Etiology of Diarrhea in Bangladeshi Infants in the First Year of Life Analyzed Using Molecular Methods

Taniuchi, Mami; Sobuz, Shihab U.; Begum, Sharmin; Platts-Mills, James A; Liu, Jie; Yang, Zhengyu; Wang, Xin-Qun; Petri, William A.; Haque, Rashidul; Houpt, Eric R.

doi:10.1093/infdis/jit507

Cited by 159 publications

(179 citation statements)

References 30 publications

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“…Similarly, PCR-based detection of C. jejuni/C. coli in Malawi revealed a substantially higher burden of disease than had been previously reported (20), and we recently found a 20 to 40% detection rate in a different cohort of Bangladeshi children using a PCR-based approach (21). This contrasts with the previously described comparable performance of culture in comparison to that of immunoassay and PCR in children with diarrhea in the setting of more sporadic exposure (22), as well as in military personnel in settings where Campylobacter is endemic (23).…”

Section: Discussionsupporting

confidence: 63%

Detection of Campylobacter in Stool and Determination of Significance by Culture, Enzyme Immunoassay, and PCR in Developing Countries

et al. 2014

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iCampylobacter is a common bacterial enteropathogen that can be detected in stool by culture, enzyme immunoassay (EIA), or PCR. We compared culture for C. jejuni/C. coli, EIA (ProSpecT), and duplex PCR to distinguish Campylobacter jejuni/C. coli and non-jejuni/coli Campylobacter on 432 diarrheal and matched control stool samples from infants in a multisite longitudinal study of enteric infections in Tanzania, Bangladesh, and Peru. The sensitivity and specificity of culture were 8.5% and 97.6%, respectively, compared with the results of EIA and 8.7% and 98.0%, respectively, compared with the results of PCR for C. jejuni/C. coli. Most (71.6%) EIA-positive samples were positive by PCR for C. jejuni/C. coli, but 27.6% were positive for nonjejuni/coli Campylobacter species. Sequencing of 16S rRNA from 53 of these non-jejuni/coli Campylobacter samples showed that it most closely matched the 16S rRNA of C. hyointestinalis subsp. lawsonii (56%), C. troglodytis (33%), C. upsaliensis (7.7%), and C. jejuni/C. coli (2.6%). Campylobacter-negative stool spiked with each of the above-mentioned Campylobacter species revealed reactivity with EIA. PCR detection of Campylobacter species was strongly associated with diarrhea in Peru (odds ratio [OR] ‫؍‬ 3.66, P < 0.001) but not in Tanzania (OR ‫؍‬ 1.56, P ‫؍‬ 0.24) or Bangladesh (OR ‫؍‬ 1.13, P ‫؍‬ 0.75). According to PCR, Campylobacter jejuni/C. coli infections represented less than half of all infections with Campylobacter species. In sum, in infants in developing country settings, the ProSpecT EIA and PCR for Campylobacter reveal extremely high rates of positivity. We propose the use of PCR because it retains high sensitivity, can ascertain burden, and can distinguish between Campylobacter infections at the species level.

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Section: Discussionsupporting

confidence: 63%

Detection of Campylobacter in Stool and Determination of Significance by Culture, Enzyme Immunoassay, and PCR in Developing Countries

et al. 2014

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“…Our population had a high prevalence of pathogens detected via molecular multiplex assays, which is in keeping with other studies done on pediatric gastroenteritis in developing countries (17). As outlined in Materials and Methods, during the study, we changed our extraction method from the QIAsymphony platform to the easyMAG platform, as the easyMAG platform had become available at the laboratory in Botswana, and we planned to transition testing on site using this method.…”

Section: Discussionmentioning

confidence: 67%

Evaluation of Anatomically Designed Flocked Rectal Swabs for Molecular Detection of Enteric Pathogens in Children Admitted to Hospital with Severe Gastroenteritis in Botswana

