vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

Chisenga, Caroline Cleopatra; Bosomprah, Samuel; Laban, Natasha Makabilo; Mwila-Kazimbaya, Katayi; Mwaba, John; Simuy, Michelo; Chilengi, Roma

doi:10.21767/2573-0282.100064

Cited by 24 publications

(33 citation statements)

References 23 publications

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“…However, it must be emphasized that our study was entirely conducted in a very disadvantaged community with poor sanitation and very few resources. We are aware of only one other study in Zambia using the same diagnostic tool 33 ; that study included rural areas and a broader range of urban socio-economic conditions and found carriage rates about half of those reported in this study. Molecular diagnosis has been widely used for analysis of enteropathogen burden and the xTAG GPP panel has been reported to deliver accurate pathogen detection 34 , 35 .…”

Section: Discussionmentioning

confidence: 99%

Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting

et al. 2021

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Environmental enteropathy is a major contributor to growth faltering in millions of children in Africa and South Asia. We carried out a longitudinal, observational and interventional study in Lusaka, Zambia, of 297 children with stunting (aged 2–17 months at recruitment) and 46 control children who had good growth (aged 1–5 months at recruitment). Control children contributed data only at baseline. Children were provided with nutritional supplementation of daily cornmeal-soy blend, an egg and a micronutrient sprinkle, and were followed up to 24 months of age. Children whose growth did not improve over 4–6 months of nutritional supplementation were classified as having non-responsive stunting. We monitored microbial translocation from the gut lumen to the bloodstream in the cohort with non-responsive stunting (n = 108) by measuring circulating lipopolysaccharide (LPS), LPS-binding protein and soluble CD14 at baseline and when non-response was declared. We found that microbial translocation decreased with increasing age, such that LPS declined in 81 (75%) of 108 children with non-responsive stunting, despite sustained pathogen pressure and ongoing intestinal epithelial damage. We used confocal laser endomicroscopy and found that mucosal leakiness also declined with age. However, expression of brush border enzyme, nutrient transporter and mucosal barrier genes in intestinal biopsies did not change with age or correlate with biomarkers of microbial translocation. We propose that environmental enteropathy arises through adaptation to pathogen-mediated epithelial damage. Although environmental enteropathy reduces microbial translocation, it does so at the cost of impaired growth. The reduced epithelial surface area imposed by villus blunting may explain these findings.

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Section: Discussionmentioning

confidence: 99%

Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting

et al. 2021

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“…Samples were shipped frozen with temperatures monitors to the Georgia Institute of Technology (Atlanta, USA) where we used the xTAG GPP (Luminex Corp, Austin, USA), a qualitative multiplex molecular assay, to detect 15 enteric pathogens in stool samples: Campylobacter jejuni/coli/lari; Clostridium difficile , toxin A/B; enterotoxigenic Escherichia coli (ETEC) LT/ST; Shiga-like toxin producing E. coli (STEC) stx1/stx2; E. coli O157; Salmonella; Shigella boydii/sonnei/flexneri/dysenteriae; Vibrio cholerae; Yersinia enterocolitica; Giardia lamblia; Cryptosporidium parvum/hominis; Entamoeba histolytica; adenovirus 40/41; norovirus GI/GII; and rotavirus. The GPP has been rigorously tested and extensively used for stool-based enteric pathogen detection ( Chisenga et al, 2018 ; Claas, 2013 ; Deng et al, 2015 ; Duong et al, 2016 ; Huang et al, 2016 ; Kellner et al, 2019 ; Khare et al, 2014 ; Navidad et al, 2013 ; Patel et al, 2014 ). We analyzed samples according to manufacturer instructions with the addition of elution steps for the pretreatment of rectal swabs and diaper material saturated with liquid stool (Appendix 1- Consent procedures, survey administration, and specimen collection and analysis).…”

Section: Methodsmentioning

confidence: 99%

Effects of an urban sanitation intervention on childhood enteric infection and diarrhea in Maputo, Mozambique: A controlled before-and-after trial

