Etiology of Diarrhea Among Hospitalized Children in Blantyre, Malawi, Following Rotavirus Vaccine Introduction: A Case-Control Study

被引：43

作者：

Iturriza-Gomara, Miren ^{[1
]}

Jere, Khuzwayo C. ^{[1
,2
,3
]}

Hungerford, Daniel ^{[1
]}

Bar-Zeev, Naor ^{[2
,4
]}

Shioda, Kayoko ^{[5
]}

Kanjerwa, Oscar ^{[2
]}

Houpt, Eric R. ^{[6
]}

Operario, Darwin J. ^{[6
]}

Wachepa, Richard ^{[2
]}

Pollock, Louisa ^{[1
,2
]}

Bennett, Aisleen ^{[1
,2
]}

Pitzer, Virginia E. ^{[5
]}

Cunliffe, Nigel A. ^{[1
]}

机构：

[1] Univ Liverpool, Inst Infect & Global Hlth, Ctr Global Vaccine Res, Liverpool, Merseyside, England

[2] Univ Malawi, Coll Med, Malawi Liverpool Wellcome Trust Clin Res Programm, Blantyre, Malawi

[3] Univ Malawi, Coll Med, Dept Med Lab Sci, Blantyre, Malawi

[4] Johns Hopkins Bloomberg Sch Publ Hlth, Int Vaccine Access Ctr, Baltimore, MD USA

[5] Yale Univ, Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT USA

[6] Univ Virginia, Div Infect Dis & Int Hlth, Charlottesville, VA USA

来源：

JOURNAL OF INFECTIOUS DISEASES | 2019年 / 220卷 / 02期

基金：

英国惠康基金; 美国国家卫生研究院;

关键词：

Gastroenteritis; diarrhea; children; PCR; rotavirus; case-control; Malawi; INFECTION; MORTALITY; INFANTS; DISEASE; BURDEN; IMPACT; GEMS;

D O I：

10.1093/infdis/jiz084

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years of age hospitalized with diarrhea (cases) and 527 asymptomatic community controls for 4 years after rotavirus vaccine introduction in Malawi. Specimens were tested for 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens were detected in 71% of cases and 48% of controls. Pathogens significantly associated with diarrhea included rotavirus (in 34.7% of cases and 1.5% of controls), enteric adenovirus (in 29.1% and 2.7%, respectively), Cryptosporidium (in 27.8% and 8.2%, respectively), heat-stable enterotoxin-producing Escherichia coli (in 21.2% and 8.5%, respectively), typical enteropathogenic E. coli (in 18.0% and 8.3%, respectively), and Shigella/enteroinvasive E. coli (in 15.8% and 5.7%, respectively). Additional interventions are required to prevent diarrhea due to rotavirus and other common causal pathogens.

引用

页码：213 / 218

页数：6

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