2025/06/25 by Fahima Chowdhury, Md Taufiqul Islam, Faisal Ahmmed +23 · 1 voice · 1 citation
Biochemistry, Genetics and Molecular Biology · Nursing · #Child Nutrition and Water Access #Escherichia coli research studies #Vibrio bacteria research studies
paper · doi:10.1093/ofid/ofaf375
openalex publication_date 2025/06/25 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Background: (ETEC) is a major cause of diarrheal illness, and population-based data on the incidence of clinically significant ETEC diarrhea in developing countries are limited. We provide insight into ETEC epidemiology; we followed a population-based cohort in a vaccine trial. Methods: We analyzed data from a cluster-randomized controlled trial of an oral cholera vaccine conducted in an urban slum in Dhaka, Bangladesh. The study covers 90 geographical clusters with an average population of 2988 households/cluster (baseline population 268 896). Two cohort analyses were conducted, 1 as dynamic cohort that included all subjects at vaccination, in-migrants, and births over 4 years and a closed cohort, which included only individuals present at baseline. We evaluated individuals placed under treatment center-based diarrheal surveillance between 2011 and 2015. Results: In the dynamic cohort, the ETEC incidence was 150/100 000 person-years (PY; 95% CI, 141-159), with seasonal peaks during warmer months, and in the closed cohort, the incidence was 153/100 000 PY (95% CI, 140, 166). The highest rate was seen in children aged <1 year (2007; 95% CI, 1664-2402), then in those aged 1-4 years (314; 95% CI, 252-386), and again the rate rose in those aged >45 years (219/100 000 PY; 95% CI, 177-267). The rate of severe ETEC was ≤35/100 000 PY for persons aged ≤45 years (95% CI, 27-44), but rose to 82 for adults aged >45 years (95% CI, 58-113). Conclusions: ETEC diarrhea is a major health problem in young children and older adults, prevention through vaccination and improved water, sanitation, and hygiene should target both age groups.