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Somji, Sarah; Ashorn, Per; Manji, Karim; Ahmed, Tahmeed; Chisti, Md; Dhingra, Usha; Sazawal, Sunil; Singa, Benson; Walson, Judd L; Pavlinac, Patricia; Bar-Zeev, Naor; Houpt, Eric; Dube, Queen; Kotloff, Karen; Sow, Samba; Yousafzai, Mohammad Tahir; Qamar, Farah; Bahl, Rajiv; De Costa, Ayesha; Simon, Jonathon; Sudfeld, Christopher R; Duggan, Christopher P

Clinical and nutritional correlates of bacterial diarrhoea aetiology in young children: a secondary cross-sectional analysis of the ABCD trial

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  • Media type: E-Article
  • Title: Clinical and nutritional correlates of bacterial diarrhoea aetiology in young children: a secondary cross-sectional analysis of the ABCD trial
  • Contributor: Somji, Sarah; Ashorn, Per; Manji, Karim; Ahmed, Tahmeed; Chisti, Md; Dhingra, Usha; Sazawal, Sunil; Singa, Benson; Walson, Judd L; Pavlinac, Patricia; Bar-Zeev, Naor; Houpt, Eric; Dube, Queen; Kotloff, Karen; Sow, Samba; Yousafzai, Mohammad Tahir; Qamar, Farah; Bahl, Rajiv; De Costa, Ayesha; Simon, Jonathon; Sudfeld, Christopher R; Duggan, Christopher P
  • imprint: BMJ, 2024
  • Published in: BMJ Paediatrics Open
  • Language: English
  • DOI: 10.1136/bmjpo-2023-002448
  • ISSN: 2399-9772
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Objective</jats:title><jats:p>The objective was to assess the association between nutritional and clinical characteristics and quantitative PCR (qPCR)-diagnosis of bacterial diarrhoea in a multicentre cohort of children under 2 years of age with moderate to severe diarrhoea (MSD).</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A secondary cross-sectional analysis of baseline data collected from the AntiBiotics for Children with Diarrhoea trial (<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT03130114">NCT03130114</jats:ext-link>).</jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p>Children with MSD (defined as<jats:underline>&gt;</jats:underline>3 loose stools within 24 hours and presenting with at least one of the following: some/severe dehydration, moderate acute malnutrition (MAM) or severe stunting) enrolled in the ABCD trial and collected stool sample.</jats:p></jats:sec><jats:sec><jats:title>Study period</jats:title><jats:p>June 2017–July 2019.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>None.</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>Likely bacterial aetiology of diarrhoea. Secondary outcomes included specific diarrhoea aetiology.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 6692 children with MSD had qPCR results available and 28% had likely bacterial diarrhoea aetiology. Compared with children with severe stunting, children with MAM (adjusted OR (aOR) (95% CI) 1.56 (1.18 to 2.08)), some/severe dehydration (aOR (95% CI) 1.66 (1.25 to 2.22)) or both (aOR (95% CI) 2.21 (1.61 to 3.06)), had higher odds of having likely bacterial diarrhoea aetiology. Similar trends were noted for stable toxin-enterotoxigenic<jats:italic>Escherichia coli</jats:italic>aetiology. Clinical correlates including fever and prolonged duration of diarrhoea were not associated with likely bacterial aetiology; children with more than six stools in the previous 24 hours had higher odds of likely bacterial diarrhoea (aOR (95% CI) 1.20 (1.05 to 1.36)) compared with those with fewer stools.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The presence of MAM, dehydration or high stool frequency may be helpful in identifying children with MSD who might benefit from antibiotics.</jats:p></jats:sec>
  • Access State: Open Access