ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Epidemiology of Enteroaggregative, Enteropathogenic, and Shiga Toxin-Producing Escherichia coli Among Children Aged <5 Years in 3 Countries in Africa, 2015-2018: Vaccine Impact on Diarrhea in Africa (VIDA) Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Childhood diarrhoea attributed to enteropathogenic bacteria in low- and middle-income countries: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- Etiology-specific incidence and mortality of diarrheal diseases in the African region: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Allelic variations of intimin virulence gene (eae) in typical and atypical enteropathogenic Escherichia coli isolated from children with and without diarrhea in a rural area of southern Mozambique.BMC infectious diseases · 2026Article
- Article
- Genome-Based In Silico Analysis of the Structural and Functional Characteristics of the Type Three Secretion System (T3SS) and Core Effector Proteins in EnteropathogenicPathogens (Basel, Switzerland) · 2025Article
- Environmental Exposures Associated with Enteropathogen Infection in Six-Month-Old Children Enrolled in the ECoMiD Cohort along a Rural-Urban Gradient in Northern Ecuador†.Environmental science & technology · 2025Article
- Detection ofInfection and drug resistance · 2025Article
- EnteroaggregativeFrontiers in microbiology · 2025Article
- Article
Corrections and comments
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Authors and funding
32 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo address knowledge gaps regarding diarrheagenic Escherichia coli (DEC) in Africa, we assessed the clinical and epidemiological features of enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), and Shiga toxin-producing E. coli (STEC) positive children with moderate-to-severe diarrhea (MSD) in Mali, The Gambia, and Kenya.
methodsBetween May 2015 and July 2018, children aged 0-59 months with medically attended MSD and matched controls without diarrhea were enrolled. Stools were tested conventionally using culture and multiplex polymerase chain reaction (PCR), and by quantitative PCR (qPCR). We assessed DEC detection by site, age, clinical characteristics, and enteric coinfection.
resultsAmong 4840 children with MSD and 6213 matched controls enrolled, 4836 cases and 1 control per case were tested using qPCR. Of the DEC detected with TAC, 61.1% were EAEC, 25.3% atypical EPEC (aEPEC), 22.4% typical EPEC (tEPEC), and 7.2% STEC. Detection was higher in controls than in MSD cases for EAEC (63.9% vs 58.3%, P < .01), aEPEC (27.3% vs 23.3%, P < .01), and STEC (9.3% vs 5.1%, P < .01). EAEC and tEPEC were more frequent in children aged <23 months, aEPEC was similar across age strata, and STEC increased with age. No association between nutritional status at follow-up and DEC pathotypes was found. DEC coinfection with Shigella/enteroinvasive E. coli was more common among cases (P < .01).
conclusionsNo significant association was detected between EAEC, tEPEC, aEPEC, or STEC and MSD using either conventional assay or TAC. Genomic analysis may provide a better definition of the virulence factors associated with diarrheal disease.
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Registered trials
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