Etiology of Diarrhea Among Hospitalized Children in Blantyre, Malawi, Following Rotavirus Vaccine Introduction: A Case-Control Study
- Iturriza-Gomara, Miren
- Jere, KC
- Hungerford, DJ
- Bar-Zeev, NH
- Shioda, Kayoko
- Kanjerwa, Oscar
- Houpt, Eric
- Operario, Darwin J
- Wachepa, Richard
- Pollock, Louisa
- Bennett, Aisleen
- Pitzer, Virginia E
- Cunliffe, N
DOIAbstract
Despite rotavirus vaccination, diarrhea remains a leading cause of child mortality. We collected stool specimens from 684 children <5 years of age hospitalized with diarrhea (cases) and 527 asymptomatic community controls for 4 years after rotavirus vaccine introduction in Malawi. Specimens were tested for 29 pathogens, using polymerase chain reaction analysis. Three or more pathogens were detected in 71% of cases and 48% of controls. Pathogens significantly associated with diarrhea included rotavirus (in 34.7% of cases and 1.5% of controls), enteric adenovirus (in 29.1% and 2.7%, respectively), Cryptosporidium (in 27.8% and 8.2%, respectively), heat-stable enterotoxin-producing Escherichia coli (in 21.2% and 8.5%, respectively), typical en...
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