Department of Medicine at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.
The Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, 3052, Australia.
BMC Infect Dis. 2021 Jan 6;21(1):9. doi: 10.1186/s12879-020-05685-1.
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.
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.
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).
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.
使用常规和分子诊断技术确定 0-2 岁的原住民儿童的肠道感染流行情况，并探讨病原体的存在与儿童生长之间的关系。
对 2017 年 7 月 24 日至 10 月 30 日居住在澳大利亚北部偏远社区的原住民儿童（n=62）进行横断面分析。通过显微镜检查（直接在现场以及固定和储存在醋酸钠福尔马林中后）和定性 PCR 检测病毒、细菌和寄生虫以及针对 Strongyloides 的特异性 IgG 进行血清学分析，对粪便样本中的生物体进行分析。根据世界卫生组织生长标准测量儿童的生长（身高和体重）并计算 z 分数。
近 60%的儿童粪便中至少有一种肠道病原体的证据（37/62）。感染负担最高的是腺病毒/萨波病毒（22.9%），其次是星状病毒（9.8%）和隐孢子虫/小隐孢子虫（8.2%）。在 22.5%的儿童中检测到非致病性生物体。10%的儿童在采集粪便时患有腹泻。两种或多种病原体感染与身高年龄 z 分数呈负相关（-1.34，95%CI-2.61 至-0.07），非致病性 Blastocystis hominis 携带也呈负相关（-2.05，95%CI-3.55 至-0.54）。
生活在这个偏远的澳大利亚北部原住民社区的婴儿和幼儿肠道病原体和非病原体负担很重。在生命的最初 1000 天中，病原体/非病原体的携带与儿童生长受损之间的关联对儿童的健康生长和发育有影响，值得进一步研究。这些发现与许多其他面临贫困、感染和营养不良等同样挑战的原住民社区有关。
