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Targeting pathogens can reduce diarrheal deaths illness
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Moderate-to-severe diarrhea could be reduced by using interventions targeting five pathogens —rotavirus, Shigella, heat-stable toxin Escherichia coli, Cryptosporidium, and typical enteropathogenic Escherichia coli, according to study results recently published in The Lancet.
“Our results documenting the substantial burden of moderate-to-severe diarrhea (MSD) in sub-Saharan Africa and South Asia and its close association to malnutrition show that preventive strategies targeting as few as four pathogens could potentially reduce this disease and its sequelae by about 40% during the first 2 years of life,” researchers wrote.
The study included 9,439 children with MSD and 13,129 controls without diarrhea in sub-Saharan Africa and South Asia. Clinical and epidemiological data, anthropometric measurements, and a fecal sample were obtained from all participants. There was a follow-up home visit about 60 days later.
The researchers said the most attributable cases of MSD were due to four pathogens: rotavirus, Cryptosporidium, enterotoxigenic E. coli producing health-stable toxin, and Shigella.
They also found that participants with MSD were at an increased risk for death compared with the controls (OR=8.5; 95% CI, 5.8-12.5); 87.9% of the deaths occurred within the first 2 years of life.
According to the researchers, the pathogens associated with an increased risk for death in infants aged 0 to 11 months were enterotoxigenic E. coli producing health-stable toxin (HR=1.9; 95% CI, 0.99-3.5) and typical enteropathogenic E. coli (HR=2.6; 95% CI, 1.6-4.1), and Cryptosporidium in toddlers aged 12 to 23 months (HR=2.3; 95% CI, 1.3-4.3).
“Targeting these pathogens with existing interventions, such as the rotavirus vaccine, as well as developing new therapies and treating the malnutrition that follows MSD, could have a large impact on the mortality and morbidity caused by this debilitating condition,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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