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Relationship between feeding practice and viral gastroenteritis in Egyptian infants

ObjectiveTo identify the causative viruses of gastroenteritis affecting infants in the first 6 months of life, to investigate the role of feeding practices as a risk factor on viral gastroenteritis, and to validate the enzyme-linked immunosorbent assay (ELISA) technique as a diagnostic tool for the detection of viral gastroenteritis. MethodsThe present study was conducted on 80 infants aged 6 months and less, diagnosed as having gastroenteritis and admitted to the gastroenteritis department in Abo El Rish pediatric hospital, Cairo University. Infants participated in the study were classified into two groups; the exclusively breast-fed group and the nonexclusively breast-fed group, which included mixed-feeding regimens and formulae feeding. A self-designed questionnaire was verbally administered to mothers. Stool samples were obtained from the infants on admission. Viruses were screened using ELISA kits for rotaviruses, adenoviruses, and astroviruses. Also, samples were screened by reverse transcription-PCR for the presence of rotaviruses, astroviruses, and noroviruses, and by PCR for detection of adenoviruses. ResultsThe infant mean age was 4.8±1.4 months and 57% were males. The mean of family number was 4.4±1.0 with 27% working mothers and 12% of infants attending nurseries. By using the ELISA test, rotavirus-positive cases were 35 (44%), adenovirus-positive were 4 (5.1%), and astrovirus-positive were 2 (2.5%). By using reverse transcription-PCR and PCR test, the number of rotavirus-positive cases increased to 42 (53%). There is an agreement between rotaviral ELISA and PCR findings, although the PCR findings were considered the gold standard test. Rotavirus-positive cases were nonsignificantly lower in exclusively breast-fed infants. Only mixed feeding was significant at P less than 0.1 as a risk factor for being rotavirus PCR positive. ConclusionFeeding practice not only affects the incidence but also the prognosis and type of virus, as exclusively breast-fed infants were reported to be more protected from rotavirus and less liable to develop complications. New strategies should be established for improving infant nutrition, with particular emphasis on the importance of breastfeeding.