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dc.contributor.authorGosselin, Kerri B.
dc.contributor.authorAboud, Said
dc.contributor.authorMcDonald, Christine M.
dc.contributor.authorMoyo, Sabrina
dc.contributor.authorKhavari, Nasim
dc.contributor.authorManji, Karim
dc.contributor.authorKisenge, Rodrick
dc.contributor.authorFawzi, Wafaie
dc.contributor.authorKellogg, Mark
dc.contributor.authorTran, Hao Q.
dc.contributor.authorKibiki, Gibson
dc.contributor.authorGratz, Jean
dc.contributor.authorLiu, Jie
dc.contributor.authorGewirtz, Andrew
dc.contributor.authorHoupt, Eric
dc.contributor.authorDuggan, Christopher
dc.date2022-08-11T08:10:12.000
dc.date.accessioned2022-08-23T16:59:15Z
dc.date.available2022-08-23T16:59:15Z
dc.date.issued2017-01-01
dc.date.submitted2017-01-06
dc.identifier.citationJ 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.issn0277-2116 (Linking)
dc.identifier.doi10.1097/MPG.0000000000001323
dc.identifier.pmid27347720
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43541
dc.description.abstractOBJECTIVE: 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.isoen_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.urlhttp://journals.lww.com/jpgn/Abstract/2017/01000/Etiology_of_Diarrhea,_Nutritional_Outcomes,_and.18.aspx
dc.subjectdiarrhea
dc.subjectenteropathogen
dc.subjectintestinal biomarker
dc.subjectrotavirus
dc.subjectTanzania
dc.subjectundernutrition
dc.subjectBiological Factors
dc.subjectDietetics and Clinical Nutrition
dc.subjectDigestive System Diseases
dc.subjectGastroenterology
dc.subjectNutrition
dc.subjectPediatrics
dc.titleEtiology of Diarrhea, Nutritional Outcomes, and Novel Intestinal Biomarkers in Tanzanian Infants
dc.typeArticle
dc.source.journaltitleJournal of pediatric gastroenterology and nutrition
dc.source.volume64
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/peds_pp/108
dc.identifier.contextkey9518188
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.submissionpathpeds_pp/108
dc.contributor.departmentDepartment of Pediatrics, Division of Gastroenterology and Nutrition
dc.source.pages104-108


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