title: Pediatric diarrhea in southern Ghana: etiology and association with intestinal inflammation and malnutrition.
abstract: Diarrhea is a major public health problem that affects the development of children. Anthropometric data were collected from 274 children with (N = 170) and without (N = 104) diarrhea. Stool specimens were analyzed by conventional culture, polymerase chain reaction for enteroaggregative Escherichia coli (EAEC), Shigella, Cryptosporidium, Entamoeba, and Giardia species, and by enzyme-linked immunosorbent assay for fecal lactoferrin levels. About 50% of the study population was mildly to severely malnourished. Fecal lactoferrin levels were higher in children with diarrhea (P = 0.019). Children who had EAEC infection, with or without diarrhea, had high mean lactoferrin levels regardless of nutritional status. The EAEC and Cryptosporidium were associated with diarrhea (P = 0.048 and 0.011, respectively), and malnourished children who had diarrhea were often co-infected with both Cryptosporidium and EAEC. In conclusion, the use of DNA-biomarkers revealed that EAEC and Cryptosporidium were common intestinal pathogens in Accra, and that elevated lactoferrin was associated with diarrhea in this group of children.
authors.affiliation: Department of Microbiology, University of Ghana Medical School, Accra, Ghana. japh_opintan@yahoo.com
authors.forename: Japheth A
authors.initials: JA
authors.lastname: Opintan
authors.forename: Mercy J
authors.initials: MJ
authors.lastname: Newman
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Ayeh-Kumi
authors.forename: Raymond
authors.initials: R
authors.lastname: Affrim
authors.forename: Rosina
authors.initials: R
authors.lastname: Gepi-Attee
authors.forename: Jesus E A D
authors.initials: JE
authors.lastname: Sevilleja
authors.forename: James K
authors.initials: JK
authors.lastname: Roche
authors.forename: James P
authors.initials: JP
authors.lastname: Nataro
authors.forename: Cirle A
authors.initials: CA
authors.lastname: Warren
authors.forename: Richard L
authors.initials: RL
authors.lastname: Guerrant
mesh_terms: D016022:Case-Control Studies; D015362:Child Nutrition Disorders / Q000150:complications* / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology; D004405:Dysentery, Bacillary / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D054324:Enterohemorrhagic Escherichia coli / Q000235:genetics / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000737:chemistry / Q000382:microbiology / Q000469:parasitology; D005260:Female; D005759:Gastroenteritis / Q000150:complications*; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007781:Lactoferrin / Q000032:analysis; D008297:Male; D010272:Parasitic Diseases / Q000150:complications / Q000453:epidemiology / Q000469:parasitology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014774:Virulence
chemical_list: D007781:Lactoferrin