Table 2.
Enteric pathogens associated with increased risk of EED or undernutrition at the 95% confidence level.
| EED | Undernutrition | |||||||
|---|---|---|---|---|---|---|---|---|
| Pathogen group | Genus/common name | Species | Subtype | Reservoir*(References) | Affected gut function& | References | Outcome@ | References |
| Viruses | Adenovirus | A (130) | Gut inflammation | (131) | –HAZ | (132) | ||
| Norovirus | A (133) | N/A | N/A | –HAZ | (132) | |||
| Rotavirus | A (134) | N/A | N/A | –HAZ | (132) | |||
| Bacteria | Aeromonas | spp. | S (135) | Epithelial damage/repair | (131) | N/A | N/A | |
| Campylobacter | spp. | Z (136) | Epithelial damage/repair, gut inflammation, intestinal permeability | (131, 137, 138) | –LAZ, –weight | (138–140) | ||
| jejuni/coli | Z (136) | N/A | N/A | –LAZ | (141, 142) | |||
| Escherichia | coli | Enterotoxigenic | A (143) | Gut inflammation | (131, 137, 144) | WAZ < −2, –LAZ | (141, 145) | |
| Enteroaggregative | A (143) | Gut inflammation, epithelial damage/repair | (131, 146–148) | –LAZ | (139, 147) | |||
| Enteroinvasive | A (143) | Gut inflammation, intestinal permeability | (131) | N/A | N/A | |||
| Enteropathogenic | A (143) | Epithelial damage/repair | (131) | N/A | N/A | |||
| Helicobacter | pylori | A (149) | Epithelial damage/repair | (150) | N/A | N/A | ||
| Plesiomonas | shigelloides | S (151) | Gut inflammation | (131) | N/A | N/A | ||
| Salmonella | spp. | A/Z (152) | Epithelial damage/repair | (131) | N/A | N/A | ||
| Shigella | spp. | A (153) | Gut inflammation, intestinal permeability | (131) | –LAZ, –height | (131, 139, 154) | ||
| Yersinia | enterocolitica | Z (155) | Gut inflammation | (131) | N/A | N/A | ||
| Protozoa | Cryptosporidium | spp. | A/Z (156) | Intestinal permeability, epithelial damage/repair | (131, 157) | –LAZ, –WAVZ, –LAVZ, WAZ < −2 | (145, 158, 159) | |
| hominis | A (156) | N/A | N/A | LAZ < −3, HAZ < -2, WAZ < −2, WHZ < −2 | (160, 161)$ | |||
| parvum | A/Z (162) | N/A | N/A | HAZ < −2, WAZ < −2, WHZ < −2 | (163) | |||
| Entamoeba | histolytica | A (164) | N/A | N/A | –WAZ, WAZ < −2 | (145, 165) | ||
| Giardia | spp. | A/Z (166) | Gut inflammation, epithelial damage/repair, intestinal permeability, microbial translocation | (131, 137, 148, 167) | –LAZ, –WAZ, | (139, 167, 168) | ||
| lamblia | A/Z (166) | Intestinal permeability | (169) | HAZ < −2, WHZ < −2, –LAZ, –WAZ, –WHZ, MUAC <12.5 cm, –LAD | (159, 170–174) | |||
| Geohelminths | A∧ | N/A | N/A | LAZ < −2, –LAZ, –LAD | (159, 175) | |||
| Ascaris | lumbricoides | A (176) | N/A | N/A | –HAZ | (172) | ||
| Hookworm | A (177) | N/A | N/A | –LAZ | (165) | |||
| Trichuris | spp. | A (176) | Gut inflammation, epithelial damage/repair | (148) | N/A | N/A | ||
| trichiura | A (176) | N/A | N/A | HAZ < −2 | (178) | |||
A, anthroponotic; Z, zoonotic; S, sapronotic; A/Z, anthroponotic/zoonotic.
Markers in original literature measuring the gut functions: myeloperoxidase, neopterin, calprotectin, lactoferrin—gut inflammation; regenerating protein 1β, α-1-antitrypsin, intestinal fatty acid binding protein—epithelial damage/repair; lactulose:mannitol—intestinal permeability; anti-flic immunoglobulin A—microbial translocation.
Undernutrition outcomes associated with the infections included binary undernutrition indicators based on anthropometric Z-scores (i.e., severe stunting, stunting, wasting, underweight) or common thresholds (i.e., MUAC <12.5 cm), and slow gains in the Z-scores (i.e., –L/HAZ, –WAZ, –WHZ) and weight and height velocities (i.e., –WAVZ, –LAVZ) (179) or crude anthropometric measures (i.e., -weight, -height), and length-for-age difference (-LAD). MUAC, mid-upper arm circumference; L/HAZ, length/height-for-age Z score; WAZ, weight-for-age Z score; WHZ, weight-for-height Z score; WAVZ and LAVZ, weight and length velocities; LAD, length-for-age difference.
Cryptosporidium hominis was the dominant species in the affected populations.
Geohelminths consisted of Ascaris spp., Trichuris spp., hookworm.