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Potential Diarrheal Pathogens Common Also in Healthy Children in Angola

Pelkonen, Tuula*†; dos Santos, Mauro, Dias; Roine, Irmeli; dos Anjos, Elisabete*; Freitas, César*; Peltola, Heikki; Laakso, Sanna§; Kirveskari, Juha§

The Pediatric Infectious Disease Journal: September 6, 2017 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/INF.0000000000001781
Original Studies: PDF Only

Background: Globally, diarrhea kills almost 1,500 children daily. In diagnostics, molecular methods are replacing traditional assays. We aimed to investigate enteropathogens in children with and without diarrhea in Luanda, the capital of Angola.

Methods: 194 stool samples from 98 children with acute diarrhea and 96 children without diarrhea were investigated for 17 enteropathogens with multiplex real-time polymerase chain reaction (PCR).

Results: The median age of children was 10.5 months. Enteropathogens, bacteria, viruses, and parasites were detected in 91%, 78%, 50%, and 25%, respectively. A positive finding was significantly (P < 0.0001) more common in diarrhea when testing for all pathogens combined, for bacteria alone, and for viruses alone. More than one pathogen was found more frequently in diarrhea than non-diarrhea stool samples, in 87% and in 59% (P < 0.0001), respectively. The median number (IQR) of pathogens detected was 3 (2) vs. 1.5 (2) (P < 0.0001), respectively. When age was taken into account, diarrhea associated with enterotoxigenic and enteroaggregative Escherichia coli, Shigella, Campylobacter, rotavirus, sapovirus, and Cryptosporidium.

Conclusions: Multiplex PCR detected enteropathogens in almost all stool samples of children in Luanda, albeit this occurred more often in diarrhea. Children with diarrhea showed more mixed infections than children without diarrhea.

* Hospital Pediátrico David Bernardino, Luanda, Angola

Children´s Hospital, Helsinki University Central Hospital, and University of Helsinki, Helsinki, Finland

Faculty of Medicine, University Diego Portales, Santiago, Chile

§ Mobidiag ltd, Espoo, Finland


Funding The work was supported by the Foundation for Paediatric Research of Finland and The Päivikki ja Sakari Sohlberg Foundation, Helsinki. Finland.

Conflict of interest: SL and JK are employees of Mobidiag ltd, Espoo, Finland. All other authors: No potential conflicts of interest.

Corresponding author: Dr. Tuula Pelkonen, Tammitie 20 A 11, 00330 Helsinki, Finland, Tel: +358-50-4140758, Fax: 358-9-47174708, Email:

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