Table 2. Adjusted attributable fractions for pathogens causing moderate to severe diarrhoea assessed with quantitative molecular diagnostic methods.
| Basse, The Gambia | Bamako, Mali | Manhiça, Mozambique | Nyanza Province, Kenya | Kolkata, India | Mirzapur, Bangladesh | Karachi (Bin Qasim Town), Pakistan | |
|---|---|---|---|---|---|---|---|
| 0–11 months | |||||||
|
| |||||||
| Number of case-control | 258 | 285 | 247 | 267 | 275 | 293 | 284 |
| Rotavirus | 23·0% (18·8–29·1) | 22·7% (18·5–28·3) | 34·5% (29·4–41·1) | 22·4% (17·6–27·9) | 30·7% (26·1–37·2) | 23·4% (18·9–28·7) | 27·0% (22·7–33·5) |
| Adenovirus 40/41 | 9·6% (4·9–15·9) | 10·8% (6·8–20·9) | 13·3% (8·1–24·1) | 8·5% (4·7–13·3) | 22·4% (7·5–33·8) | 8·3% (47–13·9) | 7·2% (0·9–10·6) |
| Cryptosporidium spp | 11·5% (4·6–16) | 17·2% (13·1–26·4) | 14·7% (11·3–24·1) | 9·9% (4·9–15·5) | 5·4% (2·8–9·0) | 1·2% (0·1–2·7) | 10·4% (5·1–16·1) |
| Shigella spp or EIEC | 7·5% (3·9–12·9) | 4·0% (1·6–7·2) | 4·0% (1·6–7·0) | 6·1% (2·8–11·1) | 3·9% (1·5–7·5) | 15·8% (12–20·4) | 13·8% (97–197) |
| C jejuni or C coli | * | 8·1% (3·3–14·3) | 11·2% (3·0–20·0) | 6·1% (0·1–137) | 9·3% (2·4–16·8) | 12·3% (7·6–19·8) | 7·0% (0–17·1) |
| ST-ETEC | 5·5% (1·8–9·7) | 5·0% (2·5–8·4) | 9·3% (5·8–14·3) | 8·8% (5·4–13·6) | 4·6% (2·4–8·3) | 2·0% (0·5–3·9) | 12·2% (8·9–17·6) |
| Norovirus GII | 4·4% (1·8–11·1) | 4·2% (0·4–9) | 3·8% (1·7–9·2) | 3·1% (0·8–7·8) | 4·2% (1·3–9·5) | 1·8% (0·2–5·3) | 2·7% (0–6·2) |
| tEPEC | 2·7% (0–5·7) | 3·4% (0·9–8·7) | 3·4% (1·5–10·5) | 2·2% (0·5–9·9) | 1·8% (0·1–5·1) | 0·3% (0–2·6) | 2·1% (0–5·1) |
| Sapovirus | 1·0% (0–5·4) | 1·6% (0–6·4) | 0·5% (0–2·6) | 2·4% (0–7·2) | 37% (1·4–8·7) | 1·1% (0–3·4) | 4·4% (0·2–11·1) |
| Astrovirus | 0·7% (0–4·4) | 2·8% (0–6·4) | 0·2% (0–1·2) | 1·8% (0·2–4·5) | 5·5% (2·6–10·2) | 1·4% (0–3·9) | 3·3% (0·1–7·6) |
| V cholerae | * | 0·3% (0–1·1) | 0·4% (0–1·2) | 0·7% (0–1·9) | 1·6% (0·3–3·1) | 0·6% (0–1·7) | 5·6% (2·3–8·8) |
| H pylori | 0·6% (0–2·8) | 0·8% (0–4·3) | 1·1% (0–2·8) | 0·5% (0–1·5) | 0·9% (0–3·6) | 0·2% (0–1·4) | * |
| Aeromonas spp | * | 0·2% (0–1·3) | 0·8% (0–2·5) | * | 0·9% (0–4·5) | 1·4% (0–4·2) | 2·9% (0·1–8·2) |
| Salmonella spp | 0·7% (0–3) | 0·7% (0–2·1) | 1·3% (0–2·7) | 0·7% (0–3·1) | 0·1% (0–0·8) | 0·4% (0–3·3) | 0·2% (0–0·9) |
| C cayetanensis | * | 0·3% (0–1·1) | * | 0·3% (0–1·3) | * | 0·2% (0–1·0) | 0·3% (0–1·1) |
| C belli | * | 0·1% (0–0·6) | 0·7% (0–2·4) | * | 0·3% (0–1·2) | * | * |
| EAEC | * | * | 0·1% (0–8·1) | * | * | * | * |
| E histolytica | * | 0·4% (0·3–1·2) | * | * | * | * | * |
|
| |||||||
| 12–23 months | |||||||
|
