An evaluation of low-cost specimen preservation for characterization of enteric disease in children
Amanda Debes, PhD, MS
BACKGROUND: Worldwide, more than 600,000 children under five years of age die annually from diarrheal diseases; nearly one-third of pediatric diarrheal deaths are due to Enterotoxigenic Escherichia coli (ETEC) and Shigellae.
GAP: There is a further lack of understanding of the predominant strains and serotypes that are found in endemic areas, information which is crucial to the development of effective vaccines targeting the most vulnerable populations. Standard methods which rely on classical microbiological methods are not practical in remote areas or in resource constraint settings where future vaccine efficacy trials need to be conducted.
HYPOTHESIS: This is exploratory analysis, and we hypothesize that ETEC and Shigellae cause a large proportion of moderate-to-severe diarrheal illnesses which may be controlled with vaccines currently being developed.
METHODS: We propose to nest a pediatric ETEC and Shigella surveillance cohort into on-going multi-site surveillance efforts in Cameroon. Study subjects were enrolled between 1/1/15 and 12/31/2017 and included children and adolescents <18 years of age and were recruited based on having 3 or more loose stools within 24hours with the presence of dehydration (based on established WHO criteria) and/or blood, providing a stool specimen with epidemiological information upon enrollment. A total of 1995 persons were enrolled, for which 838 meet the enrollment criteria and whose specimens are currently being screened for the analysis.
IMPACT: The results of this study will aid in identifying potential field sites for evaluation of the vaccine candidates being developed, and the genetic and phenotypic characterization of strains identified will provide critical information to improve the effectiveness of these vaccines in the most vulnerable populations in Cameroon and other endemic countries.
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