Pediatric diarrhea in Southern Ghana: Etiology and association with intestinal inflammation and malnutrition

Japheth A. Opintan, Mercy J. Newman, Patrick F. Ayeh-Kumi, Raymond Affrim, Rosina Gepi-Attee, Jesus E.A.D. Sevilleja, James K. Roche, James P. Nataro, Cirle A. Warren, Richard L. Guerrant

Research output: Contribution to journalArticlepeer-review

87 Citations (Scopus)

Abstract

Diarrhea is a major public health problem that affects the development of children. Anthropometric data were collected from 274 children with ( N = 170) and without ( N = 104) diarrhea. Stool specimens were analyzed by conventional culture, polymerase chain reaction for enteroaggregative Escherichia coli (EAEC), Shigella, Cryptosporidium, Entamoeba, and Giardia species, and by enzyme-linked immunosorbent assay for fecal lactoferrin levels. About 50% of the study population was mildly to severely malnourished. Fecal lactoferrin levels were higher in children with diarrhea ( P = 0.019). Children who had EAEC infection, with or without diarrhea, had high mean lactoferrin levels regardless of nutritional status. The EAEC and Cryptosporidium were associated with diarrhea ( P = 0.048 and 0.011, respectively), and malnourished children who had diarrhea were often co-infected with both Cryptosporidium and EAEC. In conclusion, the use of DNA-biomarkers revealed that EAEC and Cryptosporidium were common intestinal pathogens in Accra, and that elevated lactoferrin was associated with diarrhea in this group of children.

Original languageEnglish
Pages (from-to)936-943
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume83
Issue number4
DOIs
Publication statusPublished - Oct 2010

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