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Etiological, epidemiological, and clinical features of acute diarrhea in China

Etiological, epidemiological, and clinical features of acute diarrhea in China
Etiological, epidemiological, and clinical features of acute diarrhea in China

National-based prospective surveillance of all-age patients with acute diarrhea was conducted in China between 2009‒2018. Here we report the etiological, epidemiological, and clinical features of the 152,792 eligible patients enrolled in this analysis. Rotavirus A and norovirus are the two leading viral pathogens detected in the patients, followed by adenovirus and astrovirus. Diarrheagenic Escherichia coli and nontyphoidal Salmonella are the two leading bacterial pathogens, followed by Shigella and Vibrio parahaemolyticus. Patients aged <5 years had higher overall positive rate of viral pathogens, while bacterial pathogens were more common in patients aged 18‒45 years. A joinpoint analysis revealed the age-specific positivity rate and how this varied for individual pathogens. Our findings fill crucial gaps of how the distributions of enteropathogens change across China in patients with diarrhea. This allows enhanced identification of the predominant diarrheal pathogen candidates for diagnosis in clinical practice and more targeted application of prevention and control measures.

2041-1723
Wang, Li-Ping
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Zhou, Shi-Xia
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Wang, Xin
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Lu, Qing-Bin
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Shi, Lu-Sha
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Ren, Xiang
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Zhang, Hai-Yang
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Wang, Yi-Fei
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Lin, Sheng-Hong
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Zhang, Cui-Hong
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Geng, Meng-Jie
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Zhang, Xiao-Ai
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Li, Jun
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Zhao, Shi-Wen
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Yi, Zhi-Gang
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Chen, Xiao
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Yang, Zuo-Sen
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Meng, Lei
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Wang, Xin-Hua
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Liu, Ying-Le
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Cui, Ai-Li
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Lai, Sheng-Jie
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Liu, Meng-Yang
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Zhu, Yu-Liang
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Xu, Wen-Bo
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Chen, Yu
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Wu, Jian-Guo
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Yuan, Zheng-Hong
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Li, Meng-Feng
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Huang, Liu-Yu
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Li, Zhong-Jie
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Liu, Wei
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Fang, Li-Qun
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Jing, Huai-Qi
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Hay, Simon I
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Gao, George F
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Yang, Wei-Zhong
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Chinese Centers for Disease Control and Prevention (CDC) Etiology of Diarrhea Surveillance Study Team
Wang, Li-Ping
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Zhou, Shi-Xia
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Wang, Xin
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Lu, Qing-Bin
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Shi, Lu-Sha
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Ren, Xiang
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Zhang, Hai-Yang
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Wang, Yi-Fei
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Lin, Sheng-Hong
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Zhang, Cui-Hong
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Geng, Meng-Jie
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Zhang, Xiao-Ai
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Li, Jun
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Zhao, Shi-Wen
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Yi, Zhi-Gang
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Chen, Xiao
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Yang, Zuo-Sen
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Meng, Lei
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Wang, Xin-Hua
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Liu, Ying-Le
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Cui, Ai-Li
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Lai, Sheng-Jie
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Liu, Meng-Yang
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Zhu, Yu-Liang
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Xu, Wen-Bo
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Chen, Yu
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Wu, Jian-Guo
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Yuan, Zheng-Hong
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Li, Meng-Feng
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Huang, Liu-Yu
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Li, Zhong-Jie
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Liu, Wei
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Fang, Li-Qun
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Jing, Huai-Qi
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Hay, Simon I
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Gao, George F
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Yang, Wei-Zhong
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Chinese Centers for Disease Control and Prevention (CDC) Etiology of Diarrhea Surveillance Study Team (2021) Etiological, epidemiological, and clinical features of acute diarrhea in China. Nature Communications, 12 (1), [2464]. (doi:10.1038/s41467-021-22551-z).

Record type: Article

Abstract

National-based prospective surveillance of all-age patients with acute diarrhea was conducted in China between 2009‒2018. Here we report the etiological, epidemiological, and clinical features of the 152,792 eligible patients enrolled in this analysis. Rotavirus A and norovirus are the two leading viral pathogens detected in the patients, followed by adenovirus and astrovirus. Diarrheagenic Escherichia coli and nontyphoidal Salmonella are the two leading bacterial pathogens, followed by Shigella and Vibrio parahaemolyticus. Patients aged <5 years had higher overall positive rate of viral pathogens, while bacterial pathogens were more common in patients aged 18‒45 years. A joinpoint analysis revealed the age-specific positivity rate and how this varied for individual pathogens. Our findings fill crucial gaps of how the distributions of enteropathogens change across China in patients with diarrhea. This allows enhanced identification of the predominant diarrheal pathogen candidates for diagnosis in clinical practice and more targeted application of prevention and control measures.

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Submitted date: 22 November 2020
Accepted/In Press date: 15 March 2021
Published date: 29 April 2021
Additional Information: Funding Information: We would like to thank all the subjects, their families, and collaborating clinicians for their participation. This work was financially supported by grants from the China MegaProject on Infectious Disease Prevention (Nos. 2018ZX10713001, 2018ZX10713002, 2018ZX10201001, and 2017ZX10103004), the National Natural Science Funds (Nos. 91846302, 81825019). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. We thank staff members of the Department of Science and Education of the National Health Commission, and the diarrheal surveillance network laboratories and sentinel hospitals in the participating 31 provinces of China for assistance with field investigation, administration, and data collection. Publisher Copyright: © 2021, The Author(s).

Identifiers

Local EPrints ID: 449194
URI: http://eprints.soton.ac.uk/id/eprint/449194
ISSN: 2041-1723
PURE UUID: 276f2601-6da7-49e8-a059-5c1e4072ed0a
ORCID for Sheng-Jie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 19 May 2021 18:15
Last modified: 14 May 2024 01:55

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Contributors

Author: Li-Ping Wang
Author: Shi-Xia Zhou
Author: Xin Wang
Author: Qing-Bin Lu
Author: Lu-Sha Shi
Author: Xiang Ren
Author: Hai-Yang Zhang
Author: Yi-Fei Wang
Author: Sheng-Hong Lin
Author: Cui-Hong Zhang
Author: Meng-Jie Geng
Author: Xiao-Ai Zhang
Author: Jun Li
Author: Shi-Wen Zhao
Author: Zhi-Gang Yi
Author: Xiao Chen
Author: Zuo-Sen Yang
Author: Lei Meng
Author: Xin-Hua Wang
Author: Ying-Le Liu
Author: Ai-Li Cui
Author: Sheng-Jie Lai ORCID iD
Author: Meng-Yang Liu
Author: Yu-Liang Zhu
Author: Wen-Bo Xu
Author: Yu Chen
Author: Jian-Guo Wu
Author: Zheng-Hong Yuan
Author: Meng-Feng Li
Author: Liu-Yu Huang
Author: Zhong-Jie Li
Author: Wei Liu
Author: Li-Qun Fang
Author: Huai-Qi Jing
Author: Simon I Hay
Author: George F Gao
Author: Wei-Zhong Yang
Corporate Author: Chinese Centers for Disease Control and Prevention (CDC) Etiology of Diarrhea Surveillance Study Team

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