scholarly journals Gut microbiome, enteric infections and child growth across a rural–urban gradient: protocol for the ECoMiD prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046241
Author(s):  
Gwenyth O Lee ◽  
Joseph N S Eisenberg ◽  
Jessica Uruchima ◽  
Gabriela Vasco ◽  
Shanon M Smith ◽  
...  
Keyword(s):  
Cohort Study ◽  
San Francisco ◽  
Environmental Conditions ◽  
Gut Microbiome ◽  
Child Growth ◽  
Birth Cohort Study ◽  
Institutional Review Boards ◽  
Healthy Children ◽  
Urban Gradient ◽  
Enteric Infections

IntroductionThe functional consequences of the bacterial gut microbiome for child health are not well understood. Characteristics of the early child gut microbiome may influence the course of enteric infections, and enteric infections may change the composition of the gut microbiome, all of which may have long-term implications for child growth and development.Methods and analysisWe are conducting a community-based birth cohort study to examine interactions between gut microbiome conditions and enteric infections, and how environmental conditions affect the development of the gut microbiome. We will follow 360 newborns from 3 sites along a rural–urban gradient in northern coastal Ecuador, characterising enteric infections and gut microbial communities in the children every 3 to 6 months over their first 2 years of life. We will use longitudinal regression models to assess the correlation between environmental conditions and gut microbiome diversity and presence of specific taxa, controlling for factors that are known to be associated with the gut microbiome, such as diet. From 6 to 12 months of age, we will collect weekly stool samples to compare microbiome conditions in diarrhoea stools versus stools from healthy children prior to, during and after acute enteric infections, using principal-coordinate analysis and other multivariate statistical methods.Ethics and disseminationEthics approvals have been obtained from Emory University and the Universidad San Francisco de Quito institutional review boards. The findings will be disseminated through conference presentations and peer-reviewed journals.

scholarly journals Early childhood cognitive development is affected by interactions among illness, diet, enteropathogens and the home environment: findings from the MAL-ED birth cohort study

2018 ◽  
Vol 3 (4) ◽  
pp. e000752 ◽  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Cognitive Development ◽  
Birth Cohort ◽  
Home Environment ◽  
Low Income ◽  
Child Growth ◽  
Birth Cohort Study ◽  
Middle Income ◽  
Enteric Infections

BackgroundMillions of children in low-income and middle-income countries (LMICs) are at risk of not reaching their full cognitive potential. Malnutrition and enteric infections in early life are implicated as risk factors; however, most studies on these risks and their associations with cognitive development have failed to adequately account for confounding factors or the accumulation of putative insults. Here, we examine the interaction between infections and illness on cognitive development in LMIC community settings.MethodsAs part of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) longitudinal birth cohort study, children from eight LMICs were followed from birth to 24 months to understand the influence of repeated enteric infections on child growth and development. Here, data from six sites were employed to evaluate associations between infection, illness, the home environment, micronutrient intake and status, maternal reasoning, and cognitive development at 24 months.ResultsHigher rates of enteropathogen detection and days with illness were associated with lower haemoglobin concentrations, which in turn were associated with lower cognitive scores at 24 months. Children with lower environmental health/safety scores and lower intakes of vitamin B6 and folate had more enteropathogen detections and illness. Strength of associations varied by weight-for-age in the first 17 days of life; lower weight infants were more susceptible to the negative effects of enteropathogens and illness.ConclusionsEnteropathogens were negatively related to child cognitive development. However, other factors were more strongly associated with child cognition. Targeting of interventions to improve cognitive development should include a focus on reducing frequency of illness, improving the safety and healthfulness of the child’s environment, and improving dietary intake.

scholarly journals Parechovirus A Infections in Healthy Australian Children During the First 2 Years of Life: A Community-based Longitudinal Birth Cohort Study

2019 ◽  
Vol 71 (1) ◽  
pp. 116-127 ◽  
Author(s):  
Claire Y T Wang ◽  
Robert S Ware ◽  
Stephen B Lambert ◽  
Lebogang P Mhango ◽  
Sarah Tozer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Birth Cohort ◽  
Observational Research ◽  
Birth Cohort Study ◽  
Healthy Children ◽  
Community Based ◽  
Nasal Swabs ◽  
Severe Infections ◽  
Polymerase Chain

