{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:41:42Z","timestamp":1790876502571,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infectious causes of diarrhea contribute significantly to morbidity in Asia. We conducted a systematic review and meta\u2010analysis of the prevalence of infectious etiologies of persistent and chronic diarrhea in Asian adults. Searches were performed on PubMed and Scopus for studies from January 1, 1970, to May 30, 2023. Sixteen studies were identified and included. The meta\u2010analysis was conducted with the random\u2010effects method, estimating the pooled prevalence of groups of infectious pathogens as causes of persistent and chronic diarrhea among Asian adults. The findings were highly heterogeneous and indicative of publication bias. The majority of studies were conducted on persons living with human immunodeficiency virus infection (PLHIV). The studies were predominantly from low\u2010income and middle\u2010income Asian countries. The most common cause was parasitic, with a pooled prevalence of 0.52 (95% confidence interval 0.28\u20130.65, I<jats:sup>2<\/jats:sup>\u00a0=\u00a099%, Cochran's Q\u00a0=\u00a01027.44, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01), followed by bacterial, fungal, and viral causes, which were substantially rarer. Negative microbiological testing was also common, with a pooled prevalence for a negative test being 0.37 (95% confidence interval 0.17\u20130.52, I<jats:sup>2<\/jats:sup>\u00a0=\u00a099%, Cochran's Q\u00a0=\u00a01027.44, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Subgroup analyses of studies conducted among PLHIV, from year 2000 and among those conducted in Southeast Asia showed a similar prevalence of parasitic causes of diarrhea. In conclusion, in\u00a0Asian adults with persistent and chronic diarrhea, parasitic causes were most prevalent. However, the estimate of true prevalence is limited by significant heterogeneity among the available studies. More study in this field is required, especially examining PLHIV in the post\u2010antiretroviral therapy era and from high\u2010income countries.<\/jats:p>","DOI":"10.1111\/jgh.16613","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T01:34:28Z","timestamp":1715650468000},"page":"1760-1768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Infectious etiologies of persistent and chronic diarrhea in Asian developing countries: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7374-8207","authenticated-orcid":false,"given":"Matthew Chung Yi","family":"Koh","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine National University Health System  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi Ni","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine National University Health System  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghao Nicholas","family":"Ngiam","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine National University Health System  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Anantharajah","family":"Tambyah","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine National University Health System  Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"},{"name":"Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kewin Tien Ho","family":"Siah","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine National University Health System  Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12704"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102017\u2010315909"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7833"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116483"},{"key":"e_1_2_9_6_1","first-page":"472","article-title":"Chronic diarrhea in adults: evaluation and differential diagnosis","volume":"101","author":"Burgers K","year":"2020","journal-title":"Am. 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