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

• Main Authors: Jie Liu (Author), Christopher R Sudfeld (Author), Per Ashorn (Author), Queen Dube (Author), Tahmeed Ahmed (Author), Pratibha Dhingra (Author), Usha Dhingra (Author), Arup Dutta (Author), Sunil Sazawal (Author), Karim Manji (Author), Rodrick Kisenge (Author), Mohamed Bakari (Author), Christopher P Duggan (Author), Rajiv Bahl (Author), Naor Bar-Zeev (Author), Ayesha De Costa (Author), Nigel Cunliffe (Author), Sadia Shakoor (Author), Desiree Witte (Author), Doreen Rwigi (Author), Judd L Walson (Author), Shahida Qureshi (Author), Eric Houpt (Author), James Platts-mills (Author), Jonathon Simon (Author), Chifundo Ndamala (Author), Sarah Somji (Author), Abraham Samma (Author), Fadima Cheick Haidara (Author), Karen Kotloff (Author), Emily L Deichsel (Author), Md Chisti (Author), Benson Singa (Author), Patricia Pavlinac (Author), Samba Sow (Author), Mohammad Tahir Yousafzai (Author), Farah Qamar (Author), Muhammad Waliur Rahman (Author), Irin Parvin (Author), Md. Farhad Kabir (Author), Anil Kumar Sharma (Author), Vijay Kumar Jaiswal (Author), Churchil Nyabinda (Author), Christine McGrath (Author), Maurine Anyango (Author), Kevin Mwangi Kariuki (Author), Stephanie N Tornberg-Belanger (Author), Flanon Coulibaly (Author), Jasnehta Permala-Booth (Author), Dramane Malle (Author), Latif Ndeketa (Author), Rozina Thobani (Author), Jan Mohammed (Author), Cecylia Msemwa (Author)
• Format: Book
• Published: BMJ Publishing Group, 2024-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Objective 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).Design A secondary cross-sectional analysis of baseline data collected from the AntiBiotics for Children with Diarrhoea trial (NCT03130114).Patients Children with MSD (defined as >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.Study period June 2017-July 2019.Interventions None.Main outcome measures Likely bacterial aetiology of diarrhoea. Secondary outcomes included specific diarrhoea aetiology.Results 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 Escherichia coli 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.Conclusion The presence of MAM, dehydration or high stool frequency may be helpful in identifying children with MSD who might benefit from antibiotics.

Item Description

10.1136/bmjpo-2023-002448
2399-9772