ArticleThe Lancet. Global health2019
Burden of enterotoxigenic Escherichia coli and shigella non-fatal diarrhoeal infections in 79 low-income and lower middle-income countries: a modelling analysis.
Article in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 3 of them syntheses that pooled it.
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Who cites it
107 citing papers in PubMed, 3 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- Anthropometric and neurocognitive consequences of Campylobacter, enterotoxigenic Escherichia coli, and norovirus: A systematic review.PLoS neglected tropical diseases · 2025Pooled it
- Burden of Shigella among children with diarrhea in the Americas: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2025Pooled it
- Consequences of Shigella infection in young children: a systematic review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Pooled it
- Effects of improved water, sanitation, handwashing, and nutrition on early childhood IgG immune repertoire development againstmSphere · 2026Trial
- Safety and immunogenicity of the oral, inactivated, enterotoxigenic Escherichia coli vaccine ETVAX in Bangladeshi children and infants: a double-blind, randomised, placebo-controlled phase 1/2 trial.The Lancet. Infectious diseases · 2020Trial
- Indole decreases the virulence of enterotoxigenic Escherichia coli.World journal of microbiology & biotechnology · 2026Article
- Review
- Emerging and Underdetected Colonization Factors in EnterotoxigenicMicroorganisms · 2026Review
- Regulation and Characterization of the Cex system of enteric pathogens: a pathway for the lipidation and secretion of noncanoncial bacterial lipoproteins.bioRxiv : the preprint server for biology · 2026Article
- Genomic characterization of Enterotoxigenic Escherichia coli lineage 2 (CS2 + CS3) by long-read sequencing reveals distinct lineage-specific genome organization.Scientific reports · 2026Article
- One Health Perspective on the EnterotoxigenicMicroorganisms · 2026Review
- Prevalence of extended-spectrum β-lactamase and carbapenemase-producing Escherichia coli from patients, cattle, and environmental sources in northwest Amhara, Ethiopia: a one health approach.BMC microbiology · 2026Article
- Impact of Oral Pre-Exposure Secretory IgA Prophylactic Produced in Rice on Gut Microbiome Homeostasis.Pharmaceutics · 2026Article
- Vaccine Candidates Designed to Prevent Enterotoxigenic Escherichia coli Diarrhoea: A Scoping Review of Clinical Trials Evaluating Vaccine Candidates in Development.Tropical medicine & international health : TM & IH · 2026Article
- Systemic and mucosal immunity to enterotoxigenicFrontiers in immunology · 2026Review
- Preclinical evaluation of multivalent vaccine combinations againstFrontiers in immunology · 2026Article
- Evaluation of cross-functional antibody responses elicited by a four-component GMMA Shigella vaccine.NPJ vaccines · 2025Article
- Evaluation of the performance and feasibility of RLDT in detectingmedRxiv : the preprint server for health sciences · 2025Article
- Effects of improved water, sanitation, handwashing and nutrition on early childhood IgG immune repertoire development againstmedRxiv : the preprint server for health sciences · 2025Article
- Burden of inflammatory enteritis caused by diarrheagenicPreventive medicine reports · 2025Article
47 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnterotoxigenic Escherichia coli (ETEC) and shigella are two major pathogens that cause moderate-to-severe diarrhoea in children younger than 5 years. Diarrhoea is associated with an increased risk of stunting, which puts children at risk of death due to other infectious diseases.
methodsWe modelled ETEC-related and shigella-related mortality and the effect of moderate-to-severe diarrhoea episodes to determine the number of children with stunting due to these infections in 79 low-income and lower middle-income countries. We applied population attributable risk for increased number of deaths due to other infectious diseases in children who are stunted. We calculated 95% uncertainty intervals (UIs) for the point estimates.
findingsIn children younger than 5 years, we estimate 196 million (95% UI 135-269) episodes of ETEC and shigella diarrhoea occur annually, resulting in 3·5 million (0·8-5·4) cases of moderate-to-severe stunting and 44 400 (29 400-59 800) total ETEC deaths and 63 100 (44 000-81 900) total shigella deaths in 2015. Additional infectious disease mortality due to stunting resulted in increases of 24% (8-34; for ETEC) and 28% (10-39; for shigella) over direct deaths due to diarrhoeal episodes. The distribution of mortality and morbidity varied geographically, with African Region and Eastern Mediterranean Region countries bearing the greatest burden.
interpretationThe expanded effects of non-fatal ETEC and shigella-related diarrhoeal episodes can have lasting consequences. Prevention of these infections could reduce the risk of direct death and stunting and deaths due to other infectious diseases. Understanding the countries and populations with the highest disease risk helps to target interventions for the most vulnerable populations.
fundingThe Bill & Melinda Gates Foundation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.