###### Abstract  
Acute gastroenteritis (AGE) contributes to increased morbidity and mortality worldwide. In particular, children in resource-poor settings suffer from frequent episodes of diarrhea. A variety of pathogens, including bacteria, viruses, fungi, and protozoa, can cause AGE. Common viruses associated with AGE are norovirus, rotavirus, adenovirus, and sapovirus. Due to their similar clinical presentation, AGE pathogens cannot be distinguished on clinical grounds rendering the etiological diagnosis challenging. However, reliable diagnosis is essential for individual and public health reasons, e.g., to limit transmission, for appropriate antibiotic use, prognostic appreciation, and vaccination programs. Therefore, high-quality data derived by accurate diagnostics are important to improve global health. In Western industrialized countries, diagnosis relies on microbiological testing, including culture methods, microscopy, immunocompromised, and single-target molecular methods. Recently, multiplex PCR or syndromic panels have been introduced, which simultaneously analyze for multiple pathogens in a very short time. A further technological advancement is cartridge-based syndromic panels, which allow for near patient/point-of-care testing independently from a laboratory. In resource-poor tropical regions, however, laboratory diagnosis is rarely established, and there are little routine laboratory data on the epidemiology of viral AGE pathogens. Limiting factors for the implementation of syndromic panels are high costs, sophisticated equipment, and the need for trained personnel. In addition, pilot studies have shown a large number of viral (co-)detections among healthy controls, thus further challenging their clinical utilization. Hence, there are little evidence-based data on the impact of multiplex syndromic panels from resource-limited regions. Here, we aim to provide a brief overview of what is known about the use of syndromic panels for virus-associated AGE in tropical regions and to address future challenges. molecular methods; multiplex syndromic panels; acute viral gastroenteritis; resource-poor settings; tropics +
Footnote †: journal: Medical Medicine and Infectious Disease  
particular, constitute the most vulnerable population in tropical regions; around 2 million deaths occur each year, mainly those with malnutrition [5]. Based on data from a large multicentric children cohort study from eight resource-poor sites (Banglades, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania), a predominant viral cause (36.4%) could be identified by quantitative RT-PCR, followed by bacterial (25.0%) and parasitic (3.5%) (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED), [6]). Common viruses associated with childhood AGE in the resource-poor settings, in descending order, are rotavirus, enteric adenovirus (types 40/41), sapovirus, norovirus, and astrovirus [7; 8; 6]. Virus transmission is facilitated by unfavorable socioeconomic levels with cramped and crowded households, malnutrition, contaminated water or food, poor sanitation and hygiene, and climatic conditions that allow environmental contamination by pathogens [9]. All of these could possibly explain the high disease burden of AGE in developing countries, where large and explosive outbreaks can occur (e.g., in refugee camps) [10]. Outbreaks can also occur, e.g., in hospitals, long-term care facilities (LTCF), or nursing homes. Traditional methods for the detection of AGE pathogens include laborious and time-consuming stool cultures, antigen detection methods, and microscopy. In addition, all of these traditional techniques are less sensitive and specific compared to nucleic acid amplification techniques (NAT) [11]. However, timely diagnosis may prevent adverse patient outcomes and stop further spread by rapid isolation precautions, e.g., in a hospital or an LTCF setting.