BackgroundAcute diarrhea is a global health problem, resulting in high morbidity and mortality in children. It has been suggested that enteric pathogen co-infections play an important role in gastroenteritis, but most research efforts have only focused on a small range of species belonging to a few pathogen groups. This study aimed to assess the impact of co-infections with a broad range of enteric pathogens on children aged below five years who suffer from acute diarrhea in southwest China.MethodA total of 1020 subjects (850 diarrhea cases and 170 healthy controls) were selected from four sentinel hospitals in Kunming, Yunnan province, southwest China, from June 2014 to July 2015. Stool specimens were collected to detect five virus (rotavirus group A, RVA; norovirus, NoV; Sapovirus, SaV; astrovirus, As; and adenovirus, Ad), seven bacterial (diarrheagenic Escherichia coli, DEC; non-typhoidal Salmonella, NTS; Shigella spp.; Vibrio cholera; Vibrio parahaemolyticus; Aeromonas spp.; and Plesiomonas spp.), and three protozoan (Cryptosporidium spp., Giardia lamblia, and Blastocystis hominis, B. hominis) species using standard microbiologic and molecular methods. Data were analyzed using the partial least square regression technique and chi-square test.ResultsAt least one enteric pathogen was detected in 46.7 % (n = 397) of acute gastroenteritis cases and 13.5 % (n = 23) of healthy controls (χ2 = 64.4, P < 0.05). Single infection with RVA was associated with acute diarrhea (26.5 % vs. 5.8 %, P < 0.05). The prevalence of a single infection with B. hominis in diarrhea cases was higher than in healthy controls (3.1 % vs. 0.5 %, OR = 4.7, 95 % CI: 1.01–112.0). Single infection with NoV GII was not associated with diarrhea (4.4 % vs. 3.5 %, OR = 1.2, 95 % CI: 0.5–3.3). Single infections with bacterial species were not observed. The prevalence of co-infections with two enteric pathogens in diarrhea cases was higher than in asymptomatic children (20.1 % vs. 5.3 %, P < 0.05). RVA-NoV GII was the most common co-infection in symptomatic children (4.4 %), with it aggravating the severity of diarrhea.ConclusionsAlthough it is clear that RVA has an overwhelming impact on diarrhea illnesses in children, co-infection with other enteric pathogens appears to also aggravate diarrhea severity. These findings should serve as evidence for public health services when planning and developing intervention programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0157-2) contains supplementary material, which is available to authorized users.

Body size of large herbivores is a crucial life history variable influencing individual fitness‐related traits. While the importance of this parameter in determining temporal trends in population dynamics is well established, much less information is available on spatial variation in body size at a local infra‐population scale. The relatively recent increase in landscape fragmentation over the last century has lead to substantial spatial heterogeneity in habitat quality across much of the modern agricultural landscape. In this paper, we analyse variation in body mass and size of roe deer inhabiting a heterogeneous agricultural landscape characterised by a variable degree of woodland fragmentation. We predicted that body mass should vary in relation to the degree of access to cultivated meadows and crops providing high quality diet supplements. In support of our prediction, roe deer body mass increased along a gradient of habitat fragmentation, with the heaviest deer occurring in the most open sectors and the lightest in the strict forest environment. These spatial differences were particularly pronounced for juveniles, reaching >3 kg (ca 20% of total body mass) between the two extremes of this gradient, and likely have a marked impact on individual fates. We also found that levels of both nitrogen and phosphorous were higher in deer faecal samples in the more open sectors compared to the forest environment, suggesting that the spatial patterns in body mass could be linked to the availability of high quality feeding habitat provided by the cultivated agricultural plain. Finally, we found that adults in the forest sector were ca 1 kg lighter for a given body size than their counterparts in the more open sectors, suggesting that access to nutrient rich foods allowed deer to accumulate substantial fat reserves, which is unusual for roe deer, with likely knock‐on effects for demographic traits and, hence, population dynamics.

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