Emerg Infect Dis. 2023 Dec;29(12):2433-41. doi: 10.3201/eid2912.230780.
We collected stool from school-age children from 352 households living in the Black Belt region of Alabama, USA, where sanitation infrastructure is lacking. We used quantitative reverse transcription PCR to measure key pathogens in stool that may be associated with water and sanitation, as an indicator of exposure. We detected genes associated with 1 targets in 26% of specimens, most frequently (6.6%), atypical enteropathogenic (6.1%), and enteroaggregative (3.9%). We used generalized estimating equations to assess reported risk factors for detecting 1 pathogen in stool. We found no association between lack of sanitation and pathogen detection (adjusted risk ratio 0.95 [95% CI 0.55–1.7]) compared with specimens from children served by sewerage. However, we did observe an increased risk for pathogen detection among children living in homes with well water (adjusted risk ratio 1.7 [95% CI 1.1–2.5]) over those reporting water utility service.
我们从美国阿拉巴马州黑带地区 352 户家庭的学龄儿童中收集粪便，这些家庭的卫生基础设施缺乏。我们使用定量逆转录聚合酶链反应来测量粪便中可能与水和卫生设施有关的关键病原体，作为暴露的指标。我们在 26%的样本中检测到与 1 个目标相关的基因，最常见的是（6.6%），非典型肠致病性（6.1%）和肠聚集性（3.9%）。我们使用广义估计方程来评估报告的风险因素，以检测粪便中的 1 种病原体。与从有污水系统服务的儿童采集的样本相比，我们没有发现缺乏卫生设施与病原体检测之间存在关联（调整后的风险比 0.95 [95%CI 0.55-1.7]）。然而，我们确实观察到，与报告使用自来水服务的儿童相比，家中使用井水的儿童的病原体检测风险增加（调整后的风险比 1.7 [95%CI 1.1-2.5]）。
