Identifying Etiological Agents Causing Diarrhea in Low Income Ecuadorian Communities

Abstract

Abstract. Continued success in decreasing diarrheal disease burden requires targeted interventions. To develop such interventions, it is crucial to understand which pathogens cause diarrhea. Using a case-control design we tested stool samples, collected in both rural and urban Ecuador, for 15 pathogenic microorganisms. Pathogens were present in 51% of case and 27% of control samples from the urban community, and 62% of case and 18% of control samples collected from the rural community. Rotavirus and Shigellae were associated with diarrhea in the urban community; co-infections were more pathogenic than single infection; Campylobacter and Entamoeba histolytica were found in large numbers in cases and controls; and non-typhi Salmonella and enteropathogenic Escherichia coli were not found in any samples. Consistent with the Global Enteric Multicenter Study, focused in south Asia and sub-Saharan Africa, we found that in Ecuador a small group of pathogens accounted for a significant amount of the diarrheal disease burden.

Detection of Zoonotic Enteropathogens in Children and Domestic Animals in a Semirural Community in Ecuador

“…Giardia lamblia was the most prevalent enteric pathogen among children (34.4%), and its level was higher than that in previous studies in Ecuador (ranging from 11 to 24%) (8,37). Dogs, rabbits, pigs, guinea pigs, and sheep also carried G. lamblia in this location, which is an indication of transmission among animal species.…”

“…is uncommon (17). Meanwhile, STEC is considered a food-borne disease with ruminants as the main reservoir (7); however, symptomatic disease in humans seems to be uncommon in Ecuador (8,10). Despite the proximity of study households to poultry industrial operations, Salmonella was not detected in children, although it was isolated from five dogs (S. enterica serovar Infantis).…”

“…Cryptosporidium spp. are associated with morbidity and mortality in young children in developing countries (39) and may be an important cause of diarrhea in Ecuadorian rural villages (8). Although Cryptosporidium spp.…”

“…LMICs report many zoonotic pathogens that are rare in industrialized nations and vice versa (4). For instance, Campylobacter jejuni, non-Typhi Salmonella, and enterohemorrhagic Escherichia coli (EHEC) are zoonotic pathogens associated with high morbidity in high-income countries (6,7), but they are unusual causes of human disease in LMICs (8)(9)(10).…”

Frequency and antimicrobial behaviour of thermophilic Campylobacter species isolated from Ecuadorian backyard chickens

“…Few data exist regarding the frequency of Campylobacter species in children with diarrhoea in Ecuador where these bacteria have been isolated between 10 and 23% (Guderian et al 1987, Vasco et al 2014.…”