Prevalence of Infection With Waterborne Pathogens: A Seroepidemiologic Study in Children 6–36 Months Old in San Juan Sacatepequez, Guatemala

Abstract

Water and sanitation interventions in developing countries have historically been difficult to evaluate. We conducted a seroepidemiologic study with the following goals: 1) to determine the feasibility of using antibody markers as indicators of waterborne pathogen infection in the evaluation of water and sanitation intervention projects; 2) to characterize the epidemiology of waterborne diarrheal infections in rural Guatemala, and 3) to measure the age-specific prevalence of antibodies to waterborne pathogens. Between September and December 1999, all children 6-36 months of age in 10 study villages were invited to participate. We collected sufficient serum from 522 of 590 eligible children, and divided them into six-month age groups for analysis (6-12, 13-18, 19-24, 25-30, and 31-36 months). The prevalence of antibodies was lowest in children 6-12 months old compared with the four older age groups for the following pathogens: enterotoxigenic Escherichia coli (48%, 81%, 80%, 77%, and 83%), Norwalk virus (27%, 61%, 83%, 94%, and 94%), and Cryptosporidium parvum (27%, 53%, 70%, 67%, and 73%). The prevalence of total antibody to hepatitis A virus increased steadily in the three oldest age groups (40%, 28%, 46%, 60%, and 76%). In contrast, the prevalence of antibody to Helicobacter pylori was relatively constant in all five age groups (20%, 19%, 21%, 25%, and 25%). Serology appears to be an efficient and feasible approach for determining the prevalence of infection with selected waterborne pathogens in very young children. Such an approach may provide a suitable, sensitive, and economical alternative to the cumbersome stool collection methods that have previously been used for evaluation of water and sanitation projects.

Longitudinal Analysis of Cryptosporidium Species-Specific Immunoglobulin G Antibody Responses in Peruvian Children

“…from a study in rural China, and from a study in Guatemala (37,43,47). However, the results observed for the 74 children in our study must be interpreted with some caution, as they may not be representative of the entire birth cohort.…”

Towards a US national estimate of the risk of endemic waterborne disease – sero-epidemiologic studies

“…Steinberg and others studied seroprevalence of several waterborne infections in infants 6-36 months old in Guatemala (Steinberg et al 2004). They used the second generation ELISA (see below, Priest et al 2001) to measure…”

Cloning and Characterization of the Acidic Ribosomal Protein P2 ofCryptosporidium parvum, a New 17-Kilodalton Antigen

“…Populations in developing regions of the world, like Haiti and Peru, are certainly exposed to Cryptosporidium at a young age and suffer repeated infections. The prevalence of antibodies to the 27-kDa antigen was 2-to 3-fold higher for Haitian children Յ10 years of age (52 to 63%) (this work) than for U.S. children (21.3%) (21), and although the method of assay has varied between studies, similarly high seroprevalence values (40 to 100%) have been reported for children in other developing countries around the world (71,76,80). Incidence rates based on stool microscopy are also much higher among children in the developing world.…”