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Type: Journal article
Title: Co-infection by waterborne enteric viruses in children with gastroenteritis in Nepal
Author: Tandukar, S.
Sherchand, J.B.
Karki, S.
Malla, B.
Ghaju Shrestha, R.
Bhandari, D.
Thakali, O.
Haramoto, E.
Citation: Healthcare, 2019; 7(1):1-13
Publisher: MDPI
Issue Date: 2019
ISSN: 2227-9032
Statement of
Sarmila Tandukar, Jeevan B. Sherchand, Surendra Karki, Bikash Malla, Rajani Ghaju Shrestha, Dinesh Bhandari, Ocean Thakali and Eiji Haramoto
Abstract: Enteric viruses are highly contagious and a major cause of waterborne gastroenteritis in children younger than five years of age in developing world. This study examined the prevalence of enteric virus infection in children with gastroenteritis to identify risk factors for co-infections. In total, 107 stool samples were collected from patients with acute gastroenteritis along with samples of their household drinking water and other possible contamination sources, such as food and hand. The presence of major gastroenteritis-causing enteric virus species (group A rotaviruses, enteroviruses, adenoviruses, and noroviruses of genogroup I) in stool and water samples was examined using quantitative polymerase chain reaction. Among the 107 stool samples tested, 103 (96%) samples contained at least one of the four tested enteric viruses, and the combination of group A rotaviruses and enteroviruses was the most common co-infection (52%, n = 54/103). At least one viral agent was detected in 16 (16%) of 103 drinking water samples. Identical enteric viruses were detected in both the stool and water samples taken from the same patients in 13% of cases (n = 13/103). Group A rotaviruses were most frequently found in children suffering from acute diarrhea. No socio-demographic and clinical factors were associated with the risk of co-infection compared with mono-infection. These less commonly diagnosed viral etiological agents in hospitals are highly prevalent in patients with acute gastroenteritis.
Keywords: co-infection
drinking water contamination
enteric viruses
stool testing
Rights: © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
DOI: 10.3390/healthcare7010009
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