{"doi":"10.3389/fpubh.2024.1332319","title":"Epidemiology of enterotoxigenic Escherichia coli and impact on the growth of children in the first two years of life in Lima, Peru","abstract":"Background Enterotoxigenic E. coli (ETEC) is a leading cause of diarrheal morbidity and mortality in children, although the data on disease burden, epidemiology, and impact on health at the community level are limited. Methods In a longitudinal birth cohort study of 345 children followed until 24 months of age in Lima, Peru, we measured ETEC burden in diarrheal and non-diarrheal samples using quantitative PCR (LT, STh, and STp toxin genes), studied epidemiology and measured anthropometry in children. Results About 70% of children suffered from one or more ETEC diarrhea episodes. Overall, the ETEC incidence rate (IR) was 73 per 100 child-years. ETEC infections began early after birth causing 10% (8.9–11.1) ETEC-attributable diarrheal burden at the population level (PAF) in neonates and most of the infections (58%) were attributed to ST-ETEC [PAF 7.9% (1.9–13.5)] and LT + ST-ETEC (29%) of which all the episodes were associated with diarrhea. ETEC infections increased with age, peaking at 17% PAF (4.6–27.7%; p = 0.026) at 21 to 24 months. ST-ETEC was the most prevalent type (IR 32.1) with frequent serial infections in a child. The common colonization factors in ETEC diarrhea cases were CFA/I, CS12, CS21, CS3, and CS6, while in asymptomatic ETEC cases were CS12, CS6 and CS21. Only few (5.7%) children had repeated infections with the same combination of ETEC toxin(s) and CFs, suggested genotype-specific immunity from each infection. For an average ETEC diarrhea episode of 5 days, reductions of 0.060 weight-for-length z-score (0.007 to 0.114; p = 0.027) and 0.061 weight-for-age z-score (0.015 to 0.108; p = 0.009) were noted in the following 30 days. Conclusion This study showed that ETEC is a significant pathogen in Peruvian children who experience serial infections with multiple age-specific pathotypes, resulting in transitory growth impairment.","journal":"Frontiers in Public Health","year":2024,"id":422905,"datarank":0.4887144807032224,"base_score":3.258096538021482,"endowment":3.258096538021482,"self_citation_contribution":0.4887144807032224,"citation_network_contribution":0.0,"self_endowment_contribution":0.4887144807032224,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":25,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6295,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":697744,"name":"Sassan Noazin","orcid":"0000-0002-2043-2615","position":1,"is_corresponding":false},{"id":599348,"name":"Lilia Cabrera","orcid":null,"position":2,"is_corresponding":false},{"id":1137283,"name":"Angie K. Toledo","orcid":"0000-0003-4418-8378","position":3,"is_corresponding":false},{"id":900628,"name":"Mirza Velagic","orcid":"0000-0003-1404-3688","position":4,"is_corresponding":false},{"id":1217857,"name":"Lucero Arias","orcid":null,"position":5,"is_corresponding":false},{"id":697096,"name":"Mayra Ochoa","orcid":"0000-0001-8002-3314","position":6,"is_corresponding":false},{"id":52422,"name":"Lawrence H. Moulton","orcid":"0000-0001-7041-7387","position":7,"is_corresponding":false},{"id":503032,"name":"Mayuko Saito","orcid":"0000-0003-4622-7027","position":8,"is_corresponding":false},{"id":304253,"name":"Robert H. Gilman","orcid":"0000-0002-9037-0712","position":9,"is_corresponding":false},{"id":876508,"name":"Subhra Chakraborty","orcid":"0000-0002-6446-0255","position":10,"is_corresponding":false},{"id":612035,"name":"Mónica J. Pajuelo","orcid":"0000-0003-3662-2250","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:57:51.642883Z","pmid":"38584932","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}