Factors associated with typical enteropathogenic infection among children <5 years old with moderate-to-severe diarrhoea in rural western Kenya, 2008-2012
Ochieng, J B
Ayers, T L
Farag, T H
Robins-Browne, R M
Nataro, J P
Kotloff, K L
Levine, M M
Parsons, M B
Laserson, K F
Mintz, E D
Breiman, R F
O'Reilly, C E
JournalEpidemiology and Infection
PublisherCambridge University Press
MetadataShow full item record
AbstractTypical enteropathogenic Escherichia coli (tEPEC) infection is a major cause of diarrhoea and contributor to mortality in children <5 years old in developing countries. Data were analysed from the Global Enteric Multicenter Study (GEMS) examining children <5 years old seeking care for moderate-to-severe diarrhoea (MSD) in Kenya. Stool specimens were tested for enteric pathogens, including by multiplex PCR for gene targets of tEPEC. Demographic, clinical, and anthropometric data were collected at enrolment and ~60-days later; multivariable logistic regressions were constructed. Of 1778 MSD cases enrolled from 2008-2012, 135 (7.6%) children tested positive for tEPEC. In a case-to-case comparison among MSD cases, tEPEC was independently associated with presentation at enrolment with a loss of skin turgor (adjusted odds ratio [aOR]: 2.08, 95% CI: 1.37-3.17), and convulsions (aOR: 2.83, 95% CI: 1.12-7.14). At follow-up, infants with tEPEC compared to those without were associated with being underweight (OR: 2.2, 95% CI: 1.3-3.6) and wasted (OR: 2.5, 95%CI: 1.3-4.6). Among MSD cases, tEPEC was associated with mortality (aOR: 2.85, 95% CI: 1.47-5.55). This study suggests that tEPEC contributes to morbidity and mortality in children. Interventions aimed at defining and reducing the burden of tEPEC and its sequelae should be urgently investigated, prioritised, and implemented.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/14195
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