Digestive disorders are a leading cause of mortality worldwide, with diarrhea being particularly deadly. Despite declining mortality rates, diarrhea still causes an estimated 1.65 million deaths annually, with the highest burden in low- and middle-income countries, largely due to poor sanitation and lack of clean water. While acute diarrhea has been extensively studied, less is known about the pathogens responsible for long-lasting digestive issues, including diarrhea and abdominal pain that persist for 14 days or more. A recent study in Scientific Reports offers valuable insights into the prevalence of these pathogens and highlights the importance of advanced molecular diagnostics in addressing this issue.
In this study, researchers collected stool samples from 1,826 participants located in Côte d’Ivoire, Mali, and Nepal. The participants included both symptomatic patients and asymptomatic controls. By comparing the prevalence of pathogens in these two groups, the study aimed to determine which pathogens were most likely contributing to the symptoms observed.
Conventional methods to identify pathogens are insensitive and only target a narrow range of pathogens. To overcome these challenges, the researchers tried an advanced molecular technique known as multiplex real-time PCR. This technique is highly sensitive and can detect multiple pathogens (bacteria, viruses and protozoa) from a single stool sample. This capability is especially important in regions with diverse pathogen landscapes, where patients may be co-infected with multiple pathogens. To effectively process the large volume of samples, Maxwell® Instruments and kits were used to automate DNA extraction from the stool samples.
The study showed significant geographic variability of pathogen prevalence between the three study sites. For example, Mali exhibited the highest prevalence of most pathogens, with some being up to ten times more common than in Nepal. In addition, co-infection with multiple pathogens was common in Côte d’Ivoire and Mali but it was rarely observed in Nepal. The study also found that while the bacteria Campylobacter spp. and EAEC were prevalent across all locations, they were much more common in Mali compared to Côte d’Ivoire and Nepal.
The differences in pathogen prevalence between the three countries indicate that a one-size-fits-all public health approach may not be effective. Instead, interventions should be tailored to the specific pathogen profiles of each region. This study demonstrates the power of using multiplex real-time PCR to provide a comprehensive picture of pathogen prevalence, especially in regions with diverse infectious disease landscapes.
In conclusion, the insights gained from this multi-country study highlight the critical role of molecular diagnostics in combating persistent digestive disorders. By revealing the setting-specific prevalence of pathogens and the importance of diagnostic approaches, this research paves the way for more targeted and effective public health interventions that could save lives.
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