Epidemiological trends of acute watery diarrhea (AWD) across all age groups at Cumilla General Hospital: Retrospective cross-sectional insights from AWD surveillance data of 2022 to 2024.

Authors

Habib Md Ahashan, Sarker Mohammad Ferdous Rahman, Ahmed Tanvir, Hasan Md Rafiul, Islam Md Taufiqul, Khan Zahid Hasan, Amin Mohammad Ashraful, Ahmed Quazi Zaki, Hossain Rakib, Rahman Urmila, Shirin Tahmina, Qadri Firdausi, Khan Ashraful Islam

Published in

IJID regions. Volume 20. Pages 100916. Epub May 22, 2026.

Abstract

Acute watery diarrhea (AWD) remains prevalent (16/1000 population) in Bangladesh. Nationwide AWD surveillance has been active since 2014 across 16 sentinel sites. With an estimated >100,000 cases and approximately 3,500 deaths annually, cholera remains a critical public health concern. This study analyzed AWD surveillance data from June 2022 to September 2024.
Suspected cholera cases (rapid diagnostic test [RDT]-positive and culture/polymerase chain reaction [PCR]-positive for cholera) were identified using the United States Centers for Disease Control and Prevention (CDC) clinical definitions, RDTs, and microbiological culture. Socio-demographic, clinical, and etiological characteristics were examined descriptively. Cases identified using the Cholkit RDT.
Among 977 cases, 49 (5%) were RDT-positive for cholera. Culture was not conducted in 41/49 (84%) cases. Children aged <5 years were predominantly affected (56.1%). Two culture-positive cases were RDT-negative. Suspected case surges occurred in November and January. All cases reported drinking untreated water and not using soap after defecation; 67.45% consumed roadside food. Alarmingly, 90% (881/977) of suspected cases had taken antibiotics before hospital admission. The Cumilla Adarsha Sadar sub-district bore the highest burden (66.8% of suspected cases). RDT-positive cases showed variation across demographic and clinical characteristics.
The study indicates a substantial burden of AWD, with a small proportion of cases testing RDT-positive for cholera. Enhancing diagnostic capacity particularly microbiological culture use is essential for accurate detection. Public health efforts must prioritize promotion of safe water and handwashing practices.

PMID:
42382012
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

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