Enteric pathogen infection and consequences for child growth in young Aboriginal Australian children: a cross-sectional study

Sarah Hanieh, Siddhartha Mahanty, George Gurruwiwi, Therese Kearns, Roslyn Dhurrkay, Veronica Gondarra, Jenny Shield, Norbert Ryan, Francesca Azzato, Susan A. Ballard, Nicole Orlando, Sullen Nicholson, Katherine Gibney, Julie Brimblecombe, Wendy Page, Leonard C. Harrison, Beverley Ann Biggs, on behalf of the Child Health and Nutrition Study team

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Background: To determine the prevalence of enteric infections in Aboriginal children aged 0–2 years using conventional and molecular diagnostic techniques and to explore associations between the presence of pathogens and child growth. Methods: Cross-sectional analysis of Aboriginal children (n = 62) residing in a remote community in Northern Australia, conducted from July 24th - October 30th 2017. Stool samples were analysed for organisms by microscopy (directly in the field and following fixation and storage in sodium-acetate formalin), and by qualitative PCR for viruses, bacteria and parasites and serology for Strongyloides-specific IgG. Child growth (height and weight) was measured and z scores calculated according to WHO growth standards. Results: Nearly 60% of children had evidence for at least one enteric pathogen in their stool (37/62). The highest burden of infection was with adenovirus/sapovirus (22.9%), followed by astrovirus (9.8%) and Cryptosporidium hominis/parvum (8.2%). Non-pathogenic organisms were detected in 22.5% of children. Ten percent of children had diarrhea at the time of stool collection. Infection with two or more pathogens was negatively associated with height for age z scores (− 1.34, 95% CI − 2.61 to − 0.07), as was carriage of the non-pathogen Blastocystis hominis (− 2.05, 95% CI - 3.55 to − 0.54). Conclusions: Infants and toddlers living in this remote Northern Australian Aboriginal community had a high burden of enteric pathogens and non-pathogens. The association between carriage of pathogens/non-pathogens with impaired child growth in the critical first 1000 days of life has implications for healthy child growth and development and warrants further investigation. These findings have relevance for many other First Nations Communities that face many of the same challenges with regard to poverty, infections, and malnutrition.

Original languageEnglish
Article number9
Number of pages9
JournalBMC Infectious Diseases
Issue number1
Publication statusPublished - 6 Jan 2021


  • Aboriginal
  • Child growth
  • Enteric infection
  • Height for age z scores

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