A Laboratory Perspective on an Epidemiological Pattern of Infectious Gastroenteritis: A Five-year Surveillance between 2016 to 2020 from Established Private Healthcare Centers within Klang Valley in Malaysia

Abstract

Infectious gastroenteritis is endemic globally and caused by bacteria, viruses and parasites. The study determined the epidemiological pattern of infectious gastroenteritis within selected urban areas in Malaysia. Analysis of 745 laboratory requests was conducted based on FilmArray gastrointestinal assay and socio-demographic details from suspected cases in KPJ hospitals in Klang Valley, Malaysia, between 2016 to 2020. Descriptive analysis and Fisher-Freeman-Halton Exact testing were performed to ascertain the relationship between socio-demographics with the type of infections. Of 745 requests, 288 (38.7%) were caused by one etiological agent (mono-infection), while the remaining 334 (44.8%) were due to more than one agent (co-infection). Mono-infection was significantly higher among adolescents (n=9; 47.4%) and young adults (n=37; 40.2%) in comparison to adults (n=18; 35.3%). Whereas co-infection was significantly higher in infants (n=216; 49.2%). Mono-infection was mainly caused by bacteria (n=194/288; 67.4%) with Salmonella spp. was prevalent (16.6%), followed by EPEC (12.5%), Campylobacter spp. (11.9%) and Norovirus (10.5%). The co-infections (n=334) were identified with a combination of EPEC and the following bacteria or viruses (Norovirus=38, Campylobacter spp.=30, Salmonella spp.=26, EAEC=22, Rotavirus=19, Adenovirus=10). The month of August to October was recognised as the peak season for infectious gastroenteritis. The present findings may indicate contamination of infectious agents to the food supply and food processing chain as well as reduced hygiene in food sanitation leading to foodborne health issues, particularly among the children in Klang Valley, Malaysia.