Title
A pilot study using hospital surveillance and a birth cohort to investigate enteric pathogens and malnutrition in children, Dili, Timor-Leste.
Link to article in PubMed
Author(s)
Cribb, Danielle
Sarmento, Nevio
Moniz, Almerio
Fancourt, Nicholas
Glass, Kathryn
Lay Dos Santos, Milena
Soares da Silva, Endang
Polkinghorne, Benjamin
de Lourdes da Conceiҫão, Virginia
da Conceiҫão, Feliciano
da Silva, Paulino
Jong, Joanita
Kirk, Martyn
Colquhoun, Samantha
Abstract
In low-to-middle-income countries (LMICs), enteric pathogens contribute to child malnutrition, affecting nutrient absorption, inducing inflammation, and causing diarrhoea. This is a substantial problem in LMICs due to high disease burden, poor sanitation and nutritional status, and the cyclical nature of pathogen infection and malnutrition. This relationship remains understudied in Timor-Leste. In our pilot study of enteric pathogens and malnutrition in Dili, Timor-Leste (July 2019-October 2020), we recruited 60 infants in a birth cohort from Hospital Nacional Guido Valadares (HNGV) with up to four home visits. We collected faecal samples and details of demographics, anthropometrics, diet and food practices, and animal husbandry. Additionally, we collected faecal samples, diagnostics, and anthropometrics from 160 children admitted to HNGV with a clinical diagnosis of severe diarrhoea or severe acute malnutrition (SAM). We tested faeces using the BioFire® FilmArray® Gastrointestinal Panel. We detected high prevalence of enteric pathogens in 68.8% (95%CI 60.4-76.2%) of infants at home, 88.6% of SAM cases (95%CI 81.7-93.3%) and 93.8% of severe diarrhoea cases (95%CI 67.7-99.7%). Diarrhoeagenic Escherichia coli and Campylobacter spp. were most frequently detected. Pathogen presence did not significantly differ in birth cohort diarrhoeal stool, but hospital data indicated associations between Salmonella and Shigella and diarrhoea. We observed wasting in 18.4% (95%CI 9.2-32.5%) to 30.8% (95%CI 17.5-47.7%) of infants across home visits, 57.9% (95%CI 34.0-78.9%) of severe diarrhoea cases, and 92.5% (95%CI 86.4-96.2%) of SAM cases. We associated bottle feeding with increased odds of pathogen detection when compared with exclusive breastfeeding at home (OR 8.3, 95%CI 1.1-62.7). We detected high prevalence of enteric pathogens and signs of malnutrition in children in Dili. Our pilot is proof of concept for a study to fully explore the risk factors and associations between enteric pathogens and malnutrition in Timor-Leste.
Publication information
PLoS One . 2024 Feb 1;19(2):e0296774. doi: 10.1371/journal.pone.0296774. eCollection 2024.
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A pilot study using hospital surveillance and a birth.pdf
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Re-used under a Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/
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1.33 MB
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(MD5):8263dca83d2b28a06dea0237aa971694
Date Issued
2024-02-01
Type
Journal Article
Journal Title
PloS one
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