University of California, Berkeley School of Public Health, Berkeley, California.
Colegio de Ciencias Biologicas y Ambientales, Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador.
Am J Trop Med Hyg. 2020 Jun;102(6):1269-1278. doi: 10.4269/ajtmh.19-0690.
Domestic animals in the household environment have the potential to affect a child's carriage of zoonotic enteric pathogens and risk of diarrhea. This study examines the risk factors associated with pediatric diarrhea and carriage of zoonotic enteric pathogens among children living in communities where smallholder livestock production is prevalent. We conducted an observational study of children younger than 5 years that included the analysis of child ( = 306) and animal ( = 480) fecal samples for spp atypical enteropathogenic , Shiga toxin-producing , spp., spp., , and . Among these seven pathogens, was the most commonly identified pathogen among children and animals in the same household, most of which was found in child-dog pairs. spp. was also relatively common within households, particularly among child-chicken and child-guinea pig pairs. We used multivariable Poisson regression models to assess risk factors associated with a child being positive for at least one zoonotic enteric pathogen or having diarrhea during the last week. Children who interacted with domestic animals-a behavior reported by nearly three-quarters of households owning animals-were at an increased risk of colonization with at least one zoonotic enteric pathogen (prevalence ratio [PR] = 1.56, 95% CI: 1.00-2.42). The risk of diarrhea in the last seven days was elevated but not statistically significant (PR = 2.27, CI: 0.91, 5.67). Interventions that aim to reduce pediatric exposures to enteric pathogens will likely need to be incorporated with approaches that remove animal fecal contamination from the domestic environment and encourage behavior change aimed at reducing children's contact with animal feces through diverse exposure pathways.
家庭环境中的家畜有可能影响儿童携带人畜共患肠道病原体和腹泻的风险。本研究考察了与小农户畜牧业生产普遍存在的社区中儿童腹泻和人畜共患肠道病原体携带相关的风险因素。我们对 5 岁以下儿童进行了一项观察性研究，分析了 306 名儿童和 480 份动物粪便样本，以检测 spp 非典型肠致病性、产志贺毒素的 、 spp.、 spp.、 和 。在这七种病原体中， 是同一家庭中儿童和动物最常鉴定出的病原体，其中大多数存在于儿童和狗的配对中。 spp. 在家庭中也相对常见，特别是在儿童-鸡和儿童-豚鼠配对中。我们使用多变量泊松回归模型来评估与儿童至少有一种人畜共患肠道病原体阳性或在上周内腹泻相关的风险因素。与家养动物互动的儿童（近四分之三拥有动物的家庭报告的行为）更有可能携带至少一种人畜共患肠道病原体（流行比 [PR] = 1.56，95%CI：1.00-2.42）。过去七天腹泻的风险虽然有所升高，但没有统计学意义（PR = 2.27，CI：0.91，5.67）。旨在减少儿童接触肠道病原体的干预措施可能需要与消除家庭环境中动物粪便污染和鼓励通过多种暴露途径减少儿童与动物粪便接触的行为改变的方法相结合。
