The Global Enteric Multicenter Study, GEMS, an extensive, ground-breaking study in the developing world, has come up with the clearest picture yet of the most common causes and impact of diarrheal diseases — the second leading killer of young children globally after pneumonia.
The study reveals that while the germs, rotavirus, Shigella and E. Coli are notorious for causing the majority of moderate-to-severe diarrhoea cases, Cryptosporidium and Aeromonas are two pathogens that have been underestimated for their ability to cause the disease.
At the same time, GEMS recommends going beyond the current safe hand and hygiene practices to treat diarrhoea, and that National immunisation programmes should include vaccinations for rotavirus and other bacteria for which inoculations are available.
The results of GEMS have been published in this week’s edition of The Lancet.
“When it comes to childhood disease and deaths, diarrhoea remains a leading culprit,” said Dr Anita Zaidi, principal investigator at the Pakistan study site of GEMS and Chair, Department of Paediatrics, Aga Khan University. “The GEMS data are the most conclusive evidence we have to date of the bacteria we must target and the prevention and treatment practices that need to be improved.”
The three-year-long GEMS enrolled more than 20,000 children from seven sites across Asia and Africa; in Pakistan, the study was conducted in four peri-urban field sites in Bin Qasim Town in Karachi.
“The University has been working at these field sites for the past few years and had basic data on the population. So it was easy for us to build on it,” Dr Zaidi elaborated. “To really know if something was causing diarrhoea, we included an equal number of controls. When we collected a stool sample from a sick child, we also collected one from a well child for comparison. Each stool sample was tested for 40 different diarrhoea causing pathogens. Many of these bugs were being tested for the first time in Pakistan.”
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