How Have Diarrhoeal Pathogens Affected South Africans Over 5 Years of Age in the Last 5 Years?
Enteric pathogens are a common cause of diarrhoeal diseases and affect the stomach and intestines. These pathogens spread mainly through contact with contaminated food, water, or surfaces.
Diarrhoeal disease has long been a significant global public health concern, particularly in low and middle income countries. Over the past three decades, focused interventions, ranging from improved sanitation and access to clean water, to vaccinations and better healthcare access, have contributed to remarkable progress in reducing diarrhoeal disease mortality worldwide. But even with global progress, diarrhoeal disease is still a major problem in sub-Saharan Africa, causing about 434,000 deaths each year across all age groups, with a death rate of 54.4 per 100,000 people.
While much of the focus on diarrhoeal disease burden has centred on young children under five years of age, there is limited data available on its impact on older children and adults. Diarrhoea in these populations not only leads to lost productivity but also contributes to a substantial strain on healthcare systems.
This study examines trends in enteric pathogen prevalence in participants >5 years of age at selected sentinel sites in South Africa between 2018 and 2023.
Materials and Methods
To fill this knowledge gap, data from 2018 to 2023 were analyzed from two surveillance systems: the Diarrhoeal Diseases Sentinel Surveillance (DDSS) and the African Network for Improved Diagnostics, Epidemiology, and Management of Common Infectious Agents (ANDEMIA). These programmes enrolled participants of any age presenting with diarrhoea, defined by the World Health Organization, at selected hospitals and clinics across several sentinel sites
Results
Between 2018 and 2023, 677 diarrhoea cases and 183 controls over age 5 were enrolled across growing sentinel sites in sub-Saharan Africa. The majority of cases were from hospitals (60%) and had a median age of 34 years. HIV status was known for 92% of cases, with over half being people living with HIV (PLHIV). Encouragingly, enrolment of PLHIV declined over time, and most had suppressed viral loads.
Viruses were detected in 27% of cases, bacteria in 31%, parasites in 8%, and mixed infections in 17%. Notable declines were observed in Norovirus GII, adenovirus, Cryptosporidium spp., Clostridioides difficile, and STEC. No significant changes were seen for other pathogens like Salmonella spp. or Giardia lamblia.
For a more in-depth look into this captivating study, download the full article below.
