrheal patients of all ages was conducted in 217 sentinel hospitals from 31 provinces (autonomous regions or municipalities) in China between 2011 and 2020. Seventeen diarrhea-related pathogens, including seven viruses and ten bacteria, were investigated and their association with occurrence of fever symptoms was assessed using multivariate logistic analysis.Results A total of 146,296 patients with acute diarrhea (18.6% with fever) were tested. Th diarrheal children below 5 years had the highest frequency of fever (24.2%), and related to significantly higher prevalence of viral enteropathogens (40.2%) as compared with other age groups (P < 0.001). Within each age group, the febrile-diarrheal patients were associated with a significantly higher prevalence of bacterial pathogens than afebrile-diarrheal patients (allP < 0.01). There was discrepancy when each pathogen was compared, i.e., nontyphoidalSalmonella (NTS) was over-represented in febrile vs non-febrile patients of all age groups, while the febrile vs non-febrile difference for diarrheagenicEscherichia coli (DEC) was only significant for adult groups. The multivariate analysis revealed significant association between fever and infection with rotavirus A among children [odds ratio (OR) = 1.60], for DEC in adult groups (OR = 1.64), for NTS in both children (OR = 2.95) and adults (OR = 3.59).Conclusions There are significant discrepancy of the infected enteric pathogens in patients with acute diarrhea with fever between age groups, and it is valuable for priority detection of NTS and rotavirus A in patients with children < 5 years old and NTS and DEC in adult patients. The resu

关 键 词：Acute diarrhea EPIDEMIOLOGY ENTEROPATHOGENS FEVER China 

分 类 号：R181.3[医药卫生—流行病学]