| |||||||
| Number of case-control | 273 | 274 | 151 | 264 | 289 | 291 | 293 |
| Shigella spp or EIEC | 32·7% (27·0–42·0) | 27·1% (20·5–35·9) | 34·8% (27·5–44·8) | 15·4% (9·8–23·4) | 19·2% (14·1–26·9) | 64·9% (60·4–71·5) | 35·0% (30·0–43·3) |
| Rotavirus | 17·1% (13·0–21·9) | 11·4% (7·9–15·2) | 14·8% (10·0–20·7) | 14·5% (10·7–19·0) | 28·9% (24·4–347) | 29·8% (25·4–357) | 9·4% (6·5–13·1) |
| ST-ETEC | 6·3% (2·2–10·8) | 6·6% (3·2–10·9) | 14·0% (8·7–22·6) | 9·5% (6·0–15·2) | 7·8% (4·8–12·8) | 2·2% (0·4–4·4) | 12·1% (8·2–18·5) |
| Adenovirus 40/41 | 8·4% (2·8–15·9) | 9·0% (4·0–19·4) | 11·3% (4·8–23·4) | 4·1% (1·9–7·2) | 10·3% (3·6–16·8) | 4·1% (1·8–8·5) | 5·8% (0·1–9·3) |
| Cryptosporidium spp | 6·9% (1·0–12·0) | 7·7% (4·0–16·7) | 12·6% (8·3–247) | 6·3% (2·1–11·7) | 5·6% (2·9–9·9) | 1·3% (0·2–3·0) | 7·5% (3·0–13·7) |
| Sapovirus | 2·1% (0–6·6) | 2·9% (0–7·4) | 2·2% (0–6·7) | 4·2% (0·8–9·3) | 6·7% (3·3–12·7) | 2·5% (0·1–5·9) | 6·3% (1·2–13·9) |
| Astrovirus | 0·9% (0–2·8) | 3·2% (0·8–6·8) | 0·6% (0–2·4) | 2·5% (0·8–4·8) | 4·1% (2·0–7·3) | 1·9% (0·3–4·0) | 5·5% (2·0–10·2) |
| C jejuni or C coli | * | 5·0% (0–14·0) | 2·6% (0–10·7) | 0·1% (0–6·8) | 3·6% (0–15·2) | 4·5% (1·6–9·6) | * |
| V cholerae | * | 0·3% (0–1·1) | 2·8% (0·6–5·8) | 0·7% (0–1·8) | 4·2% (2·1–7·0) | 0·4% (0–1·3) | 7·9% (5·2–12·0) |
| H pylori | 3·1% (0·8–6·9) | 2·3% (0·4–6·7) | * | 2·3% (0·2–6·5) | 1·3% (0·3–3·3) | 1·2% (0·1–4) | 0·5% (0–2·4) |
| tEPEC | 2·6% (0–6·1) | 1·9% (0·3–6·5) | 3·1% (0·9–11·4) | 1·4% (0·3–5·4) | 1·1% (0–3·9) | 0·4% (0–2·0) | 1·3% (0–4·6) |
| Salmonella spp | 3·9% (1·0–7·1) | 2·5% (0·9–4·8) | 2·8% (0·1–57) | 2·3% (0·7–4·3) | 0·2% (0–0·9) | 1·2% (0·3–3·2) | 0·4% (0–1·2) |
| Norovirus GII | 1·2% (0·2–5) | 0·5% (0–2·9) | 0·9% (0–4·9) | 0·9% (0–3·8) | 2·4% (0·2–8·4) | 1·1% (0·2–3·9) | 0·9% (0–3·5) |
| Aeromonas spp | * | 0·2% (0–1·7) | 1·4% (0–6·5) | * | 0·3% (0–4·7) | 2·2% (0–6·0) | 2·1% (0–7·2) |
| C cayetanensis | 0·1% (0–0·9) | * | 0·6% (0–3·1) | 0·6% (0–1·8) | * | 1·0% (0–2·3) | 0·6% (0–2·0) |
| C belli | * | 0·1% (0–1·7) | 0·2% (0–3·9) | 0·1% (0–1·5) | 0·1% (0–1·9) | * | 0·1% (0–0·8) |
| E histolytica | * | * | * | * | 0·3% (0–1·0) | * | 0·5% (0–1·7) |
| EAEC | * | 0·9% (0–7·9) | 4·0% (0·2–18·4) | * | * | 0·1% (0–1·7) | * |
|
| |||||||
| 24–59 months | |||||||
|
| |||||||
| Number of case-control | 154 | 275 | 86 | 256 | 285 | 293 | 211 |
| Shigella spp or EIEC | 25·9% (18·5–36·1) | 20·1% (14·1–29·5) | 41·9% (32·2–54·9) | 17·8% (12·2–25·9) | 30·0% (22·9–39·3) | 83·2% (80·2–87·9) | 29·5% (23·4–38·6) |
