Climate change and imperatives to ascertain causes of infectious diarrhoea in low-income and middle-income countries

Elsevier, The Lancet Global Health, Volume 11, March 2023
Dhimal M., Bhandari D.

Diarrhoea remains the third leading cause of disability-adjusted life-years among the paediatric population, despite a significant reduction in childhood mortality related to diarrhoea over the past two decades.1 Infectious diarrhoea can be caused by a wide variety of bacterial, viral, and protozoal pathogens. However, the specific aetiology of diarrhoea cases is rarely reported as routine practice in low-income and middle-income countries (LMICs) because of poor diagnostic capacity of health-care facilities.2 Consequently, the usual choice of care for clinicians in these settings is the temporary management of infectious diarrhoea via symptomatic treatment. Shigella infection has been reported as the most common cause of childhood diarrhoea in LMICs.3 It is a form of bacterial diarrhoea, often called shigellosis, bloody diarrhoea, or bacillary dysentery, caused by the genus Shigella from the Enterobacteriaceae family of Gram-negative bacteria. Shigellosis is a food-borne and water-borne illness, which is often self-limiting but sometimes becomes life-threatening, mainly among children and immunocompromised people.