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

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 Kalam,Fatima Aziz,Shahida Qureshi, M Ohedul Islam,Pimmada Sakpaisal,Sasikorn Silapong,Pablo P Yori,Revathi Rajendiran,Blossom Benny,Monica McGrath,Benjamin JJ McCormick,Jessica C Seidman,Dennis Lang,Michael Gottlieb,Richard L Guerrant,Aldo AM Lima,Jose Paulo Leite,Amidou Samie,Pascal O Bessong,Nicola Page,Ladaporn Bodhidatta,Carl Mason,Sanjaya Shrestha,Ireen Kiwelu,Estomih R Mduma,Najeeha T Iqbal,Zulfiqar A Bhutta,Tahmeed Ahmed,Rashidul Haque,Gagandeep Kang,Margaret N Kosek,Eric R Houpt, Angel Mendez Acosta, Rosa Rios de Burga, Cesar Banda Chavez, Julian Torres Flores,Maribel Paredes Olotegui, Silvia Rengifo Pinedo,Dixner Rengifo Trigoso, Angel Orbe Vasquez,Imran Ahmed,Didar Alam,Asad Ali,Muneera Rasheed,Sajid Soofi,Ali Turab,Aisha Yousafzai,Anita KM Zaidi, Binob Shrestha, Bishnu Bahadur Rayamajhi,Tor Strand, Geetha Ammu,Sudhir Babji,Anuradha Bose, Ajila T George,Dinesh Hariraju, M Steffi Jennifer,Sushil John, Shiny Kaki, Priyadarshani Karunakaran,Beena Koshy, Robin P Lazarus,Jayaprakash Muliyil, Preethi Ragasudha,Mohan Venkata Raghava, Sophy Raju,Anup Ramachandran, Rakhi Ramadas,Karthikeyan Ramanujam,Anuradha Rose,Reeba Roshan, Srujan L Sharma, Shanmuga Sundaram,Rahul J Thomas,William K Pan,Ramya Ambikapathi,J Daniel Carreon, Viyada Doan, Christel Hoest, Stacey Knobler,Mark A Miller, Stephanie Psaki, Zeba Rasmussen,Stephanie A Richard, Karen H Tountas,Erling Svensen,Caroline Amour,Eliwaza Bayyo,Regisiana Mvungi,John Pascal,Ladislaus Yarrot, Leah Barrett,Rebecca Dillingham,William A Petri,Rebecca Scharf,AM Shamsir Ahmed,Md Ashraful Alam, Umma Haque,Md Iqbal Hossain,Munirul Islam,Mustafa Mahfuz,Dinesh Mondal,Baitun Nahar,Fahmida Tofail,Ram Krishna Chandyo, Prakash Sunder Shrestha, Rita Shrestha,Manjeswori Ulak, Aubrey Bauck,Robert Black,Laura Caulfield,William Checkley,Gwenyth Lee,Kerry Schulze, Samuel Scott,Laura E Murray-Kolb,A Catharine Ross,Barbara Schaefer, Suzanne Simons,Laura Pendergast, Cláudia B Abreu, Hilda Costa, Alessandra Di Moura, José Quirino Filho, Álvaro M Leite, Noélia L Lima, Ila F Lima, Bruna LL Maciel, Pedro HQS Medeiros, Milena Moraes, Francisco S Mota

The Lancet Global health（2018）

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摘要

BackgroundOptimum 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 …

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