| Rotavirus | 13·6% (9·0–19·9) | 5·5% (3·0–8·3) | 4·2% (0·6–8·9) | 4·1% (1·9–6·8) | 13·7% (10·2–18·4) | 4·7% (2·7–7·2) | 2·2% (0·5–4·3) |
| H pylori | 6·7% (1·2–14·4) | 8·0% (4·0–13·1) | 4·2% (0·2–9·8) | 5·1% (1·8–8·7) | 11·0% (7·8–16·4) | 2·0% (0·8–4·0) | 2·7% (0·3–5·7) |
| ST-ETEC | 4·9% (0·6–10·6) | 4·0% (1·1–8·0) | 8·9% (3·9–16·8) | 8·3% (5·2–13·6) | 7·4% (4·4–12·4) | 1·2% (0–3·2) | 8·0% (4·4–14·4) |
| V cholerae | 0·6% (0–2·1) | 0·5% (0–1·5) | 10·6% (4·3–17·7) | 1·5% (0·3–3·1) | 9·6% (6·3–13·3) | 2·8% (1·2–4·8) | 16·1% (11·2–21·4) |
| C jejuni or C coli | * | 9·0% (0·4–19·5) | 2·2% (0–7·9) | 0·6% (0–3·8) | 5·4% (0–15·4) | 2·0% (0·8–4·1) | 0·6% (0–13·7) |
| Sapovirus | 2·3% (0–5·4) | 2·1% (0–4·8) | 2·5% (0–6·2) | 3·0% (0·8–6·3) | 6·1% (3·1–10·8) | 3·4% (0·4–6·2) | 5·2% (0·9–10·3) |
| Adenovirus 40/41 | 2·7% (0–7·6) | 1·5% (0·2–4·7) | 2·9% (0·3–8·6) | 1·6% (0·1–4·0) | 5·1% (0·3–11·2) | 5·3% (0·7–13·7) | 2·6% (0–5·9) |
| Aeromonas spp | 01% (0–0·6) | 1·0% (0–2·9) | 5·6% (1·1–12·5) | 0·8% (0–4·2) | 4·5% (0–9·2) | 3·5% (1·7–6·8) | 6·2% (2·2–12·3) |
| Norovirus GII | 1·4% (0·2–3·7) | 1·5% (0·1–3·7) | 0·4% (0–2·1) | 1·7% (0·4–4·0) | 2·6% (0·6–5·8) | 2·2% (0·6–4·8) | 3·0% (0·1–6·0) |
| Salmonella spp | 3·4% (1·1–6·9) | 2·1% (0·7–4·2) | 0·5% (0–2·2) | 3·4% (1·6–5·9) | 0·6% (0–1·6) | 0·2% (0–1·0) | 1·9% (0·4–4·0) |
| E histolytica | * | 3·1% (1·1–5·7) | * | 0·3% (0–1·2) | 2·0% (0·6–3·7) | * | 3·7% (1·2–7·1) |
| Cryptosporidium spp | 0·7% (0–2·4) | 1·0% (0–6·2) | 2·1% (0–10·7) | 0·6% (0–3·0) | 2·0% (0–5·8) | 0·1% (0–0·8) | 2·3% (0–7·5) |
| Astrovirus | * | 0·8% (0–3·0) | 0·6% (0–3·3) | 0·9% (0–2·7) | 1·9% (0·4–4·5) | 0·9% (0–3·5) | 1·3% (0–4·4) |
| C belli | 0·3% (0–3·5) | 0·7% (0–4·2) | 1·0% (0–6·8) | 0·3% (0–2·3) | 0·4% (0–3·0) | 0·1% (0–0·8) | 0·2% (0–1·2) |
| tEPEC | 0·6% (0–2·3) | 0·4% (0–2·6) | 0·9% (0–5·6) | 0·2% (0–2·4) | 0·3% (0–2·0) | 0·2% (0–1·0) | 0·9% (0–3·0) |
| LT-ETEC | * | 1·7% (0–11·3) | * | * | 0·3% (0–5·5) | 0·1% (0–3·7) | * |
| C cayetanensis | * | * | 0·6% (0–6·9) | * | 0·8% (0–3·2) | 0·5% (0–2·0) | * |
| EAEC | * | 0·6% (0–4·1) | 0·4% (0–7·0) | * | * | * | * |
Attributable fractions are shown as the percentage of cases for each age stratum and study site with 95% CIs, listed in descending order of overall value. All pathogens with attributable fractions >0 for each combination of age stratum and site are shown. Only attributable fraction CIs that exceed 0 are significant. EAEC=enteroaggregative E coli. EIEC=enteroinvasive E coli. tEPEC=typical enteropathogenic E coli. LT-ETEC=heat-labile enterotoxin-producing E coli. ST-ETEC=STh-producing enterotoxigenic E coli.
*
Point estimate ≤0.