et al. 2014

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f Two-hundred eighty matched bulk stool and anatomically designed flocked rectal swab samples were collected from children admitted to the hospital with acute diarrhea in Botswana. Their parents were asked about the acceptability of the swab collection method compared with bulk stool sampling. All samples underwent identical testing with a validated 15-target (9 bacterial, 3 viral, and 3 parasite) commercial multiplex PCR assay. The flocked swabs had a 12% higher yield for bacterial pathogen targets (241 versus 212; P ‫؍‬ 0.003) compared with that of stool samples, as well as similar yields for viral targets (110 versus 113; P ‫؍‬ 0.701) and parasite targets (59 versus 65; P ‫؍‬ 0.345). One hundred sixty-four of the flocked swab-stool pairs were also tested with separate laboratory-developed bacterial and viral multiplex assays, and the flocked rectal swabs had a performance that was similar to that seen with commercial assay testing. Almost all parents/guardians found the swabs acceptable. Flocked rectal swabs significantly facilitate the molecular diagnosis of diarrheal disease in children. Diarrheal disease remains a leading cause of global childhood morbidity and mortality, yet access to diagnostic laboratory testing is rarely available in much of the world. One of the barriers to diagnosing diarrheal disease, either for clinical or surveillance purposes, is the difficulty and time delays in obtaining and transporting a bulk stool specimen. Several investigators have sought to overcome this barrier through the use of rectal swab specimens for culture, molecular, and antigen testing, with variable results (1-5). Flocked swabs designed for respiratory and genitourinary sampling have been shown to acquire better samples than those acquired with more traditional spun fiber swabs (6, 7). We used a specially designed flocked rectal swab (FLOQSwabs; Copan Italia, Brescia, Italy) developed specifically for the diagnosis of diarrheal disease in children (Fig. 1) and then compared matched flocked rectal swabs to bulk stool samples in a clinical setting. The samples were collected from children admitted to the hospital in Botswana with severe acute gastroenteritis and tested using a U.S. FDAcleared commercial multiplex PCR assay in order to assess performance across a broad number of bacterial, viral, and parasitic pathogens.(These data were presented in part at the 29th Annual Clinical Virology Symposium, Daytona Beach, FL, 28 April to 1 May 2013, and at the Annual Pediatric Academic Society Meeting, Vancouver, Canada, 5 May 2014.) MATERIALS AND METHODSChildren Ͻ13 years of age who were admitted to the hospital with a diagnosis of acute gastroenteritis were enrolled prospectively at the Princess Marina Hospital in Gaborone, Botswana. Princess Marina Hospital is the largest referral hospital in Botswana.Clinical data were collected, and both the pediatric flocked rectal swab and bulk stool samples were obtained from each child as soon as possible after enrollment. The swab and stool samples were collected simultaneousl...

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“…Furthermore, repeated exposure to gastrointestinal pathogens can permanently harm the body's ability to absorb nutrition, reducing the effectiveness of compensatory household behavior or nutritional interventions (Lin et al 2013, Taniuchi et al 2013.…”

mentioning

confidence: 99%

Disgust, Shame, and Soapy Water: Tests of Novel Interventions to Promote Safe Water and Hygiene

Guiteras¹,

Levine²,

Luby³

et al. 2016

Journal of the Association of Environmental and Resource Econom

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Lack of access to clean water is among the most pressing environmental problems in developing countries, where diarrheal disease kills nearly 700,000 children per year. While inexpensive and effective practices such as chlorination and handwashing with soap exist, efforts to motivate their use by emphasizing health benefits have seen only limited success. This paper measures the effect of messages appealing to negative emotions (disgust at consumption of human feces) and social pressure (shame at being seen consuming human feces) on handwashing behavior and use of and willingness to pay for water chlorination among residents of slum compounds in Dhaka, Bangladesh. Neither the traditional, health-based message nor the new disgust and shame message led to high levels of chlorination during a free trial, nor to high willingness to pay for the chlorine at the end of the free trial. Provision of low-cost handwashing facilities did increase handwashing, although the effect size is modest.

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Etiology of Diarrhea in Bangladeshi Infants in the First Year of Life Analyzed Using Molecular Methods

Abstract: In this community-based study diarrhea seemed to be a multipathogen event and a state of enteropathogen excess above a high carriage baseline.

Cited by 159 publications

References 30 publications

Detection of Campylobacter in Stool and Determination of Significance by Culture, Enzyme Immunoassay, and PCR in Developing Countries

Detection of Campylobacter in Stool and Determination of Significance by Culture, Enzyme Immunoassay, and PCR in Developing Countries

Evaluation of Anatomically Designed Flocked Rectal Swabs for Molecular Detection of Enteric Pathogens in Children Admitted to Hospital with Severe Gastroenteritis in Botswana

Disgust, Shame, and Soapy Water: Tests of Novel Interventions to Promote Safe Water and Hygiene

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