Epidemiology of Acute and Persistent Diarrhea in Brazil - Special Relevance to Emerging Enteric Pathogens

• Grant number: 98/14505-5
• Support Opportunities: Research Projects - Thematic Grants
• Start date: December 01, 1999
• End date: February 28, 2002
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Ulysses Fagundes Neto
• Grantee: Ulysses Fagundes Neto
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Approximately 1/3 of the medical consultations in the emergency room of the hospitals belonging to the public health system, in infants under 2 years of age, are due to acute diarrhea. It is well established that 10 to 30% of these cases evolve to persistent diarrhea. In Brazil, several studies have been undertaken to determine the etiology of acute diarrhea, however, most frequently the methodology utilized and the selection of the cases do not follow homogeneous criteria. These problems cause difficulties in the analysis of the results in a more accurate way. Thus, the elaboration of a nationwide project, involving several cities from different states and a considerable variety of investigators all of them trained in the same institution (EPM/UNIFESP), to determine the epidemiological profile of acute and persistent diarrhea, utilizing an uniform methodology will allow the acquisition of a more precise information with a great technical-scientific repercussion. Moreover, it should be emphasized the importance of adding new techniques of identification of the enteropathogenic agents. At the present moment the vast majority of the laboratories utilize a complex and time consuming methodology to identify the enteropathogenic agents that cause enteric infections. In this sense, the introduction of new diagnostic technique such as the Polimerase Chain Reaction (PCR) becomes a real promising possibility. The utilization of PCR will allow the establishment of more precise and faster results than those obtained with the conventional techniques, which would be highly desired in the daily clinical practice. On the other hand, there are some evidences that EPEC serotypes are able to promote a lymphocyte inhibition factor that would play an important role as a risk factor in the perpetuation of diarrhea. A more detailed knowledge of this possible lymphocyte inhibition factor could offer new insights in the treatment of persistent diarrhea. (AU)