Table 3.
Differences in Rates of Pathogen-Attributable Diarrhea Associated With Water, Sanitation, and Hygiene and Infant and Young Child Feeding Interventions Among 161 Diarrhea Episodes From 129 Children in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Diarrhea Substudy
| Pathogen-Attributable Episodes (n = 159a), No. (%) | Episodes With Pathogen Detected (n = 161), No. (%) | Pathogen-Attributable Diarrhea, HRb (95% CI) |
Pathogen Detected During Diarrhea, HRb (95% CI) | |||
|---|---|---|---|---|---|---|
| Pathogen | WASH | IYCF | WASH | IYCF | ||
| Bacteria | ||||||
| EAEC | 0 | 92 (56.8) | … | … | 0.87 (.55–1.36) | 1.00 (.64–1.57) |
| ETEC | 12c (7.6) | 59 (37.9) | 3.18 (.80–12.71) | 2.28 (.60–8.71) | 1.03 (.61–1.74) | 1.13 (.67–1.90) |
| aEPEC | 0 | 45 (27.8) | … | … | .77 (.41–1.45) | 1.40 (.79–2.49) |
| Campylobacter spp | 2c (1.3) | 62 (38.3) | … | … | 1.13 (.63–2.03) | 1.21 (.69–2.15) |
| tEPEC | 1 (0.6) | 12 (7.4) | … | … | .63 (.19–2.10) | .56 (.17–1.91) |
| STEC | 0 | 7 (4.4) | … | … | .27 (.03–2.32) | .59 (.11–3.08) |
| Shigella | 13 (8.2) | 20 (12.4) | .60 (.16–2.21) | .23 (.07–.77) | .50 (.17–1.47) | .33 (.10–1.11) |
| Viruses | ||||||
| Norovirus | 15c (9.4) | 44 (27.3) | 1.47 (.51–4.23) | 1.15 (.42–3.12) | .91 (.47–1.74) | 1.48 (.83–2.66) |
| Sapovirus | 11 (6.9) | 23 (14.2) | 1.92 (.58–6.41) | 1.34 (.36–4.96) | 1.03 (.43–2.45) | 1.75 (.70–4.36) |
| Adenovirus 40/41 | 4 (2.5) | 28 (17.3) | .53 (.06–4.69) | 2.48 (.25–24.60) | 1.12 (.53–2.35) | .88 (.41–1.87) |
| Astrovirus | 5 (3.1) | 17 (10.5) | 1.38 (.22–8.62) | .19 (.02–1.47) | 1.16 (.44–3.07) | .89 (.34–2.35) |
| Rotavirus | 12 (7.6) | 19 (11.7) | .79 (.25–2.55) | 1.08 (.34–3.40) | .96 (.39–2.34) | 1.05 (.43–2.58) |
| Protozoa | ||||||
| Giardia | 0 | 26 (16.0) | … | … | .49 (.18–1.32) | 1.25 (.54–2.92) |
| Enterocytozoon bieneusi | 0 | 26 (16.3) | … | … | .53 (.22–1.27) | 1.25 (.55–2.85) |
| Cryptosporidium | 12 (7.6) | 42 (25.9) | 2.41 (.81–7.23) | .54 (.18–1.65) | .83 (.42–1.63) | .95 (.49–1.85) |
Abbreviations: aEPEC, atypical enteropathogenic Escherichia coli; CI, confidence interval; EAEC, enteroaggregative Escherichia coli; ETEC, enterotoxigenic Escherichia coli; HR, hazard ratio; IYCF, infant and young child feeding; STEC, Shiga toxin–producing Escherichia coli; tEPEC, typical enteropathogenic Escherichia coli; WASH, water, sanitation, and hygiene.
aExcludes 3 episodes for which valid quantitative polymerase chain reaction results were not available for all pathogens included in the attribution analysis.
bAdjusted for calendar month at the start of diarrhea surveillance.
cAll ETEC-attributable episodes were heat-stable enterotoxin-producing ETEC (ST-ETEC); all Campylobacter-attributable episodes were Campylobacter jejuni/coli; all norovirus-attributable episodes were norovirus GII.