Enteroaggregative Escherichia coli and acute diarrhea in children: a meta-analysis of South Asian populations

被引:0
作者
N. Pabalan
E. Singian
H. Jarjanazi
T. S. Steiner
机构
[1] Saint Louis University,Center for Research and Development
[2] Angeles University Foundation,Center for Research and Development
[3] Angeles University Foundation,College of Allied Medical Professions
[4] Ontario Ministry of the Environment,Environmental Monitoring and Reporting Branch
[5] University of British Columbia,Division of Infectious Diseases, Department of Microbiology and Immunology
来源
European Journal of Clinical Microbiology & Infectious Diseases | 2013年 / 32卷
关键词
Acute Diarrhea; Summary Effect; South Asian Population; South Asian Child; Outlier Treatment;
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摘要
The purpose of this investigation was to evaluate the association of enteroaggregative Escherichia coli (EAEC) with acute diarrhea in children of South Asian populations. Our meta-analysis included 18 studies published between 1989 and 2011. The odds ratio (OR) was used to evaluate all available observational epidemiology studies. Modifying effects on the overall OR were approached with outlier, subgroup, cumulative, and cumulative recursive analyses. Synthesis of the 18 observational studies revealed an association between EAEC carriage and acute diarrhea, with an overall OR of 1.51, which was significant (p = 0.008), heterogeneous (Pheterogeneity < 0.0001), and unaffected by outlier analysis. This analysis, however, affected the subgroups by eliminating the following: (i) heterogeneity (from Pheterogeneity < 0.0001 to 0.30–0.72) of pooled ORs in the underpowered (OR 1.37, p = 0.15), Indian (OR 1.92, p = 0.09), and hospital-based (OR 1.66, p = 0.06) studies; (ii) non-significance of these three subgroups (OR 1.56–2.01, p < 0.0001–0.003); (iii) significance of the high-powered studies (from OR 1.70, p = 0.02 to OR 1.15, p = 0.28); (iv) heterogeneity (from Pheterogeneity < 0.0001–0.0002 to 0.11–0.15) of pooled ORs in period three (OR 1.85, p = 0.14), population-based (OR 1.36, p = 0.09), and pCVD432 (OR 1.53, p = 0.07) studies. In general, outlier treatment increased precision with the narrowing of confidence intervals, overall, and in the subgroups. Cumulative meta-analysis generally resulted in increases in the frequencies of significant effects and of heterogeneity. This meta-analysis on observational studies suggests that the association between EAEC and acute diarrhea in children is that of increased risk. This effect generally comes from heterogeneous studies of South Asian populations, but is modified with outlier and subgroup treatments.
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页码:597 / 607
页数:10
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