Bacterial Pathogens in Acute Gastroenteritis via Contaminated Drinking Water in Developing Countries

Introduction

Acute gastroenteritis is a universal infectious disease syndrome with the combined occurrence of nausea, vomiting, diarrhea, and abdominal pain out of infection and inflammation of the gastrointestinal tract, involving both the stomach and small intestine caused by a wide range of infectious agents (Fletcher et al., 2013). A variety of microorganisms including bacteria, viruses, and protozoa or their toxins are the infectious agents responsible for the disease (Gerba, 2015). Acute gastroenteritis is a major cause of mortality and morbidity in developing countries. It is also the third leading cause of mortality in the world (Salami et al., 2019). Recently it was estimated that children less than three years of age had three episodes of the infection per year in developing countries (Garcia et al., 2020). According to World Health Organization (WHO) statistics, gastroenteritis accounts for 3.2% of all deaths worldwide each year and has the 5^th highest burden of diseases, expressed in DALY’s (Anderson et al., 2020). Contaminated food is the major cause behind acute gastroenteritis even though water-borne transmission through recreational and contaminated drinking water also has been well documented (Ahmed et al., 2018). An estimated 94% of the gastroenteritis burden of disease is attributable to the environment and associated with risk factors such as unsafe drinking water, lack of sanitation, and poor hygiene (Cisse, 2019). Increasing incidents of infection via contaminated drinking water are now a major public health concern in both developing and undeveloped countries (Sharma et al., 2017). According to the World Health Organization (WHO), there were estimates of 4 billion cases of diarrhea and 2.2 million deaths annually in these countries due to consumption of unsafe drinking water (Osiemo et al., 2019). In recent days viral gastroenteritis is much focused on, but bacterial acute gastroenteritis is underestimated. Changed etiology and continued outbreaks which increased antibiotic resistance may bring back acute gastroenteritis to the center. This review paper attempts to determine the role of bacterial pathogens in acute gastroenteritis via drinking water in developing countries.