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Identifying Etiological Agents Causing Diarrhea in Low Income Ecuadorian Communities
Continued success in decreasing diarrheal disease burden requires targeted interventions. To develop such interventions, it is crucial to understand which pathogens cause diarrhea. Using a case-control design we tested stool samples, collected in both rural and urban Ecuador, for 15 pathogenic microorganisms. Pathogens were present in 51% of case and 27% of control samples from the urban community, and 62% of case and 18% of control samples collected from the rural community. Rotavirus and Shigellae were associated with diarrhea in the urban community; co-infections were more pathogenic than single infection; Campylobacter and Entamoeba histolytica were found in large numbers in cases and controls; and non-typhi Salmonella and enteropathogenic Escherichia coli were not found in any samples. Consistent with the Global Enteric Multicenter Study, focused in south Asia and sub-Saharan Africa, we found that in Ecuador a small group of pathogens accounted for a significant amount of the diarrheal disease burden.
Author Notes
Financial support: This study was supported by grant No. RO1-AI050038 from the National Institute of Allergy and Infectious Diseases (NIAID) and the Center for Global Health at the University of Michigan.
Authors' addresses: Gabriela Vasco, Gabriel Trueba, and Thamara Andrade, Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador, E-mails: piavas_rc@hotmail.com, gtrueba@usfq.edu.ec, and thamaraandrade@yahoo.com. Richard Atherton, Manuel Calvopiña, and William Cevallos, Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador, E-mails: richard.atherton@hotmail.co.uk, mcalvopina@gmail.com, and wcalvopina@gmail.com. Martha Eguiguren, Centro de Salud Guamaní, Ministerio de Salud Pública, Quito, Ecuador, E-mail: m._eguiguren@hotmail.com. Joseph N. S. Eisenberg, School of Public Health, University of Michigan, CA, E-mail: jnse@umich.edu.