Enteropathogen seroepidemiology among children in low-resource settings

Arnold, Benjamin F.; Martin, Diana L.; Juma, Jane; Mkocha, Harran; Ochieng, John B.; Cooley, Gretchen; Omore, Richard; Goodhew, E. Brook; Morris, Jamae; Costantini, Verónica; Vinjé, Jan; Lammie, Patrick J.; Priest, Jeffrey W.

doi:10.1101/522920

Cited by 2 publications

(2 citation statements)

References 82 publications

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“…Serological methods for analysing antibodies to enteropathogens from dried blood spots (which are low cost and do not require cold chains for field collection) are also becoming available. 57…”

Section: Health Policymentioning

confidence: 99%

The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea

Pickering

Null

Winch

et al. 2019

The Lancet Global Health

251

222

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Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household. We have completed three randomised efficacy trials testing improved household-level WASH with and without improved infant and young child feeding (IYCF) on stunting and diarrhoea in Bangladesh, Kenya, and Zimbabwe. In all trials, improved IYCF had a statistically significant benefit, but WASH had no effect on linear growth. In observational analyses of data from the control groups of the three trials, baseline sanitation was a strong risk factor for stunting in the study populations, suggesting this frequently reported association might be confounded by unmeasured factors of household wellbeing. WASH interventions reduced diarrhoea in Bangladesh, but not in Kenya or Zimbabwe. Intervention promoters visited participants six times per month in Bangladesh compared with monthly in Kenya and Zimbabwe; a review of the literature shows that virtually all published studies that have reported an effect on diarrhoea through home-based water treatment and handwashing promotion achieved high adherence by visiting participants at daily to fortnightly intervals. Despite achieving substantial behavioural change and significant reduction in infection prevalence for some enteric pathogens, detection of enteropathogens among children in the WASH groups of the trials was typically at ten times higher prevalence compared with high-income countries. Considering these results, we recommend that future research in the WASH sector focus on developing and evaluating interventions that are radically more effective in reducing faecal contamination in the domestic environment than the interventions implemented in these trials.

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Section: Health Policymentioning

confidence: 99%

The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea

Pickering

Null

Winch

et al. 2019

The Lancet Global Health

251

222

View full text Add to dashboard Cite

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“…Additionally, it may overcome sources of uncertainty or bias in facility-based surveillance caused by healthcare seeking and prior antibiotic use. Cross-sectional sero-surveillance has been useful for rapidly generating data on the transmission of COVID-19, pertussis, dengue, and other diseases (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Estimating typhoid incidence from community-based serosurveys: A multicohort study in Bangladesh, Nepal, Pakistan and Ghana

Aiemjoy

Seidman

Saha

et al. 2021

Preprint

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The incidence of enteric fever, an invasive bacterial infection caused by typhoidal Salmonellae, is largely unknown in regions lacking blood culture surveillance. New serologic markers have proven accurate in diagnosing enteric fever, but whether they could be used to reliably estimate population-level incidence is unknown. We collected longitudinal blood samples from blood culture-confirmed enteric fever cases enrolled from surveillance studies in Bangladesh, Nepal, Pakistan and Ghana and conducted cross-sectional sero-surveys in the catchment areas of each surveillance site. We used ELISAs to measure quantitative IgA and IgG antibody responses to Hemolysin E (HlyE) and S. Typhi lipopolysaccharide (LPS). We used Bayesian hierarchical models to fit two-phase power-function decay models to the longitudinal sero-responses among enteric fever cases and used the joint distributions of the peak antibody titers and decay rate to estimate population-level incidence rates from cross-sectional serosurveys. The longitudinal antibody kinetics for all antigen-isotypes were similar across countries and did not vary by clinical severity. The incidence of typhoidal Salmonella infection ranged between 41.2 per 100 person years (95% CI: 34.0-50.1) in Dhaka, Bangladesh to 5.8 (95% CI: 4.8-7.1) in Kavrepalanchok, Nepal and followed the same rank order as clinical incidence estimates. The approach described here has the potential to expand the geographic scope of typhoidal Salmonella surveillance and generate incidence estimates that are comparable across geographic regions and time.

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Enteropathogen seroepidemiology among children in low-resource settings

Cited by 2 publications

References 82 publications

The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea

The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea

Estimating typhoid incidence from community-based serosurveys: A multicohort study in Bangladesh, Nepal, Pakistan and Ghana

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