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

Bibliographic Data

ID19590950
AuthorsJenna N Diaz, Jenna Diaz (Washington University in St. Louis), Lora L Iannotti (0000-0001-8826-0867, Washington University in St. Louis), Sherlie Jean Louis Dulience (Washington University in St. Louis), Sydney Vie (Washington University in St. Louis), Xuntian Jiang (0000-0001-9048-7294, Washington University in St. Louis), Vadim Grigura (Washington University in St. Louis), Jacques Boncy (0000-0003-0814-5530), Francesca J Marhône Pierre (Ministère de la Santé), F Kuhlmann (0000-0003-1085-0589, corresponding author)
EditorsBen Pascoe (0000-0001-6376-5121)
Year2023
Volume3
Issue5
Pagese0001863
Publication date2023-05-05
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001863
PMID37145992
OpenAlexW4372337349
LanguageEN
Citations received1
References cited48

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