Microbiologic Methods Utilized in the MAL-ED Cohort Study

Houpt, Eric R.; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K. M.; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl J.; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah J.; Lima, Aldo A. M.; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis

doi:10.1093/cid/ciu413

Cited by 92 publications

(128 citation statements)

References 39 publications

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“…33,34 Statistical analysis. Our primary objective in conducting this study was to determine if geophagy was significantly associated with elevated markers of EE and stunting in children under 5 years of age.…”

Section: Methodsmentioning

confidence: 99%

Geophagy is Associated with Environmental Enteropathy and Stunting in Children in Rural Bangladesh

George

Oldja

Biswas

et al. 2015

The American Society of Tropical Medicine and Hygiene

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134

171

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Abstract. There is a growing body of literature indicating an association between stunting and environmental enteropathy (EE), a disorder thought to be caused by repeated exposures to enteric pathogens. To investigate the relationship between exposure to enteric pathogens through geophagy, consumption of soil, EE, and stunting, we conducted a prospective cohort study of 216 children under 5 years of age in rural Bangladesh. Geophagy was assessed at baseline using 5 hour structured observation and caregiver reports. Stool was analyzed for fecal markers of intestinal inflammation: alpha-1-antitrypsin, myeloperoxidase, neopterin (all three combined to form an EE disease activity score), and calprotectin. Eighteen percent of children had observed geophagy events by structured observation and 28% had caregiver reported events in the past week. Nearly all households had Escherichia coli (97%) in soil, and 14% had diarrheagenic E. coli. Children with caregiver-reported geophagy had significantly higher EE scores (0.72 point difference, 95% confidence interval [CI]: 0.01, 1.42) and calprotectin concentrations (237.38 μg/g, 95% CI: 12.77, 462.00). Furthermore, at the 9-month follow-up the odds of being stunted (height-for-age z-score −2) was double for children with caregiver-reported geophagy (odds ratio [OR]: 2.27, 95% CI: 1.14, 4.51). These findings suggest that geophagy in young children may be an important unrecognized risk factor for EE and stunting.

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Section: Methodsmentioning

confidence: 99%

Geophagy is Associated with Environmental Enteropathy and Stunting in Children in Rural Bangladesh

George

Oldja

Biswas

et al. 2015

The American Society of Tropical Medicine and Hygiene

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134

171

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“…They were tested for an expansive panel of bacterial, viral, and parasitic enteric pathogens using a standardized microbiology protocol, as previously described. 23 Briefly, the bacteriology protocol was optimized for Salmonella , Shigella , Vibrio , Yersinia , Aeromonas , and Plesiomonas . Culture media was from BD (Sparks, Maryland) and it was purchased and prepared in house.…”

Section: Methodsmentioning

confidence: 99%

“…For Escherichia coli we selected a pool of five lactose-fermenting colonies resembling E. coli , and characterize them for virulence genes using a multiplex polymerase chain reaction (PCR) assay. The virulence genes selected for PCR probes are detailed on reference 23. For Campylobacter jejuni/coli diagnosis we used a TaqMan probe to detect the Campylobacter adhesin to fibronectin ( CadF ) gene, as previously reported.…”

Section: Methodsmentioning

confidence: 99%

“…For Campylobacter jejuni/coli diagnosis we used a TaqMan probe to detect the Campylobacter adhesin to fibronectin ( CadF ) gene, as previously reported. 24,25 For Cryptosporidium (oocyst protein), E. histolytica (surface adhesin molecule) and Giardia (cyst wall protein) detection on stool samples, we used the protozoa kits from Techlab (Blacksburg, Virginia) 23 . The ProSpecT kits (Oxoid Ltd, Ely, United Kingdom) were used for rotavirus (VP6), adenovirus (detects all human adenovirus serotypes via a genus-specific adenovirus hexon antigen), and astrovirus kits 23 .…”

Section: Methodsmentioning

confidence: 99%

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Determinant Variables, Enteric Pathogen Burden, Gut Function and Immune-related Inflammatory Biomarkers Associated With Childhood Malnutrition

