Pediatric diarrhea in southern Ghana: etiology and association with intestinal inflammation and malnutrition

Am J Trop Med Hyg. 2010 Oct;83(4):936-43. doi: 10.4269/ajtmh.2010.09-0792.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child Nutrition Disorders / complications*
  • Child Nutrition Disorders / epidemiology
  • Child, Preschool
  • Cross-Sectional Studies
  • Diarrhea / complications*
  • Diarrhea / epidemiology*
  • Diarrhea / etiology
  • Dysentery, Bacillary / complications
  • Dysentery, Bacillary / epidemiology
  • Dysentery, Bacillary / microbiology
  • Enterohemorrhagic Escherichia coli / genetics
  • Enterohemorrhagic Escherichia coli / pathogenicity
  • Escherichia coli Infections / complications
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Feces / chemistry
  • Feces / microbiology
  • Feces / parasitology
  • Female
  • Gastroenteritis / complications*
  • Ghana / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Lactoferrin / analysis
  • Male
  • Parasitic Diseases / complications
  • Parasitic Diseases / epidemiology
  • Parasitic Diseases / parasitology
  • Polymerase Chain Reaction
  • Prospective Studies
  • Virulence

Substances

  • Lactoferrin