Prevalence and genetic characterization of in relation to diarrhea in Limpopo and Gauteng provinces, South Africa.

Background: Very few studies have determined the prevalence and assemblage distribution of in South Africa. The present study aimed to ascertain the prevalence of infection and the spread of the various assemblages in two communities in South Africa - Giyani, Limpopo province (rural community) and Pretoria Guateng province (urban community).

Methods: Prevalence was determined by immunological and molecular methods analyzing a total of 516 stool samples collected from patients visiting different health centres in Giyani and Pretoria. For immunological assays, samples were screened by ELISA to detect antigen. Furthermore, a semi nested PCR amplifying the triose phosphate isomerase (tpi) gene was used to differentiate between the two most common human assemblages (A and B).

Findings: Of the 516 participants, 40 (7.75%) were identified as positive by ELISA. A statistically significant correlation was observed between the stool texture and infection (ᵡ = 10.533;  = .005). was significantly associated with watery stool types in females  = .008. Furthermore, a significant association was also noticed between the origin of samples (ᵡ = 9.725;  = .002). No significant correlation between age and gender was noted. Regarding the age groups, most people who were infected were between 3 and 20 years. A statistically significant association was seen ( = .001) with the distribution of the pathogen with the stool type. The prevalence of infection was higher in watery stool samples (71.4%) in Giyani region (rural) whereas in Pretoria, high prevalence was found in loose stool samples (6.2%). Generally, the distribution was statistically significant in the stool type collected for the study ( = .005). Genotyping revealed more assemblage B (17.8%) than assemblage A (1.7%). Furthermore, 21.0% of the samples exhibited single infection while 4.2% had mixed infections. Assemblage B was more common in Giyani than in urban Pretoria.

Conclusions: The study confirms as an important cause of diarrhea in the concerned communities with people in rural areas more at risk compared to those in urban areas with higher prevalence among younger patients. Therefore, health education campaigns should target young age groups.