Division of Epidemiology and Biostatistics, University of California, Berkeley, Berkeley, United States; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, United States; Department of Ophthalmology, University of California, San Francisco, San Francisco, United States
Diana L Martin
Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, United States
Jane Juma
Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
Harran Mkocha
Kongwa Trachoma Project, Kongwa, United Republic of Tanzania
John B Ochieng
Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
Gretchen M Cooley
Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, United States
Richard Omore
Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
E Brook Goodhew
Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, United States
Jamae F Morris
Department of African-American Studies, Georgia State University, Atlanta, United States
Veronica Costantini
Division of Viral Diseases, United States Centers for Disease Control and Prevention, Atlanta, United States
Jan Vinjé
Division of Viral Diseases, United States Centers for Disease Control and Prevention, Atlanta, United States
Patrick J Lammie
Division of Parasitic Diseases and Malaria, United States Centers for Disease Control and Prevention, Atlanta, United States; Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, United States
Jeffrey W Priest
Division of Foodborne, Waterborne, and Environmental Diseases, United States Centers for Disease Control and Prevention, Atlanta, United States
Little is known about enteropathogen seroepidemiology among children in low-resource settings. We measured serological IgG responses to eight enteropathogens (Giardia intestinalis, Cryptosporidium parvum, Entamoeba histolytica, Salmonella enterica, enterotoxigenic Escherichia coli, Vibrio cholerae, Campylobacter jejuni, norovirus) in cohorts from Haiti, Kenya, and Tanzania. We studied antibody dynamics and force of infection across pathogens and cohorts. Enteropathogens shared common seroepidemiologic features that enabled between-pathogen comparisons of transmission. Overall, exposure was intense: for most pathogens the window of primary infection was <3 years old; for highest transmission pathogens primary infection occurred within the first year. Longitudinal profiles demonstrated significant IgG boosting and waning above seropositivity cutoffs, underscoring the value of longitudinal designs to estimate force of infection. Seroprevalence and force of infection were rank-preserving across pathogens, illustrating the measures provide similar information about transmission heterogeneity. Our findings suggest antibody response can be used to measure population-level transmission of diverse enteropathogens in serologic surveillance.
