McMaster University

McMaster University

Faculty of
Health Sciences

McMaster researchers improve diagnosis, treatment of childhood diarrhoeal diseases

By Antonietta Petrella
Published: June 2, 2015
Botswana Gastroenteritis Research Collaboration: David Goldfarb, Charles Muthoga, Disaro Jack, Jeff Pernica and Kwana Lechiile
The Botswana Gastroenteritis Research Collaboration, from left: David Goldfarb, Charles Muthoga, Disaro Jack, Jeff Pernica and Kwana Lechiile.

Medical researchers from McMaster University have created a new, inexpensive diagnostic tool that can be used to save the lives of children with severe diarrhoeal diseases.

Diarrhoeal disease is the second leading cause of death in the world for children under the age of five. Gastroenteritis results in an estimated 760,000 child and infant deaths annually, and also leads to severe malnutrition, stunted growth, and cognitive delay for millions of other children.

To improve diarrhoeal diagnosis and treatment, researchers developed a flocked rectal swab, an innovative tool specially designed to collect samples from infants and children with severe diarrhoeal disease. Resembling a large Q-tip, the swab facilitates sample collection, eliminating the wait time required to gather stool samples as well as the biohazard that comes with transporting them.

The study was led by Dr. David Goldfarb (formerly from McMaster University, now at the University of British Columbia) and Dr. Jeffrey Pernica from the Division of Infectious Disease in the Department of Pediatrics. Dr. James Mahony and Dr. Marek Smieja from the Department of Pathology and Molecular Medicine of the Michael G. DeGroote School of Medicine at McMaster, were also among the study collaborators.

"The swab allows us to make an accurate diagnosis within a timely manner, and treat patients using the already existing and cost effective antibiotics," said Pernica. "It will help us improve the standard of care for children with severe diarrhoea, and can potentially help save the lives of thousands of children."

In a retrospective cohort study, researchers tested 671 babies admitted to a hospital in Botswana with gastroenteritis. The study showed that more than one third of these patients — including 17 of 26 children who died from the illness — had treatable bacterial or parasitic infections that went unrecognized at the hospital.

In a randomized, placebo-controlled pilot clinical trial, researchers also tested the effects of same-day diagnosis followed by appropriate and timely treatment.  Children that underwent rapid diagnosis were 55 per cent less likely to have persisting diarrhoea, compared to children that received standard supportive care. Researchers also found that after 60 days, children randomized to the rapid-diagnosis arm exhibited a clinically significant height increase.

"With improved diagnosis and faster treatment for diarrhoeal disease, there is an opportunity to have a major impact on the global child health," said Pernica. "

The study was made possible through a grant from federally funded Grand Challenges Canada, and published by the Journal of the Pediatric Infectious Diseases Society on May 16, 2015.

Video — Point of Care Diagnostics: Dr. Goldfarb and Co-Investigator Dr. Quaye

The best diagnostic tests are useless without properly collected specimens. The objective of this Botswana-based collaboration led by Dr. David Goldfarb is to design and evaluate a user-friendly flocked swab specimen collection system for the identification of enteric infections. This could have immediate impact in much of the world were diarrheal disease remains deadly and for the large part undiagnosed.

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