Use of quantitative molecular diagnostic methods to assess the aetiology, burden, and clinical characteristics of diarrhoea in children in low-resource settings: a reanalysis of the MAL-ED cohort study

Publication date: Available online 1 October 2018Source: The Lancet Global HealthAuthor(s): James A Platts-Mills, Jie Liu, Elizabeth T Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Mery Siguas, Shaila S Khan, Ira Praharaj, Arinao Murei, Rosemary Nshama, Buliga Mujaga, Alexandre Havt, Irene A Maciel, Timothy L McMurry, Darwin J Operario, Mami Taniuchi, Jean Gratz, Suzanne E Stroup, James H Roberts, Adil KalamSummaryBackgroundOptimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study.MethodsWe re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included active surveillance for diarrhoea and routine non-diarrhoeal stool collection. We used quantitative PCR to test for 29 enteropathogens, calculated population-level pathogen-specific attributable burdens, derived stringent quantitative cutoffs to identify aetiology for individual episodes, and created aetiology prediction scores using ...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research