Etiology of diarrheal hospitalizations following rotavirus vaccine implementation and association of enteric pathogens with malnutrition among under-five children in India
Tintu Varghese,
James A. Platts Mills,
R. Revathi,
Sebastien Antoni,
Heidi M. Soeters,
Tondo Opute Emmanuel Njambe,
Eric R. Houpt,
Jacqueline E. Tate,
Umesh D. Parashar,
Gagandeep Kang
Affiliations
Tintu Varghese
The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College
James A. Platts Mills
Division of Infectious Diseases and International Health, University of Virginia
R. Revathi
The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College
Sebastien Antoni
World Health Organization
Heidi M. Soeters
World Health Organization
Tondo Opute Emmanuel Njambe
World Health Organization Regional Office for South-East Asia
Eric R. Houpt
Division of Infectious Diseases and International Health, University of Virginia
Jacqueline E. Tate
Division of Viral Diseases, Centers for Disease Control and Prevention
Umesh D. Parashar
Division of Viral Diseases, Centers for Disease Control and Prevention
Gagandeep Kang
The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College
Abstract Malnourished children are at higher risk of mortality and morbidity following diarrheal illness and certain enteropathogens have been associated with malnutrition in children. Very few studies have comprehensively looked at the etiology of diarrhea in malnourished children and most have used conventional diagnostic methods with suboptimal sensitivity. We used a highly sensitive molecular approach against a broad range of pathogens causing diarrhea and examined their association with malnutrition. In addition, we looked at the pathogen diversity of pediatric diarrhea, three years after the nationwide rotavirus vaccine introduction to understand the evolving landscape of pathogens, which is crucial for planning strategies to further reduce the diarrhea burden. Clinical details and diarrheal stool samples were collected from hospitalized children aged 2 years. These data on the prevalence and epidemiology of enteropathogens identified potential pathogens for public health interventions.