Biosurveillance of infectious bacterial diarrhea in Pakistan: A retrospective study

Infectious diarrhea caused by enteric pathogens is one of the major factors in morbidity and mortality worldwide particularly in Pakistan. It is mainly associated with three causative agents i.e. bacteria, viruses and parasites. Emerging or reemerging bacterial diarrhea is a global problem. In Pakistan one child dies every minute from diarrhea and acute respiratory infection therefore biosurveillance must be considered as an integral and continuous task at national level to save thousands of children. A study spanning over a period of 15 years was conducted for biosurveillance of infectious diarrhea at Aga Khan University Hospital, Karachi, Pakistan. The basic objective was to isolate and identify enteric bacterial pathogens from stool. The American Society of Microbiology (ASM) guidelines were followed. During this period, total 83396 stool samples were processed, out of which 14% (n = 11 653) of samples were positive for bacterial etiology. Vibrio cholera was the most frequently isolated sp. (32%), followed by Campylobacter spp. (30%). The occurrence rate of Salmonella spp. and Shigella spp. Were 18% and 15% respectively. Results of present study shows that biosurveillance of these infections is crucial responsibility of governments and public health agencies. At present, there is need of developing methodologies for quick identification of the potential pathogens in the environment as well making use of Disease Early Warnings (DEWs) and Geographic Information System (GIS) for active surveillance and outbreak investigation respectively.