Pediatric diarrhea in southern Ghana: etiology and association with intestinal inflammation and malnutrition.
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.
Opintan
Japheth A
JA
Department of Microbiology, University of Ghana Medical School, Accra, Ghana. japh_opintan@yahoo.com
Newman
Mercy J
MJ
Ayeh-Kumi
Patrick F
PF
Affrim
Raymond
R
Gepi-Attee
Rosina
R
Sevilleja
Jesus E A D
JE
Roche
James K
JK
Nataro
James P
JP
Warren
Cirle A
CA
Guerrant
Richard L
RL
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
D007781:Lactoferrin