ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Exploring Survey-Based Water, Sanitation, and Animal Associations With Enteric Pathogen Carriage: Comparing Results in a Cohort of Cases With Moderate-to-Severe Diarrhea to Those in Controls in the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015-2018.
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, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Childhood diarrhoea attributed to enteropathogenic bacteria in low- and middle-income countries: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- Bacterial and parasitic etiologies of diarrhea and the emerging role ofIJID regions · 2026Article
- Antimicrobial resistance and toxin profiles of enterotoxigenic Escherichia coli in children under five years old with diarrhoea in Ouagadougou, Burkina Faso: a sentinel surveillance study.BMC infectious diseases · 2026Article
- Spatial clustering of Giardia duodenalis assemblages and sub-assemblages with environmental and anthropozoonotic factors in Busia, Western Kenya.Journal of health, population, and nutrition · 2025Article
- METTL14 protects sheep small intestinal epithelial cells against Escherichia coli F17 infection by influencing the PI3K-Akt signaling pathway.Veterinary research · 2025Article
- Exploring Associations Between WaSH-Related Health Outcomes and Terrorist Activities in the Sahel: A Scoping Review.Public health reviews · 2025Review
- Asymptomatic carriage of intestinal protists is common in children in Lusaka Province, Zambia.PLoS neglected tropical diseases · 2024Article
- Article
- Survey-Based Assessment of Water, Sanitation, and Animal-Associated Risk Factors for Moderate-to-Severe Diarrhea in the Vaccine Impact on Diarrhea in Africa (VIDA) Study: The Gambia, Mali, and Kenya, 2015-2018.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
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27 authors.
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Abstract
backgroundThe magnitude of pediatric enteric pathogen exposures in low-income settings necessitates substantive water and sanitation interventions, including animal feces management. We assessed associations between pediatric enteric pathogen detection and survey-based water, sanitation, and animal characteristics within the Vaccine Impact on Diarrhea in Africa case-control study.
methodsIn The Gambia, Kenya, and Mali, we assessed enteric pathogens in stool of children aged <5 years with moderate-to-severe diarrhea and their matched controls (diarrhea-free in prior 7 days) via the TaqMan Array Card and surveyed caregivers about household drinking water and sanitation conditions and animals living in the compound. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using modified Poisson regression models, stratified for cases and controls and adjusted for age, sex, site, and demographics.
resultsBacterial (cases, 93%; controls, 72%), viral (63%, 56%), and protozoal (50%, 38%) pathogens were commonly detected (cycle threshold <35) in the 4840 cases and 6213 controls. In cases, unimproved sanitation (RR, 1.56; 95% CI, 1.12-2.17), as well as cows (RR, 1.61; 95% CI, 1.16-2.24) and sheep (RR, 1.48; 95% CI, 1.11-1.96) living in the compound, were associated with Shiga toxin-producing Escherichia coli. In controls, fowl (RR, 1.30; 95% CI, 1.15-1.47) were associated with Campylobacter spp. In controls, surface water sources were associated with Cryptosporidium spp., Shigella spp., heat-stable toxin-producing enterotoxigenic E. coli, and Giardia spp.
conclusionsFindings underscore the importance of enteric pathogen exposure risks from animals alongside more broadly recognized water and sanitation risk factors in children.
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