Gastroenteritis is a serious health problem in Pakistan

Non-viral gastroenteritis is an infection of the stomach and intestines by harmful microorganisms, causing diarrhea, nausea and dehydration | File Cambio16/Reuters Earlham.ac.uk

Gastroenteritis is a major public health problem in Pakistan. Official entities estimate that approximately 60,000 people die each year and account for nearly 60% of child deaths during that period. More than one-third of children under five have been treated for diarrhea. Realizing this reality and that this painful situation can be avoided, a group of experts developed the GastroPack project.

Pakistan is one of the countries most affected by climate change. Severe and prolonged droughts and heavy rains lead to devastating floods. The 2022 disaster left thousands of homes flooded, more than 1,500 people dead, bridges and roads destroyed, crops lost, and more than 33 million people affected.

Non-viral gastroenteritis is an infection of the stomach and intestines by harmful microorganisms. It can cause diarrhea, nausea, and dehydration. It is a leading cause of death in Pakistan. Climate change is exacerbating unhealthy conditions and drinking water shortages. Not only can they lead to dehydration and malnutrition, but they can also trigger gastroenteritis. Children and the elderly are the most vulnerable.

Chris Quince, a professor and researcher at the Earlham Institute and the Quadram Institute, co-leads the GastroPak project. This is a multidisciplinary initiative to explore the cultural, social, health and microbial factors that influence the spread of gastroenteritis organisms. “This disease is a major public health burden for Pakistan’s more than 225 million residents,” he said.

Gastroenteritis epidemic in Pakistan

The GastroPak project includes social scientists, microbiologists, engineers, epidemiologists, chemists and statisticians. It focuses on agriculture, sanitation, drinking water, food, general hygiene and person-to-person contact. “We are trying to understand the factors that exacerbate the spread of gastroenteritis in Pakistan. We analyze not only biological factors but also factors including drinking water supplies, sanitation engineering solutions, food growing patterns and social dynamics,” details Quince.

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Earlier this year, international participants received two weeks of training in microbiome, bioinformatics and statistical analysis at the Earlham Institute. The goal was to develop a rapid qPCR-based screening test for the detection of bacteria and parasites associated with gastroenteritis. They may include Campylobacter and E. coli, as well as the parasites Cryptosporidium and Giardia.

Researchers will track the sources of harmful microorganisms by performing whole-genome sequencing in multiple environments, allowing scientists to test transmission pathways. For example, bacteria can be transferred from soil to fruits or vegetables. «We are working on using DNA sequencing technology to produce tests that are low-cost, easily transportable, fast and reliable. “They have the potential to open up new ways of preventing disease,” he explains.

The information gained and the new molecular tools developed to combat non-viral gastroenteritis transmission will be transferable to other countries at high risk for gastroenteritis.

GastroPack project, alternative

The second line is to raise awareness of social issues. The organization is also trying to meet with individuals or companies in Pakistan who are interested in drinking water and food, sanitation and public health, which are fundamental in dealing with gastroenteritis. Many bacteria and parasites can cause gastroenteritis. Some are found in water, some in meat, and some in salads. Shortage of drinking water is an important reason for the high incidence of non-viral gastroenteritis in Pakistan.

“If we are able to identify the source of bacterial gastroenteritis, then we (or our NGO partners such as the World Health Organization) will be able to carry out appropriately targeted campaigns to prevent transmission. “If the majority of the contamination is occurs through water, then we emphasize water treatment rather than hygiene practices. In fact, this information can be very useful to the people themselves. It provides them with evidence that they can present to policymakers to create real change. “Much of this work will involve addressing cultural issues, and our partners in Pakistan are determining how best to address these issues.”

Working across disciplines with Pakistani partners means the work will be embedded in Pakistani culture from the outset. It is created and shaped by the people and intended to benefit the people. Hopefully, the lessons learned in Pakistan will be applicable to other countries where non-viral gastroenteritis is endemic.

The GastroPak project will deploy equipment and protocols to detect different species of non-viral gastroenteritis pathogens. These samples will then be used to investigate pathogens in the environment, livestock and local communities.

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