Association between stool enteropathogen quantity and disease in Tanzanian children using TaqMan Array Cards: A nested case-control study

James A. Platts-Mills, Jean Gratz, Esto Mduma, Erling Svensen, Caroline Amour, Jie Liu, Athanasia Maro, Queen Saidi, Ndealilia Swai, Happiness Kumburu, Benjamin J.J. McCormick, Gibson Kibiki, Eric R. Houpt*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)

Abstract

Etiologic studies of diarrhea are limited by uneven diagnostic methods and frequent asymptomatic detection of enteropathogens. Polymerase chain reaction-based stool pathogen quantification may help distinguish clinically significant infections. We performed a nested case-control study of diarrhea in infants from a communitybased birth cohort in Tanzania. We tested 71 diarrheal samples and pre-diarrheal matched controls with a laboratorydeveloped TaqMan Array Card for 19 enteropathogens. With qualitative detection, no pathogens were significantly associated with diarrhea. When pathogen quantity was considered, rotavirus (odds ratio [OR] = 2.70 per log10 increase, P < 0.001), astrovirus (OR = 1.49, P = 0.01), and Shigella/enteroinvasive Escherichia coli (OR = 1.47, P = 0.04) were associated with diarrhea. Enterotoxigenic E. coli (0.15 SD decline in length-for-age z score after 3 months per log10 increase, P < 0.001) and Campylobacter jejuni/C. coli (0.11 SD decline, P = 0.003) in pre-diarrheal stools were associated with poor linear growth. Quantitative analysis can help refine the association between enteropathogens and disease in endemic settings.

Original languageEnglish
Pages (from-to)133-138
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume90
Issue number1
DOIs
Publication statusPublished - Jan 2014

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