Abstract Background Hospital-based studies identify parechovirus (PeV), primarily PeV-A3, as an important cause of severe infections in young children. However, few community-based studies have been published and the true PeV infection burden is unknown. We investigated PeV epidemiology in healthy children participating in a community-based, longitudinal birth cohort study. Methods Australian children (n = 158) enrolled in the Observational Research in Childhood Infectious Diseases (ORChID) study were followed from birth until their second birthday. Weekly stool and nasal swabs and daily symptom diaries were collected. Swabs were tested for PeV by reverse-transcription polymerase chain reaction and genotypes determined by subgenomic sequencing. Incidence rate, infection characteristics, clinical associations, and virus codetections were investigated. Results PeV was detected in 1423 of 11 124 (12.8%) and 17 of 8100 (0.2%) stool and nasal swabs, respectively. Major genotypes among the 306 infection episodes identified were PeV-A1 (47.9%), PeV-A6 (20.1%), and PeV-A3 (18.3%). The incidence rate was 144 episodes (95% confidence interval, 128–160) per 100 child-years. First infections appeared at a median age of 8 (interquartile range, 6.0–11.7) months. Annual seasonal peaks changing from PeV-A1 to PeV-A3 were observed. Infection was positively associated with age ≥6 months, summer season, nonexclusive breastfeeding at age <3 months, and formal childcare attendance before age 12 months. Sole PeV infections were either asymptomatic (38.4%) or mild (32.7%), while codetection with other viruses in stool swabs was common (64.4%). Conclusions In contrast with hospital-based studies, this study showed that diverse and dynamically changing PeV genotypes circulate in the community causing mild or subclinical infections in children. Parechovirus can cause severe illnesses in children. However, studies focus mainly on hospitalized populations. True disease burden in the community remains largely unknown. From our community-based cohort, we found diverse parechovirus genotypes in the community, causing mild or subclinical infections in children. Clinical Trials Registration NCT01304914.

scholarly journals Risk Factors for Infant Feeding Practices Along a Rural-Urban Gradient in Coastal Esmeraldas Province, Ecuador

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 824-824
Author(s):  
Jessica Uruchima ◽  
Gwenyth Lee ◽  
Andrew Jones ◽  
Nancy Castro Morillo ◽  
Andrea Anchundia Ortega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Communities ◽  
Food Insecurity ◽  
Infant Feeding ◽  
Child Growth ◽  
Rural Site ◽  
Birth Cohort Study ◽  
Urban Gradient ◽  
Lower Odds ◽  
Urban City

Abstract Objectives We describe infant and young child feeding (IYCF) practices along a rural-urban gradient in the primarily Afro-Ecuadorian province of Esmeraldas, Ecuador, an often-overlooked population. Methods Mother-child dyads from 10 communities were enrolled in the ‘Gut microbiome, enteric infections, and child growth across a rural-urban gradient’ (EcoMID) birth cohort study. Surveys to assess IYCF practices, and potential risk factors for poorer IYCF practices such as problems breastfeeding and food insecurity, were completed 1 week after the child's birth and every 3 months thereafter until the child reached 9 months of age. Fisher exact tests were used to compare the prevalence of recommended IYCF practices between sites, and between risk factors Results We collected data between May 2019 and January 2021 from 115 children: 30 in the urban city of Esmeraldas (U), and 85 in intermediate and rural communities (R). Greater food insecurity was seen in the rural site (44.0% R vs 23.3% U, p = 0.05). Both sites had a similar prevalence of breastfeeding within an hour of birth (73.3% R vs 73.3% U, p = 1.00), and problems breastfeeding at 1 week (64.3% R vs 63.3% U, p = 1.00). Compared to food secure (FS) households, infants from food insecure (FIS) households tended to have a lower prevalence of breastfeeding within an hour of birth (79.7% FS vs 61.9% FIS, p = 0.05). Reported problems breastfeeding at 1 week were associated with lower odds of solid or semi-solid foods consumed in the past 24 hours (OR: 0.29, p = 0.03) and lower odds of meeting the recommended minimum meal frequency (OR:0.23, p < 0.01) at 9 months. Conclusions Food insecurity may negatively impact early initiation of breastfeeding among both rural and urban families in Esmeraldas, and problems breastfeeding may negatively impact IYCF practices. Addressing these factors may be useful in promote optimal infant feeding in the region. Funding Sources This work is supported by the National Institutes of Health.

scholarly journals Seasonality and within-subject clustering of rotavirus infections in an eight-site birth cohort study

2018 ◽  
Vol 146 (6) ◽  
pp. 688-697 ◽  
Author(s):  
J. M. Colston ◽  
A. M. S. Ahmed ◽  
S. B. Soofi ◽  
E. Svensen ◽  
R. Haque ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preventive Measures ◽  
Diarrhoeal Disease ◽  
Birth Cohort Study ◽  
Calendar Time ◽  
Programme Design ◽  
Enteric Infections ◽  
Practical Implications ◽  
Rotavirus Infections ◽  
Model Approach

AbstractImproving understanding of the pathogen-specific seasonality of enteric infections is critical to informing policy on the timing of preventive measures and to forecast trends in the burden of diarrhoeal disease. Data obtained from active surveillance of cohorts can capture the underlying infection status as transmission occurs in the community. The purpose of this study was to characterise rotavirus seasonality in eight different locations while adjusting for age, calendar time and within-subject clustering of episodes by applying an adapted Serfling model approach to data from a multi-site cohort study. In the Bangladesh and Peru sites, within-subject clustering was high, with more than half of infants who experienced one rotavirus infection going on to experience a second and more than 20% experiencing a third. In the five sites that are in countries that had not introduced the rotavirus vaccine, the model predicted a primary peak in prevalence during the dry season and, in three of these, a secondary peak during the rainy season. The patterns predicted by this approach are broadly congruent with several emerging hypotheses about rotavirus transmission and are consistent for both symptomatic and asymptomatic rotavirus episodes. These findings have practical implications for programme design, but caution should be exercised in deriving inferences about the underlying pathways driving these trends, particularly when extending the approach to other pathogens.

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