Prevalence and Association of Escherichia coli and Diarrheagenic Escherichia coli in Stored Foods for Young Children and Flies Caught in the Same Households in Rural Bangladesh

Abstract

Abstract.Consumption of contaminated stored food can cause childhood diarrhea. Flies carry enteropathogens, although their contribution to food contamination remains unclear. We investigated the role of flies in contaminating stored food by collecting food and flies from the same households in rural Bangladesh. We selected 182 households with children ≤ 24 months old that had stored foods for later feeding at room temperature for ≥ 3 hours. We collected food samples and captured flies with fly tapes hung by the kitchen. We used the IDEXX Quanti-Tray System (Colilert-18 media; IDEXX Laboratories, Inc., Westbrook, ME) to enumerate Escherichia coli with the most probable number (MPN) method. Escherichia coli–positive IDEXX wells were analyzed by polymerase chain reaction for pathogenic E. coli genes (eae, ial, bfp, ipaH, st, lt, aat, aaiC, stx1, and stx2). Escherichia coli was detected in 61% (111/182) of food samples, with a mean of 1.1 log10 MPN/dry g. Fifteen samples (8%) contained pathogenic E. coli; seven (4%) had enteropathogenic E. coli (EPEC) genes (eae and/or bfp); and 10 (5%) had enteroaggregative E. coli genes (aat and/or aaiC). Of flies captured in 68 (37%) households, E. coli was detected in 41 (60%, mean 2.9 log10 MPN/fly), and one fly (1%) had an EPEC gene (eae). For paired fly-food samples, each log10 MPN E. coli increase in flies was associated with a 0.31 log10 MPN E. coli increase in stored food (95% confidence interval: 0.07, 0.55). In rural Bangladesh, flies possibly a likely route for fecal contamination of stored food. Controlling fly populations may reduce contamination of food stored for young children.

Ingestion of Fecal Bacteria along Multiple Pathways by Young Children in Rural Bangladesh Participating in a Cluster-Randomized Trial of Water, Sanitation, and Hygiene Interventions (WASH Benefits)

“…coli ingested, indicating that improved food hygiene intervention could substantially reduce exposure to fecal pathogens for children in this age group. Recent studies have explored the degree of contamination in foods consumed by young children. ,,− Potential mechanisms of food contamination include contamination by dust, flies, and contaminated hands. − Food hygiene interventions that focus on handwashing before food preparation and covering cooked food during storage could reduce food contamination and diarrhea. , …”

The relationship of household assets and amenities with child health outcomes: An exploratory cross-sectional study in India 2015–2016

“…Further, since cooking food is time-consuming without modern cooking stoves, in many LMICs, food is commonly stored at ambient temperature for multiple feeding events, which increases the risk of contamination (Doza et al, 2018; Islam et al, 2012). Majority of diarrheal episodes are food-borne, and both refrigerators and electric cooking stoves can reduce food contamination (Meckel, 1990; Nickles, 2002; The Economist, 2014).…”

Do Sanitation Improvements Reduce Fecal Contamination of Water, Hands, Food, Soil, and Flies? Evidence from a Cluster-Randomized Controlled Trial in Rural Bangladesh

“… 11 In low-income countries, fecal contamination is pervasive on surfaces and objects in the domestic environment 12 and ambient waters used for bathing and washing dishes. 13 Flies carry fecal pathogens 14 , 15 and can transmit these to stored food; 16 fly control programs have successfully reduced diarrheal diseases. 17 , 18 Soil is increasingly recognized as a reservoir for fecal organisms and has been linked to fecal contamination of drinking water, hands, and food; 19 ingestion of soil by children has been associated with environmental enteric dysfunction and stunting.…”

“…In low-income countries, fecal contamination is pervasive on surfaces and objects in the domestic environment and ambient waters used for bathing and washing dishes . Flies carry fecal pathogens , and can transmit these to stored food; fly control programs have successfully reduced diarrheal diseases. , Soil is increasingly recognized as a reservoir for fecal organisms and has been linked to fecal contamination of drinking water, hands, and food; ingestion of soil by children has been associated with environmental enteric dysfunction and stunting . Identifying which of these transmission pathways are blocked by different interventions elucidates the mechanisms through which water, sanitation and hygiene programs improve health and allows broader understanding of how findings might generalize to other settings.…”