{"doi":"10.1093/cid/ciac918","title":"Exploring Survey-Based Water, Sanitation, and Animal Associations With Enteric Pathogen Carriage: Comparing Results in a Cohort of Cases With Moderate-to-Severe Diarrhea to Those in Controls in the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015–2018","abstract":"BACKGROUND: The magnitude of pediatric enteric pathogen exposures in low-income settings necessitates substantive water and sanitation interventions, including animal feces management. We assessed associations between pediatric enteric pathogen detection and survey-based water, sanitation, and animal characteristics within the Vaccine Impact on Diarrhea in Africa case-control study. METHODS: In The Gambia, Kenya, and Mali, we assessed enteric pathogens in stool of children aged <5 years with moderate-to-severe diarrhea and their matched controls (diarrhea-free in prior 7 days) via the TaqMan Array Card and surveyed caregivers about household drinking water and sanitation conditions and animals living in the compound. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using modified Poisson regression models, stratified for cases and controls and adjusted for age, sex, site, and demographics. RESULTS: Bacterial (cases, 93%; controls, 72%), viral (63%, 56%), and protozoal (50%, 38%) pathogens were commonly detected (cycle threshold <35) in the 4840 cases and 6213 controls. In cases, unimproved sanitation (RR, 1.56; 95% CI, 1.12-2.17), as well as cows (RR, 1.61; 95% CI, 1.16-2.24) and sheep (RR, 1.48; 95% CI, 1.11-1.96) living in the compound, were associated with Shiga toxin-producing Escherichia coli. In controls, fowl (RR, 1.30; 95% CI, 1.15-1.47) were associated with Campylobacter spp. In controls, surface water sources were associated with Cryptosporidium spp., Shigella spp., heat-stable toxin-producing enterotoxigenic E. coli, and Giardia spp. CONCLUSIONS: Findings underscore the importance of enteric pathogen exposure risks from animals alongside more broadly recognized water and sanitation risk factors in children.","journal":"Clinical Infectious Diseases","year":2023,"id":358391,"datarank":0.37273599746820013,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.0,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9549,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":479281,"name":"Richard Omore","orcid":"0000-0003-3702-3030","position":1,"is_corresponding":false},{"id":888574,"name":"Graeme Prentice‐Mott","orcid":"0000-0002-8711-3635","position":2,"is_corresponding":false},{"id":1061517,"name":"Kirsten Fagerli","orcid":"0000-0001-7471-6317","position":3,"is_corresponding":false},{"id":936221,"name":"Sun-Kyung Kim","orcid":"0000-0001-6063-488X","position":4,"is_corresponding":false},{"id":821941,"name":"Dilruba Nasrin","orcid":null,"position":5,"is_corresponding":false},{"id":917572,"name":"Helen Powell","orcid":"0000-0002-6145-6226","position":6,"is_corresponding":false},{"id":479278,"name":"M Jahangir Hossain","orcid":"0000-0002-8415-3180","position":7,"is_corresponding":false},{"id":299788,"name":"Samba O. Sow","orcid":"0000-0002-6335-5066","position":8,"is_corresponding":false},{"id":908757,"name":"Doh Sanogo","orcid":null,"position":9,"is_corresponding":false},{"id":1064684,"name":"Joquina Chiquita M Jones","orcid":"0009-0001-4213-1493","position":10,"is_corresponding":false},{"id":1068459,"name":"John B. Ochieng","orcid":"0000-0002-5301-4559","position":11,"is_corresponding":false},{"id":1108841,"name":"Jane Juma","orcid":null,"position":12,"is_corresponding":false},{"id":1064685,"name":"Alex O Awuor","orcid":"0009-0003-9138-7748","position":13,"is_corresponding":false},{"id":1108482,"name":"Billy Ogwel","orcid":"0000-0002-9097-2713","position":14,"is_corresponding":false},{"id":616173,"name":"Jennifer R. 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