Molecular Epidemiology of E nteric Adenovirus

Gastroenteritisin under-Five-Year-Old Children in Iran

Background. Acute gastroenteritis is one of the major sources of morbidity and mortality among
young children in developed and developing countries. Th aim of this study was to determine the
prevalence of human adenovirus- (HAdV-) 40 and HAdV-41
in children hospitalized with gastroenteritis in fie diffrent health centers of Iran.
Methods. In a cross-sectional epidemiological study, we studied 2682 fecal specimens that were
collected from children under the age of 5 years in fie educational and therapeutic pediatric centers in
Iran from February 2012 to February 2013. Samples were tested for HAdV-40 and HAdV-41, using a
specifi pair of primers in polymerase chain reaction (PCR) method.
Results. HAdV-40 and HAdV-41 were detected in 132 (5.18%) of the patients with diarrhea. A
signifiantly higher prevalence of HAdV-40 and HAdV-41 (58.3%) was observed in children under 12
months of age, compared to other age groups. Th male to female ratio was 1.7.
Conclusion. Th results of this study demonstrated that HAdV- 40 and HAdV-41 could be considered
etiological agents for acute gastroenteritis among children in Iran. Th PCR as a rapid test may increase
the chance for a relatively mild course of the disease followed by a complete recovery and avoiding
administration of unnecessary antibiotics.

Clinical Profile of Dengue Fever in Children: A Study from

Southern Odisha, India
Background. In India, dengue epidemics are becoming more frequent (WHO, 2008). Th majority of
dengue viral infections are
self-limiting, but complications may cause high morbidity and mortality.
Objectives. To assess the clinical profie of the dengue infection in children less than 14 years of age
and to evaluate the outcomes of dengue fever from September 2013 to August 2015 at the Pediatric
Department of Maharaja Krishna Chandra Gajapati Medical College, the largest tertiary care hospital of
southern Odisha.
Results. A total of 97 cases were classifid into 84 (86.59%) nonsevere and 13 (13.40%) severe dengue
cases. The most common age of presentation was above 11 yrs. Th mean age of admission was 8.7
yrs. The most common presenting symptom was fever seen in 100% and hepatomegaly (43.8%), the
most common physical fiding. Gastrointestinal bleeding was markedly seen in severe dengue (76.9%).
Elevation in aspartate transaminase (SGOT) was found in 47.42% and thrombocytopenia in 27.5%.
The correlation between hepatomegaly and elevated SGOT was signifiant (value 0.0346). Case fatality
rate (CFR) was 1.03%.
The mean duration of hospitalisation was 3.8 days.
Conclusion. In children, if symptoms like fever, pain, rashes, and vomiting are associated with
hepatomegaly and elevated SGOT in context of low TPC, a strong possibility of dengue fever is present,
especiallyin an epidemic setting. Early suspicion and effctive management can reduce the severity.

Pediatric Tuberculosis in Young Children in India: A

Prospective Study
Background. India has one of the highest tuberculosis (TB) burdens globally. However, few studies
have focused on TB in young children, a vulnerable population, where lack of early diagnosis results in
poor outcomes.
Methods. Young children (5 years) with suspected TB were prospectively enrolled at a tertiary
hospital in Pune, India. Detailed clinical evaluation, HIV testing, mycobacterial cultures, and drug
susceptibility testing were performed.
Results. 223 children with suspected TB were enrolled. The median age was 31 months, 46% were
female, 86% had received BCG, 57% were malnourished, and 10% were HIV positive. 12% had TB
disease (defiite or probable), 35% did not have TB, while TB could not be ruled out in 53%.
Extrapulmonary disease was noted in 46%, which was predominantly meningeal. Tuberculin skin test
(TST) was positive in 20% of children with TB. Four of 7 (57%) children with culture-confimed TB
harbored drug-resistant (DR) strains of whom 2 (50%) were multi-DR (MDR). In adjusted analyses, HIV
infection, positive TST, and exposure to household smoke were found to be signifiantly associated with
children with TB ( 0.04). Mortality (at 1 year) was 3 of 26 (12%) and 1 of 79 (1%), respectively, in
children with TB and those without TB (< 0.05).
Conclusions. Diagnosis of TB is challenging in young children, with high rates of extra-pulmonary and
meningeal disease. While the data on DR-TB are limited by the small sample size, they are however
concerning, and additional studies are needed to more accurately defie the prevalence of DR strains in
this vulnerable population.