Knee

Sumner

Adriano³

et al. 2021

eLife

141

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We conducted a controlled before-and-after trial to evaluate the impact of an onsite urban sanitation intervention on the prevalence of enteric infection, soil transmitted helminth re-infection, and diarrhea among children in Maputo, Mozambique. A non-governmental organization replaced existing poor-quality latrines with pour-flush toilets with septic tanks serving household clusters. We enrolled children aged 1-48 months at baseline and measured outcomes before and 12 and 24 months after the intervention, with concurrent measurement among children in a comparable control arm. Despite nearly exclusive use, we found no evidence that intervention affected the prevalence of any measured outcome after 12 or 24 months of exposure. Among children born into study sites after intervention, we observed a reduced prevalence of Trichuris and Shigella infection relative to the same age group at baseline (<2 years old). Protection from birth may be important to reduce exposure to and infection with enteric pathogens in this setting.

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“…Acute diarrhea can be caused by different types of pathogens, among them the major five enteric pathogens Rotavirus (67.6%), Adenovirus (41.5%), enterotoxigenic E. coli (40.7%), Salmonella (38.4%), and Giardia (37.0%) [ 1 ]. Globally, acute diarrhea is the leading cause of morbidity and mortality among under-five children.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of acute diarrhea and associated factors among children under five in semi-urban areas of northeastern Ethiopia

2021

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Background Diarrheal disease is still one of the most common causes of mortality and morbidity in children under five in developing countries, including Ethiopia. Lack of specific data on the prevalence of acute diarrhea and associated factors among under-five children in the semi-urban areas of Gelsha, found in northeastern Ethiopia’s South Wollo zone, remains a major gap. Therefore, this study was designed to provide data that is important for proper planning of intervention measures to reduce the problem in this area. Methods A community-based cross-sectional study was conducted among 340 systematically selected children under five in semi-urban areas of Gelsha from January to March 2019. The data was collected using a structured questionnaire and an observational checklist. Bivariable (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were employed using binary logistic regression model with 95% CI (confidence interval). Variables with a p-value < 0.05 from the multivariable analysis were declared as factors significantly associated with acute diarrhea. Result The prevalence of acute diarrhea among children under five in the study area was 11% (95%CI: 7.8–14.3%). About two-thirds (63.60%) of study participants used water from improved sources. About half (54.90%) of study participants practiced poor handwashing and 45.10% practiced good handwashing. We found that factors significantly associated with acute diarrhea were a child’s age of 12–23 months (AOR = 4.68, 95% CI: 1.45–1.50), the presence of two or more under-five children in the house (AOR = 2.84, 95% CI: 1.19–6.81), unimproved water sources (AOR = 2.97, 95% CI: 1.28–6.87) and presence of feces around the pit hole/slab/floor of the latrine (AOR = 3.34, 95% CI: 1.34–8.31). Conclusion The prevalence of acute diarrhea among children under five was relatively high. To reduce the problem, various prevention strategies are essential, such as the provision of health education to mothers/caregivers that focuses on keeping sanitation facilities clean and child care, and construction of improved water sources. Furthermore, implementing a strong health extension program, advocating an open defecation-free environment, and practicing a community-led total sanitation and hygiene approach might be helpful to sustainably reduce childhood diarrhea.

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vAetiology of Diarrhoea in Children Under Five in Zambia Detected Using Luminex xTAG Gastrointestinal Pathogen Panel

Abstract: Background: We aimed to document viral, bacterial, and protozoan enteric pathogens responsible for causing moderate-to-severe diarrhoea among children under five presenting at public health facilities in Zambia following the introduction of rotavirus vaccination.

Cited by 24 publications

References 23 publications

Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting

Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting

Effects of an urban sanitation intervention on childhood enteric infection and diarrhea in Maputo, Mozambique: A controlled before-and-after trial

Prevalence of acute diarrhea and associated factors among children under five in semi-urban areas of northeastern Ethiopia

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