A study of the importance of the enterotoxigenic E. coli in children with acute diarrhoea in Recife, Brazil.

Even today acute diarrhoea is a major cause of morbidity and mortality in young children. It is a serious public health problem in less-developed countries, primarily in households whose income is low. As such, it is one of the main causes of death, affecting the undernourished in particular. The potential enteropathogenic agents are distributed universally. However, there is a major difference in the prevalence, according to the areas and the characteristics of the population groups which were studied. In Brazil, since the 1970s, our attention has been drawn to the importance of the classic enteropathogenic strains of E. coli (EPEC) in the aetiology of diarrhoeal diseases, primarily those present in weaned infants in inner city neighbourhoods. On the other hand, Guerrant and co-workers, and Queiroz and co-workers found significant percentages of isolated colonies of enterotoxigenic coli (ETEC) in the stool material of children with symptoms of acute diarrhoea. In rural areas of less-developed countries the incidence of episodes of ETEC provoking diarrhoea is estimated to be between five and ten per person/year. Due to the social and medical gravity of acute diarrhoea, and to the lack of studies dealing with the aetiopathogenic role of the strains of ETEC in our area, we decided to analyse the frequency of isolation of ETEC in children with and without diarrhoea who were attending the out-patient department of the Instituto Materno Infantil de Pernambuco/IMIP.