Sarah Hanieh1, Siddhartha Mahanty2,3, George Gurruwiwi4, Therese Kearns4, Roslyn Dhurrkay4, Veronica Gondarra4, Jenny Shield2, Norbert Ryan5, Francesca Azzato5, Susan A Ballard6, Nicole Orlando6, Sullen Nicholson5, Katherine Gibney3, Julie Brimblecombe7, Wendy Page8,9, Leonard C Harrison10, Beverley-Ann Biggs3. 1. Department of Medicine at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia. shanieh@unimelb.edu.au. 2. Department of Medicine at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia. 3. The Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, 3052, Australia. 4. Menzies School of Health Research, Darwin, Northern Territory, 0810, Australia. 5. Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia. 6. Microbiological Diagnostic Unit Public Health Laboratory at the University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia. 7. Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia. 8. Miwatj Health Aboriginal Corporation, Nhulunbuy, NT, 0881, Australia. 9. Public Health and Tropical Medicine, James Cook University, Cairns, QLD, 4870, Australia. 10. Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.
Abstract
BACKGROUND: To determine the prevalence of enteric infections in Aboriginal children aged 0-2 years using conventional and molecular diagnostic techniques and to explore associations between the presence of pathogens and child growth. METHODS: Cross-sectional analysis of Aboriginal children (n = 62) residing in a remote community in Northern Australia, conducted from July 24th - October 30th 2017. Stool samples were analysed for organisms by microscopy (directly in the field and following fixation and storage in sodium-acetate formalin), and by qualitative PCR for viruses, bacteria and parasites and serology for Strongyloides-specific IgG. Child growth (height and weight) was measured and z scores calculated according to WHO growth standards. RESULTS: Nearly 60% of children had evidence for at least one enteric pathogen in their stool (37/62). The highest burden of infection was with adenovirus/sapovirus (22.9%), followed by astrovirus (9.8%) and Cryptosporidium hominis/parvum (8.2%). Non-pathogenic organisms were detected in 22.5% of children. Ten percent of children had diarrhea at the time of stool collection. Infection with two or more pathogens was negatively associated with height for age z scores (- 1.34, 95% CI - 2.61 to - 0.07), as was carriage of the non-pathogen Blastocystis hominis (- 2.05, 95% CI - 3.55 to - 0.54). CONCLUSIONS: Infants and toddlers living in this remote Northern Australian Aboriginal community had a high burden of enteric pathogens and non-pathogens. The association between carriage of pathogens/non-pathogens with impaired child growth in the critical first 1000 days of life has implications for healthy child growth and development and warrants further investigation. These findings have relevance for many other First Nations Communities that face many of the same challenges with regard to poverty, infections, and malnutrition.
BACKGROUND: To determine the prevalence of enteric infections in Aboriginal children aged 0-2 years using conventional and molecular diagnostic techniques and to explore associations between the presence of pathogens and child growth. METHODS: Cross-sectional analysis of Aboriginal children (n = 62) residing in a remote community in Northern Australia, conducted from July 24th - October 30th 2017. Stool samples were analysed for organisms by microscopy (directly in the field and following fixation and storage in sodium-acetate formalin), and by qualitative PCR for viruses, bacteria and parasites and serology for Strongyloides-specific IgG. Child growth (height and weight) was measured and z scores calculated according to WHO growth standards. RESULTS: Nearly 60% of children had evidence for at least one enteric pathogen in their stool (37/62). The highest burden of infection was with adenovirus/sapovirus (22.9%), followed by astrovirus (9.8%) and Cryptosporidium hominis/parvum (8.2%). Non-pathogenic organisms were detected in 22.5% of children. Ten percent of children had diarrhea at the time of stool collection. Infection with two or more pathogens was negatively associated with height for age z scores (- 1.34, 95% CI - 2.61 to - 0.07), as was carriage of the non-pathogen Blastocystis hominis (- 2.05, 95% CI - 3.55 to - 0.54). CONCLUSIONS:Infants and toddlers living in this remote Northern Australian Aboriginal community had a high burden of enteric pathogens and non-pathogens. The association between carriage of pathogens/non-pathogens with impaired child growth in the critical first 1000 days of life has implications for healthy child growth and development and warrants further investigation. These findings have relevance for many other First Nations Communities that face many of the same challenges with regard to poverty, infections, and malnutrition.
Entities:
Keywords:
Aboriginal; Child growth; Enteric infection; Height for age z scores
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