Title
Protection from Natural Immunity against Enteric Infections and Etiology-Specific Diarrhea in a Longitudinal Birth Cohort
Date Issued
01 December 2020
Access level
open access
Resource Type
journal article
Author(s)
Rogawski McQuade E.T.
Liu J.
Kang G.
Lima A.A.M.
Bessong P.O.
Samie A.
Haque R.
Mduma E.R.
Shrestha S.
Leite J.P.
Bodhidatta L.
Iqbal N.
Page N.
Kiwelu I.
Bhutta Z.
Ahmed T.
Houpt E.R.
Platts-Mills J.A.
Publisher(s)
Oxford University Press
Abstract
Background: The degree of protection conferred by natural immunity is unknown for many enteropathogens, but it is important to support the development of enteric vaccines. Methods: We used the Andersen-Gill extension of the Cox model to estimate the effects of previous infections on the incidence of subsequent subclinical infections and diarrhea in children under 2 using quantitative molecular diagnostics in the MAL-ED cohort. We used cross-pathogen negative control associations to correct bias due to confounding by unmeasured heterogeneity of exposure and susceptibility. Results: Prior rotavirus infection was associated with a 50% lower hazard (calibrated hazard ratio [cHR], 0.50; 95% confidence interval [CI], 0.41-0.62) of subsequent rotavirus diarrhea. Strong protection was evident against Cryptosporidium diarrhea (cHR, 0.32; 95% CI, 0.20-0.51). There was also protection due to prior infections for norovirus GII (cHR against diarrhea, 0.67; 95% CI, 0.49-0.91), astrovirus (cHR, 0.62; 95% CI, 0.48-0.81), and Shigella (cHR, 0.79; 95% CI, 0.65-0.95). Minimal protection was observed for other bacteria, adenovirus 40/41, and sapovirus. Conclusions: Natural immunity was generally stronger for the enteric viruses than bacteria, potentially due to less antigenic diversity. Vaccines against major causes of diarrhea may be feasible but likely need to be more immunogenic than natural infection.
Start page
1858
End page
1868
Volume
222
Issue
11
Language
English
OCDE Knowledge area
Enfermedades infecciosas
GastroenterologÃa, HepatologÃa
Subjects
Scopus EID
2-s2.0-85095966517
PubMed ID
Source
Journal of Infectious Diseases
ISSN of the container
00221899
Sponsor(s)
National Institute of Allergy and Infectious Diseases, K01AI130326, K23AI114888, NIAID.
Sources of information:
Directorio de Producción CientÃfica
Scopus