Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea

• Published in: Biomédica
• Main Authors: Adson Santos Martins, Samara Alves Santos, Cláudia Alves da Silva Lisboa, Tânia Fraga Barros, Tereza Cristina Medrado Ribeiro, Hugo da Costa-Ribeiro, Ângela Peixoto de Mattos, Patrícia Silva de Almeida Mendes, Carlos Maurício Cardeal Mendes, Edna Lúcia Souza, Ana Lúcia Moreno Amor, Neci Matos Soares, Márcia Cristina Aquino Teixeira
• Format: Article in Journal/Newspaper
• Language: English; Spanish
• Published: Instituto Nacional de Salud 2024
• Subjects: diarrheal disease; infectious; children; enterobacteria; enterovirus; entamoeba histolytica; giardia duodenalis; blastocystis; steatocrit; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.7705/biomedica.6913; https://doaj.org/article/b369d92cf90a4f7e8cec233b141b6e35

Introduction. The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease. Objective. To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity. Materials and methods. The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests. Results. We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method. Conclusions. Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.