Prevalence of diarrheagenic Escherichia coli and impact on child health in Cap-Haitien, Haiti

Background Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti. Methods We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6–36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was determined using multivariate linear regression. Lastly, we assessed the association between specific biomarkers, choline and docosahexaenoic acid (DHA) and diarrheal burden. Results Enterotoxigenic Escherichia coli (ETEC) was identified in 21.9% of cases vs. 16.1% of controls with heat-stable producing ETEC significantly associated with symptomatic disease. Enteroaggregative E . coli (EAEC) was found in 30.2% of cases vs. 27.3% of controls, and typical enteropathogenic E . coli in 6.3% vs. 4.0% of cases and controls, respectively. Multivariate linear regression, controlled for case or control status, demonstrated ETEC and EAEC were significantly associated with reduced weight-age z-score (WAZ) and height-age z-score (HAZ) after adjusting for confounders. An interaction between ETEC and EAEC was observed. Choline and DHA were not associated with diarrheal burden. Conclusions DEC are prevalent in north Haitian children. ETEC, EAEC, household environment, and diet are associated with unfavorable anthropometric measures, with possible synergistic interactions between ETEC and EAEC. Further studies with longer follow up may quantify the contribution of individual pathogens to adverse health outcomes

Biology · Environmental health · Escherichia coli · Gene · Geography · Child Nutrition and Water Access · Escherichia coli research studies · Medicine · Salmonella and Campylobacter epidemiology · Genetics

• Childhood diarrhoea attributed to enteropathogenic bacteria in low- and middle-income countries

  Open Access•Md Abu Sayeed, Samantha Colquhoun et al.•Journal of Global Health•2025

  Incluir item

• Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, Gems)

  Karen L Kotloff, James P Nataro et al.•The Lancet•2013

  Incluir item

• Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries

  Open Access•Christopher Troeger, Brigette F Blacker et al.•The Lancet Infectious Diseases•2018

  Incluir item

• Maternal and child undernutrition and overweight in low-income and middle-income countries

  Open Access•Robert E Black, Cesar G Victora et al.•The Lancet•2013

  Incluir item

• Multiplex Serology for Measurement of IgG Antibodies Against Eleven Infectious Diseases in a National Serosurvey

  Open Access•YuYen Chan, YuYen L Chan et al.•Frontiers in Public Health•2022

  Incluir item

• Egg intervention effect on linear growth no longer present after two years

  Open Access•Lora L Iannotti, Melissa Chapnick et al.•Maternal and Child Nutrition•2019

  Incluir item