Prevalence of Clostridium difficile-associated diarrhea in developing countries is 15%

Afbeelding

Objectives:
The prevalence of Clostridium difficile infection is rapidly increasing worldwide, but prevalence is difficult to estimate in developing countries where awareness, diagnostic resources and surveillance protocols are limited. Therefore, this review article has been conducted.

The goal of this review article is to determine the current prevalence and incidence density rates of first episodes of Clostridium difficile-associated diarrhea in developing countries.

Study design:
This review article included studies with data providing prevalence or incidence rates of Clostridium difficile-associated diarrhea in developing countries within four regions: Africa-Middle East, developing Asia, Latin America and China.

Results and conclusions:
The investigators found within the regions, the prevalence of Clostridium difficile infection in patients with diarrhea was 15% [95% CI = 13-17%] (including community and hospitalized patients), with no significant difference across regions.

The investigators found the incidence of Clostridium difficile infection in 17 studies including this information was 8.5 per 10,000 patient-days [95% CI = 5.83-12.46]. Prevalence was significantly higher in hospitalized patients versus community patients [p = 0.0227].

The investigators concluded the prevalence estimate of 15% is concerning; however, low awareness and inconsistent diagnostic and surveillance protocols suggest this is markedly underestimated. Enhanced awareness and management of Clostridium difficile infection in patients with diarrhea, along with improvements in infection control and surveillance practices, should be implemented to reduce prevalence of Clostridium difficile-associated diarrhea in developing countries.

Original title:
Clostridium difficile-associated Diarrhea in Developing Countries: A Systematic Review and Meta-Analysis by Curcio D, Cané A, […], Correa J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/30659481

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