Association between Pathogenic Variants of Diarrheagenic Escherichia coli and Growth in Children under 5 Years of Age in the Global Enteric Multicenter Study

Abstract

ABSTRACT. There is a lack of information highlighting associations between different pathogenic variants of diarrheagenic Escherichia coli and childhood growth. Pathogenic variants of E. coli from stool samples, collected from 22,567 children enrolled in the Global Enteric Multicenter Study from December 2007 to March 2011, were detected by real-time polymerase chain reaction. We estimated the associations of different pathogenic variants of diarrheagenic E. coli with child growth. The association between an explanatory variable and the outcome variable was assessed using multiple linear regression, where the dependent variables were height-for-age, weight-for-age, and weight-for-height z-scores, and the independent variable was the presence of different pathogenic variants of diarrheagenic E. coli. After adjusting for potential covariates, such as age, gender, diarrhea, breastfeeding status, mother’s education, number of under-5 children, handwashing practice, handwashing material, source of drinking water, wealth index, available toilet facility, copathogens, comorbidity, time, and study site, the multivariable model identified a negative association between different pathogenic variants of diarrheagenic E. coli and child growth. Our analyses may provide the cornerstone for prospective epidemiologic investigation for the development of preventive measures for diarrheagenic E. coli and combat childhood undernutrition.