Title
Enteroaggregative Escherichia coli Subclinical Infection and Coinfections and Impaired Child Growth in the MAL-ED Cohort Study
Date Issued
01 February 2018
Access level
metadata only access
Resource Type
journal article
Author(s)
Lima A.A.M.
Soares A.M.
Filho J.Q.S.
Havt A.
Lima I.F.N.
Lima N.L.
Abreu C.B.
Francisco S.
Mota R.M.S.
Pan W.K.Y.
Troeger C.
Medeiros P.H.Q.S.
Veras H.N.
Prata M.A.
McCormick B.J.J.
McGrath M.
Rogawski E.T.
Houpt E.R.
Platts-Mills J.A.
Gratz J.
Samie A.
Bessong P.
Babji S.
Kang G.
Qureshi S.
Shakoor S.
Bhutta Z.A.
Haque R.
Ahmed T.
Mduma E.R.
Svensen E.
Yori P.P.
Bodhidatta L.
Jasmin S.
Mason C.J.
Lang D.
Gottlieb M.
Guerrant R.L.
Johns Hopkins University
Publisher(s)
Lippincott Williams and Wilkins
Wiley-Blackwell
Abstract
Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infection alone and in combination with other pathogens in the first 6 months of life on child growth. Methods: Nondiarrheal samples from 1684 children across 8 Multisite Birth Cohort Study, Malnutrition and Enteric Diseases (MAL-ED) sites in Asia, Africa, and Latin America were tested monthly; more than 90% of children were followed-up twice weekly for the first 6 months of life. Results: Children with subclinical EAEC infection did not show altered growth between enrollment and 6 months. Conversely, EAEC coinfection with any other pathogen was negatively associated with delta weight-for-length (P < 0.05) and weight-for-age (P > 0.05) z scores between 0 and 6 months. The presence of 2 or more pathogens without EAEC was not significantly associated with delta weight-for-length and weight-for-age. The most frequent EAEC coinfections included Campylobacter spp, heat-labile toxin-producing enterotoxigenic E coli, Cryptosporidium spp, and atypical enteropathogenic E coli. Myeloperoxidase levels were increased with EAEC coinfection (P < 0.05). EAEC pathogen codetection was associated with lower neopterin levels compared to those of no-pathogen control children (P < 0.05). Mothers of children with EAEC coinfections had lower levels of education, poorer hygiene and sanitation, lower socioeconomic status, and lower breast-feeding rates compared to mothers of children in whom no pathogen was detected (P < 0.05). Conclusions: These data emphasize the public health importance of subclinical EAEC infection in early infancy in association with other pathogens and the need for improved maternal and child care, hygiene, sanitation, and socioeconomic factors.
Start page
325
End page
333
Volume
66
Issue
2
Language
English
OCDE Knowledge area
Gastroenterología, Hepatología
Subjects
Scopus EID
2-s2.0-85041555976
PubMed ID
Source
Journal of Pediatric Gastroenterology and Nutrition
ISSN of the container
0277-2116
Sponsor(s)
The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. The authors thank the staff and participants of the MAL-ED Network for their important contributions
Research Institute of Medical Sciences, Kathmandu, Nepal, and the zzzFoundation for the National Institutes of Health, Baltimore, MD.
Acknowledgments: The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. The authors thank the staff and participants of the MAL-ED Network for their important contributions.
Universidade Federal do Ceara, Fortaleza, Ceará, Brazil, the †Duke Global Health Institute, Duke University, Durham, NC, the zInstitute for Health Metrics and Evaluation, Seattle, WA, the §National Institutes of Health, Fogarty International Center, Bethesda, MD, the ||Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, the ôDepartment of Microbiology, University of Venda, the #Division of Gastrointestinal Sciences, Christian Medical College and Hospital Vellore, Vellore, India, the **Department of Gastrointestinal Sciences Christian Medical College, the ††Aga Khan University, the zzDepartment of Pediatrics, Aga Khan University, Naush-ahro Feroze, Pakistan, the §§International Centre for Diarrhoeal Disease Research, ICDDR-B, Dhaka, Bangladesh, the ||||Haydom Lutheran Hospital, Moshi, Tanzania, the ôôHaukeland University Hospital, Haydom, Tanzania, the ##Johns Hopkins University, Baltimore, MD, the
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