Etiological, epidemiological, and clinical features of acute diarrhea in China
Liping Wang, Shi-Xia Zhou, Xin Wang, Qing‐Bin Lu, Lusha Shi, Xiang Ren, Xiao‐Ai Zhang, Yifei Wang, Sheng-Hong Lin, Cuihong Zhang, Mengjie Geng, Xiao‐Ai Zhang, Jun Li, Shi-Wen Zhao, Zhigang Yi, Xiao Chen, Zuosen Yang, Lei Meng, Xinhua Wang, Yingle Liu, Ai‐Li Cui, Shengjie Lai, Meng-Yang Liu, Yuliang Zhu, Wenbo Xu, Yu Chen, Jianguo Wu, Zhenghong Yuan, Mengfeng Li, Liuyu Huang, Zhongjie Li, Wei Liu, Li‐Qun Fang, Huaiqi Jing, Simon I Hay, George F. Gao, Weizhong Yang, Weizhong Yang, George F. Gao, Zhongjie Li, Liping Wang, Xiang Ren, Yifei Wang, Sheng-Hong Lin, Cuihong Zhang, Mengjie Geng, Xin Wang, Huaiqi Jing, Wenbo Xu, Ai‐Li Cui, Yujuan Shen, Yanyan Jiang, Qiao Sun, Lipeng Hao, Chuchu Ye, Wei Liu, Xiao‐Ai Zhang, Liuyu Huang, Yong Wang, Wenyi Zhang, Yingle Liu, Jianguo Wu, Zhang Qi, Weiyong Liu, Ziyong Sun, Faxian Zhan, Ying Xiong, Lei Meng, Deshan Yu, Chunxiang Wang, Shengcang Zhao, Wenrui Wang, Xia Lei, Juansheng Li, Yuhong Wang, Yan Zhang, Jun-Peng Yang, Yanbo Wang, Fu-Cai Quan, Xiong Zhi-jun, Liping Liang, Quan-E Chang, Yun Wang, Ping Wang, Zuosen Yang, Lingling Mao, Jiameng Li, Likun Lv, Jun Xu, Chang Shu, Xiao Chen, Yu Chen, Yanjun Zhang, Lunbiao Cui, Kuicheng Zheng, Xingguo Zhang, Xi Zhang, Lihong Tu, Zhigang Yi, Wei Wang
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.