Etiology of Diarrhea, Nutritional Outcomes, and Novel Intestinal Biomarkers in Tanzanian Infants
dc.contributor.author | Gosselin, Kerri B. | |
dc.contributor.author | Aboud, Said | |
dc.contributor.author | McDonald, Christine M. | |
dc.contributor.author | Moyo, Sabrina | |
dc.contributor.author | Khavari, Nasim | |
dc.contributor.author | Manji, Karim | |
dc.contributor.author | Kisenge, Rodrick | |
dc.contributor.author | Fawzi, Wafaie | |
dc.contributor.author | Kellogg, Mark | |
dc.contributor.author | Tran, Hao Q. | |
dc.contributor.author | Kibiki, Gibson | |
dc.contributor.author | Gratz, Jean | |
dc.contributor.author | Liu, Jie | |
dc.contributor.author | Gewirtz, Andrew | |
dc.contributor.author | Houpt, Eric | |
dc.contributor.author | Duggan, Christopher | |
dc.date | 2022-08-11T08:10:12.000 | |
dc.date.accessioned | 2022-08-23T16:59:15Z | |
dc.date.available | 2022-08-23T16:59:15Z | |
dc.date.issued | 2017-01-01 | |
dc.date.submitted | 2017-01-06 | |
dc.identifier.citation | J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):104-108. doi: 10.1097/MPG.0000000000001323. <a href="http://dx.doi.org/10.1097/MPG.0000000000001323">Link to article on publisher's site</a> | |
dc.identifier.issn | 0277-2116 (Linking) | |
dc.identifier.doi | 10.1097/MPG.0000000000001323 | |
dc.identifier.pmid | 27347720 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/43541 | |
dc.description.abstract | OBJECTIVE: Diarrheal diseases are a leading cause of morbidity and mortality worldwide, but the etiology of diarrhea and its relation to nutritional outcomes in resource-limited settings is poorly defined. We sought to determine the etiology of community-acquired diarrhea in Tanzanian infants and to assess the association with anthropometrics and novel intestinal biomarkers. METHODS: A convenience sample of infants in a trial of zinc and/or multivitamin supplementation in Tanzania was selected. Subjects were enrolled at age 6 weeks and studied for 18 months. Stool samples were obtained from children with acute diarrhea. A novel, polymerase chain reaction-based TaqMan array was used to screen stool for 15 enteropathogens. A subset of subjects had serum gastrointestinal biomarkers measured. RESULTS: One hundred twenty-three subjects with diarrhea were enrolled. The mean +/- SD age at stool sample collection was 12.4 +/- 3.9 months. Thirty-five enteropathogens were identified in 34 (27.6%) subjects: 11 rotavirus, 9 Cryptosporidium spp, 7 Shigella spp, 3 Campylobacter jejuni/coli, 3 heat stable-enterotoxigenic Escherichia coli, and 2 enteropathogenic E coli. Subjects with any identified enteropathogen had significantly lower weight-for-length z scores (-0.55 +/- 1.10 vs 0.03 +/- 1.30, P = 0.03) at the final clinic visit than those without an identified pathogen. Fifty of the 123 subjects (40.7%) had serum analyzed for antibodies to lipopolysaccharide (LPS) and flagellin. Subjects with any identified enteropathogen had lower immunoglobulin (IgA) antibodies to LPS (0.75 +/- 0.27 vs 1.13 +/- 0.77, P = 0.01) and flagellin (0.52 +/- 0.16 vs 0.73 +/- 0.47, P = 0.02) than those without an identified pathogen. CONCLUSIONS: This quantitative polymerase chain reaction method may allow identification of enteropathogens that place children at higher risk for suboptimal growth. IgA anti-LPS and flagellin antibodies hold promise as emerging intestinal biomarkers. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=27347720&dopt=Abstract">Link to Article in PubMed</a> | |
dc.relation.url | http://journals.lww.com/jpgn/Abstract/2017/01000/Etiology_of_Diarrhea,_Nutritional_Outcomes,_and.18.aspx | |
dc.subject | diarrhea | |
dc.subject | enteropathogen | |
dc.subject | intestinal biomarker | |
dc.subject | rotavirus | |
dc.subject | Tanzania | |
dc.subject | undernutrition | |
dc.subject | Biological Factors | |
dc.subject | Dietetics and Clinical Nutrition | |
dc.subject | Digestive System Diseases | |
dc.subject | Gastroenterology | |
dc.subject | Nutrition | |
dc.subject | Pediatrics | |
dc.title | Etiology of Diarrhea, Nutritional Outcomes, and Novel Intestinal Biomarkers in Tanzanian Infants | |
dc.type | Journal Article | |
dc.source.journaltitle | Journal of pediatric gastroenterology and nutrition | |
dc.source.volume | 64 | |
dc.source.issue | 1 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/peds_pp/108 | |
dc.identifier.contextkey | 9518188 | |
html.description.abstract | <p>OBJECTIVE: Diarrheal diseases are a leading cause of morbidity and mortality worldwide, but the etiology of diarrhea and its relation to nutritional outcomes in resource-limited settings is poorly defined. We sought to determine the etiology of community-acquired diarrhea in Tanzanian infants and to assess the association with anthropometrics and novel intestinal biomarkers.</p> <p>METHODS: A convenience sample of infants in a trial of zinc and/or multivitamin supplementation in Tanzania was selected. Subjects were enrolled at age 6 weeks and studied for 18 months. Stool samples were obtained from children with acute diarrhea. A novel, polymerase chain reaction-based TaqMan array was used to screen stool for 15 enteropathogens. A subset of subjects had serum gastrointestinal biomarkers measured.</p> <p>RESULTS: One hundred twenty-three subjects with diarrhea were enrolled. The mean +/- SD age at stool sample collection was 12.4 +/- 3.9 months. Thirty-five enteropathogens were identified in 34 (27.6%) subjects: 11 rotavirus, 9 Cryptosporidium spp, 7 Shigella spp, 3 Campylobacter jejuni/coli, 3 heat stable-enterotoxigenic Escherichia coli, and 2 enteropathogenic E coli. Subjects with any identified enteropathogen had significantly lower weight-for-length z scores (-0.55 +/- 1.10 vs 0.03 +/- 1.30, P = 0.03) at the final clinic visit than those without an identified pathogen. Fifty of the 123 subjects (40.7%) had serum analyzed for antibodies to lipopolysaccharide (LPS) and flagellin. Subjects with any identified enteropathogen had lower immunoglobulin (IgA) antibodies to LPS (0.75 +/- 0.27 vs 1.13 +/- 0.77, P = 0.01) and flagellin (0.52 +/- 0.16 vs 0.73 +/- 0.47, P = 0.02) than those without an identified pathogen.</p> <p>CONCLUSIONS: This quantitative polymerase chain reaction method may allow identification of enteropathogens that place children at higher risk for suboptimal growth. IgA anti-LPS and flagellin antibodies hold promise as emerging intestinal biomarkers.</p> | |
dc.identifier.submissionpath | peds_pp/108 | |
dc.contributor.department | Department of Pediatrics, Division of Gastroenterology and Nutrition | |
dc.source.pages | 104-108 |