ArticleAmerican journal of epidemiology2012
Synergistic effects between rotavirus and coinfecting pathogens on diarrheal disease: evidence from a community-based study in northwestern Ecuador.
Article in American journal of epidemiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers.
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69 citing papers in PubMed.
- Vulnerability to climate-driven pathogen-specific diarrheal diseases: secondary analysis from the Global Enteric Multicenter Study and Vaccine Impact on Diarrhea in Africa follow-up.Nature communications · 2026Article
- Co-infection and interaction of enteric pathogens in acute diarrhea among children under five years: a large-scale multicenter observational study from China.Infectious diseases of poverty · 2025Observational
- Viral co-infections in pediatric acute gastroenteritis: epidemiology of rotavirus, norovirus, adenovirus, and astrovirus in Tehran, Iran (2021-2022).BMC infectious diseases · 2025Article
- Goblet cells dictate viral tropism and pathogenesis in nasal and intestinal mucosae.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Molecular mechanisms of co-infections.EMBO reports · 2025Review
- Giardia-induced Type 2 mucosal immunity attenuates intestinal inflammation caused by co-infection or colitis in mice.Nature microbiology · 2025Article
- Comparative clinical, virological and pathological characterization of equine rotavirus A G3P[12] and G14P[12] infection in neonatal mice.The Journal of general virology · 2025Article
- Viral-bacterial co-infections screen in vitro reveals molecular processes affecting pathogen proliferation and host cell viability.Nature communications · 2024Article
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- Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance.BMC infectious diseases · 2024Article
- Synergistic Effects of Rotavirus and Co-Infecting Viral Enteric Pathogens on Diarrheal Disease - Guangzhou City, Guangdong Province, China, 2019.China CDC weekly · 2023Article
- Giardia Detection and Codetection With Other Enteric Pathogens in Young Children in the Vaccine Impact on Diarrhea in Africa (VIDA) Case-Control Study: 2015-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Detection of Foodborne Pathogens in Acute Gastroenteritis Patient's Stool Samples Using the BioFireMicroorganisms · 2022Article
- Epidemiological investigations of diarrhea in children in Praia city, Cape Verde.Frontiers in microbiology · 2022Article
- Infection WithFrontiers in cellular and infection microbiology · 2022Article
- Viral Etiology of Acute Gastroenteritis Among Forcibly Displaced Myanmar Nationals and Adjacent Host Population in Bangladesh.The Journal of infectious diseases · 2021Article
- High Prevalence of Coinfecting Enteropathogens in Suspected Rotavirus Vaccine Breakthrough Cases.Journal of clinical microbiology · 2021Article
- Gut microbiome, enteric infections and child growth across a rural-urban gradient: protocol for the ECoMiD prospective cohort study.BMJ open · 2021Article
- Multiple burdens of malnutrition and relative remoteness in rural Ecuadorian communities.Public health nutrition · 2021Article
9 more citing papers are in PubMed but not listed here.
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Abstract
In developing countries where diarrheal disease is a leading cause of morbidity and mortality in children under 5 years of age, enteric coinfection is common. There is little understanding, however, of the biologic interaction between coinfecting pathogens. The authors investigated the potential for synergistic interaction between coinfecting pathogens on diarrhea pathogenesis using an epidemiologic framework. They conducted community-based, case-control studies in 22 communities in northwestern Ecuador between 2003 and 2008. Risk ratios of diarrhea associated with single infections and coinfections were estimated. Interaction between coinfecting pathogens was assessed through departure from risk ratio additivity and multiplicativity after adjustment for age. On the additive scale, the authors found departure from the null value of 0 for rotavirus-Giardia coinfections (interaction contrast ratio = 8.0, 95% confidence interval: 3.1, 18.9) and for rotavirus-Escherichia coli coinfections (interaction contrast ratio = 9.9, 95% confidence interval: 2.6, 28.4). On the multiplicative scale, they found departure from the value of 1 for rotavirus-Giardia coinfections (multiplicative interaction = 3.6, 95% confidence interval: 1.3, 8.7). This research provides epidemiologic evidence for synergism between rotavirus and other enteric pathogens. During coinfection, the pathogenic potential of each organism appears to be enhanced. The potential for pathogenesis to be more severe in the presence of a rotavirus coinfection amplifies the need for rotavirus vaccination.
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