Lima

Leite²,

Moura³

et al. 2017

Pediatric Infectious Disease Journal

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Malnutrition results in serious consequences for growth and cognitive development in children. We studied select child and maternal biological factors, socio-economic factors, enteric pathogenic burden, and gut function biomarkers in 402 children 6–24 months of age in North-eastern Brazil. In this prospective case-control study, not being fed colostrum (odds ratio [OR] = 3.29, 95% confidence interval [CI] 1.73–6.26), maternal age ≥18 years (OR = 1.88, 95% CI 1.10–3.22), and no electrical fan (OR = 2.46, 95% CI 1.22–4.96) or bicycle (OR = 1.80, 95% CI 1.10–2.95) in the household were positively associated, and higher birth weight (OR = 0.27, 95% CI 0.19–0.38), larger head circumference (OR = 0.74, 95% CI 0.66–0.82), and shortness of breath in the last two weeks (OR = 0.49, 95% CI 0.27–0.90) were negatively associated with malnutrition. Subclinical enteric pathogen infections were common, and enteroaggregative Escherichia coli infections were more prevalent in malnourished children (p = 0.045). Biomarkers such as the lactulose:mannitol test, myeloperoxidase, neopterin, and calprotectin were highly elevated in both malnourished and nourished children. Nourished children had a better systemic immune response than the malnourished children, as detected by elevated serum amyloid A-1 (SAA-1) and soluble cluster of differentiation protein 14 (sCD14) biomarkers (P < 0.001). SAA-1 and sCD14 were also associated with better nutritional z-scores. Neonatal, maternal, and socio-economic factors were associated with malnutrition in children. There was a substantial subclinical enteric pathogen burden, particularly with EAEC, in malnourished children.

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“…The ongoing Study of Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED), designed to assess the impact of malnutrition and recurrent early enteropathogen infections on long-term developmental outcomes in children across eight sites in South America, sub-Saharan Africa, and Asia, has used an EIA for Campylobacter detection, chosen for ease of standardization across laboratories [25]. Campylobacter has the highest associated burden of diarrhea of all pathogens in children in the first year of life from Loreto, Peru and Venda, South Africa [26].…”

Section: Introductionmentioning

confidence: 99%

Update on the burden of Campylobacter in developing countries

Platts-Mills

Kosek

2014

Current Opinion in Infectious Diseases

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Purpose of review Recent work has added to the understanding of the burden of Campylobacter jejuni, C. coli, and non-jejuni/coli Campylobacter strains in children living in the developing world. Recent findings New diagnostic modalities and carefully-designed field studies are demonstrating that the burden of Campylobacter diarrhea in children in the developing world has been greatly underestimated. Furthermore, there is emerging recognition of an association between Campylobacter infection and malnutrition. Important progress has been made towards a Campylobacter jejuni vaccine. Finally, evidence of antibiotic resistance continues to be an important issue that is accentuated by the realization that the burden of disease is greater than previously recognized. Summary Additional research is needed to refine our understanding of the epidemiology of Campylobacter infections in developing countries, in particular to improve estimates of the burden of Campylobacter diarrhea in endemic settings, to determine the impact of recurrent Campylobacter infections on child development, and to describe the prevalence and clinical significance of non-jejuni/coli Campylobacter infections. Progressive antibiotic resistance of isolates argues for augmented and expanded control measures of antibiotics in livestock. Continued work in vaccine development is warranted as is the extension of data available on the serotypes related to burden in different areas of the world and the relationship of serotypes to disease severity.

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Microbiologic Methods Utilized in the MAL-ED Cohort Study

Cited by 92 publications

References 39 publications

Geophagy is Associated with Environmental Enteropathy and Stunting in Children in Rural Bangladesh

Geophagy is Associated with Environmental Enteropathy and Stunting in Children in Rural Bangladesh

Determinant Variables, Enteric Pathogen Burden, Gut Function and Immune-related Inflammatory Biomarkers Associated With Childhood Malnutrition

Update on the burden of Campylobacter in developing countries

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