The circumference is divided into 12 months in a clockwise direction, and the radius from inside to outside represents a particular year from 2009 to 2018. The seasonality was presented with a radar diagram based on the monthly positive rate from 2009 to 2018. Thirteen of the tested enteropathogens were formed into four clusters ( a‒ d). This allows enhanced identification of the predominant diarrheal pathogen candidates for diagnosis in clinical practice and more targeted application of prevention and control measures. Our findings fill crucial gaps of how the distributions of enteropathogens change across China in patients with diarrhea. A joinpoint analysis revealed the age-specific positivity rate and how this varied for individual pathogens. Patients aged <5 years had higher overall positive rate of viral pathogens, while bacterial pathogens were more common in patients aged 18‒45 years. Diarrheagenic Escherichia coli and nontyphoidal Salmonella are the two leading bacterial pathogens, followed by Shigella and Vibrio parahaemolyticus. Rotavirus A and norovirus are the two leading viral pathogens detected in the patients, followed by adenovirus and astrovirus. Here we report the etiological, epidemiological, and clinical features of the 152,792 eligible patients enrolled in this analysis. National-based prospective surveillance of all-age patients with acute diarrhea was conducted in China between 2009‒2018.
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