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- Title
Etiology of Diarrhea Among Hospitalized Children in Blantyre, Malawi, Following Rotavirus Vaccine Introduction: A Case-Control Study.
- Authors
Iturriza-Gómara, Miren; Jere, Khuzwayo C; Hungerford, Daniel; Bar-Zeev, Naor; Shioda, Kayoko; Kanjerwa, Oscar; Houpt, Eric R; Operario, Darwin J; Wachepa, Richard; Pollock, Louisa; Bennett, Aisleen; Pitzer, Virginia E; Cunliffe, Nigel A
- Abstract
Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years of age hospitalized with diarrhea (cases) and 527 asymptomatic community controls for 4 years after rotavirus vaccine introduction in Malawi. Specimens were tested for 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens were detected in 71% of cases and 48% of controls. Pathogens significantly associated with diarrhea included rotavirus (in 34.7% of cases and 1.5% of controls), enteric adenovirus (in 29.1% and 2.7%, respectively), Cryptosporidium (in 27.8% and 8.2%, respectively), heat-stable enterotoxin-producing Escherichia coli (in 21.2% and 8.5%, respectively), typical enteropathogenic E. coli (in 18.0% and 8.3%, respectively), and Shigella/enteroinvasive E. coli (in 15.8% and 5.7%, respectively). Additional interventions are required to prevent diarrhea due to rotavirus and other common causal pathogens.
- Subjects
MALAWI; BLANTYRE (Malawi); ROTAVIRUS vaccines; ETIOLOGY of diseases; HOSPITAL care of children; SHIGELLOSIS; DIARRHEA; CASE-control method; COMPARATIVE studies; CRYPTOSPORIDIOSIS; CRYPTOSPORIDIUM; ESCHERICHIA coli; FECES; GASTROENTERITIS; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RETROVIRUS diseases; ROTAVIRUSES; EVALUATION research; DISEASE complications
- Publication
Journal of Infectious Diseases, 2019, Vol 220, Issue 2, p213
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiz084