Association between stool enteropathogen quantity and disease in Tanzanian children using TaqMan array cards: a nested case-control study

Am J Trop Med Hyg. 2014 Jan;90(1):133-8. doi: 10.4269/ajtmh.13-0439. Epub 2013 Nov 4.

Abstract

Etiologic studies of diarrhea are limited by uneven diagnostic methods and frequent asymptomatic detection of enteropathogens. Polymerase chain reaction-based stool pathogen quantification may help distinguish clinically significant infections. We performed a nested case-control study of diarrhea in infants from a community-based birth cohort in Tanzania. We tested 71 diarrheal samples and pre-diarrheal matched controls with a laboratory-developed TaqMan Array Card for 19 enteropathogens. With qualitative detection, no pathogens were significantly associated with diarrhea. When pathogen quantity was considered, rotavirus (odds ratio [OR] = 2.70 per log10 increase, P < 0.001), astrovirus (OR = 1.49, P = 0.01), and Shigella/enteroinvasive Escherichia coli (OR = 1.47, P = 0.04) were associated with diarrhea. Enterotoxigenic E. coli (0.15 SD decline in length-for-age z score after 3 months per log10 increase, P < 0.001) and Campylobacter jejuni/C. coli (0.11 SD decline, P = 0.003) in pre-diarrheal stools were associated with poor linear growth. Quantitative analysis can help refine the association between enteropathogens and disease in endemic settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Astroviridae Infections / epidemiology
  • Astroviridae Infections / virology*
  • Case-Control Studies
  • Endemic Diseases
  • Feces / microbiology*
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / microbiology*
  • Humans
  • Infant
  • Male
  • Mamastrovirus / isolation & purification*
  • Odds Ratio
  • Risk Factors
  • Rotavirus / isolation & purification*
  • Rotavirus Infections / epidemiology
  • Rotavirus Infections / virology
  • Tanzania / epidemiology