Gastroenteritis in Young Children and Water Quality in Rural Areas With Intensive Animal Farming Activities

ISEE-188 Objective: To (1) describe the microbial etiology of cases of diarrhea in hospitalized children aged 6 months to 4 years and (2) study the possible association between diarrhea and drinking water quality characteristics, in a rural area with intensive farming activities. Material and Methods: This is a regional population-based case-control study with 180 cases and 360 controls matched for age. Parents of children aged 6 months to 4 years of age, hospitalized in the 5 hospitals used by the residents of the study region, were selected for participation. After obtaining consent, fecal samples were obtained and analyzed for bacteria, viruses, and parasites. Controls were sampled from public health insurance database that covers all the families in Quebec. Parents of cases and controls were interviewed by phone for gastrointestinal symptoms, water consumption as well as risk factors for gastroenteritis (contact with diseased persons, animals, raw foods, recreational activities, travel, etc). When a groundwater well was used as the source of drinking water (which was expected in about 30% of controls), a sample of tap water was taken within 2 weeks after hospitalization and analyzed for Escherichia coli, enterocci, and coliphages. If their tap water was obtained from a municipal distribution system, its quality was inferred by means of a semiquantitative multicriteria method based on indicators of quality of water source, type of treatment, and operational efficacy. Results: Preliminary results will be presented, including a description of water quality characteristics and etiology of the disease in cases. Observed risk factors for diarrhea will also be presented with an estimation of their attributable fraction. Conclusions: Gastroenteritis is more frequent in young children, and water quality in areas with intensive farming could be partly responsible for an increase of occurrence in rural regions. The present study should help to clarify the impact of animal farming activities.