Pathogens causing diarrhoea among Bangladeshi children with malignancy: Results from two pilot studies

Table 1 Patient demographics and laboratory results of hospitalised paediatric oncology patients with diarrhoea at Bangabandhu Sheikh Mujib Medical University hospital, n (%)

Particulars	Study 11	Study 22
Male:Female	32:19	47:19
Age in mo, range (mean)	13-180 (70.8)	11-216 (73.2)
Age group
≤ 60 mo	32 (55.2)	41 (58.6)
61-120 mo	16 (27.6)	15 (21.4)
> 120 mo	10 (17.2)	14 (20)
Diagnosis
ALL	37 (63.8)	40 (57.1)
NHL	17 (29.4)	10 (14.3)
AML	4 (7.9)	7 (10)
Others		1 (1.4)
Solid tumours		12 (17.1)
Phase of treatment
Induction	37 (63.8)	43 (61.4)
Consolidation	14 (24.1)	10 (14.3)
Maintenance	6 (10.3)	12 (17.1)
Not applicable	1 (1.7)	5 (7.1)
ANC category
< 500/mm3	47 (81)	42 (60)
≥ 500/mm3	11 (19)	28 (40)
Number of bowel motions/d
≥ 10	29 (50)	10 (14.2)
6-9	19 (32.8)	40 (57.1)
≤ 5	10 (17.2)	20 (28.6)
Pathogens detected in stool samples
Giardia lamblia	37 (68.5)2	1 (1.4)
Entamoeba histolytica	7 (13)2	7 (10)
Cryptosporidium	3 (5.6)2	3 (4.3)
Clostridium difficile	13 (22.4)	2 (5.1)2
Campylobacter jejuni	2 (3.4)	1 (1.4)
Salmonella spp	1 (1.7)	1 (1.4)
Shigella sonnei	0 (0)	1 (1.4)
Vibrio cholerae	0 (0)	1 (1.4)

¹Each episode of diarrhoea was included as a separate event counting towards the denominator used for each characteristic, with the exception of gender (where each child was counted only once irrespective of the number of episodes of diarrheal experienced);

²In the first study, only 54 of the total 58 samples were processed by polymerase chain reaction for parasites, and in the second study Clostridium difficile was investigated in only 39 randomly selected samples out of the total 70 samples, of which 2 were positive, none were toxin-positive. ALL: Acute lymphoblastic leukaemia; AML: Acute myeloblastic leukaemia; ANC: Absolute neutrophil count per µL; NHL: Non-Hodgkin’s lymphoma.

Table 2 Summary of paediatric oncology patients with diarrhoea from whose stool samples Cryptosporidium was detected

Patients	Age in yr	Gender	Primary diagnosis	Phase of treatment	Preceding hospital stay in d1	Frequency of bowel motions/d	Fever	Mucositis	Stool microscopy	ANC
Study 1
Patient 1	4.5	Male	NHL	Induction	15	16	Present	Present	11-20 pus cells per HPF	150
Patient 2	3.5	Male	ALL	Maintenance	0	6-9	Present	Absent	> 50 pus cells per HPF	20
Patient 3	6	Male	ALL	Maintenance	0	3	Present	Absent	> 10 per HPF	180
Study 2
Patient 1	4	Male	RMS	Induction	7	> 10	Absent	Absent	Normal	790
Patient 2	5	Female	PNET	Induction	0	6-9	Present	Present	Pus cells	20
Patient 3	2.5	Male	ALL	Induction	22	6-9	Present	Absent	Normal	40

¹Days in hospital prior to the onset of diarrhoea. ALL: Acute lymphoblastic leukaemia; ANC: Absolute neutrophil count per µL; HPF: High power field; NHL: Non-Hodgkin’s lymphoma; PNET: Primitive neuroectodermal tumour; RMS: Rhabdomyosarcoma.