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Healthcare 2019, 7(1), 9;

Co-Infection by Waterborne Enteric Viruses in Children with Gastroenteritis in Nepal

Department of Natural, Biotic and Social Environment Engineering, University of Yamanashi, Yamanashi 400-8511, Japan
Institute of Medicine, Tribhuvan University, Kathmandu 1524, Nepal
School of Public Health and Community Medicine, University of New South Wales, New South Wales 2052, Australia
Interdisciplinary Center for River Basin Environment, University of Yamanashi, Yamanashi 400-8511, Japan
Author to whom correspondence should be addressed.
Received: 17 November 2018 / Revised: 22 December 2018 / Accepted: 8 January 2019 / Published: 13 January 2019
(This article belongs to the Special Issue Water Quality and Public Health)
Full-Text   |   PDF [260 KB, uploaded 13 January 2019]


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. View Full-Text
Keywords: co-infection; enteric viruses; stool testing; drinking water contamination co-infection; enteric viruses; stool testing; drinking water contamination
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Tandukar, S.; Sherchand, J.B.; Karki, S.; Malla, B.; Ghaju Shrestha, R.; Bhandari, D.; Thakali, O.; Haramoto, E. Co-Infection by Waterborne Enteric Viruses in Children with Gastroenteritis in Nepal. Healthcare 2019, 7, 9.

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