Enteropathogens Associated with Acute and Persistent Diarrhea in Bangladeshi Children <5 Years of Age

A longitudinal study of diarrhea was carried out from May 1988 to April 1989 by household surveillance of 705 children <5 years old in rural Bangladesh. Stool samples were examined for enteric pathogens at the beginning of each diarrheal episode. For persistent episodes, stool examination was repeated on days 15-17 of the illness. For each case of persistent diarrhea, stool samples from age-matched acute diarrheal and healthy controls were examined. Compared with healthy controls, cases of diarrhea were associated with Shigella species (P =.07) and rotavirus (P <.05). Diffusely adherent Escherichia coli (P <.05) and Cryptosporidia (P =.07) were the only enteropathogens associated with persistent diarrhea in comparison with acute diarrhea. No more than 15% of children had the same class of pathogen identified from stool on both days 1-3 and days 15-17, indicating that persistent infection was uncommon. However, a different entero- pathogen was frequently found on days 15-17, suggesting that sequential infection may be a cause of persistent diarrhea.