Measuring enteric pathogen force of infection through antibody responses in children
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Enteric pathogens account for a substantial global disease burden, yet population-based surveillance remains limited by the transient nature of pathogen shedding, which constrains the sensitivity of stool-based molecular testing to a narrow detection window. Detection of IgG responses in serological surveys could enable new insights into enteric pathogen transmission, but benchmarking serological measures relative to stool-based measures of infection remains a critical evidence gap. We compared measures of disease transmission in longitudinal birth cohort samples using multiplex IgG (1,575 dried blood spots, 369 children) and PCR assays (2,229 stool samples, 369 children) that overlapped for nine pathogens (norovirus GI/GII, Shigella /enteroinvasive Escherichia coli (EIEC), Campylobacter spp., enterotoxigenic Escherichia coli (LT-ETEC), Salmonella enterica , Giardia spp., Cryptosporidium spp., Entamoeba histolytica ). Campylobacter and LT-ETEC ranked highest while E. histolytica and S. enterica ranked among the lowest by both IgG and PCR measures of infection. Measures of infection were less aligned for norovirus GI, norovirus GII, Cryptosporidium , Shigella /EIEC, and Giardia . Despite this, for most pathogens, and across both measures, force of infection was lowest in the urban city of Esmeraldas and substantially higher in more rural populations, with relative risks in assay measures (seroconversion rate and PCR detected prevalence) of approximately 2.0 for pathogens with the largest differences ( Shigella /EIEC and norovirus GI). Together, our results suggest that although absolute levels of infection differed between assays, IgG and PCR captured consistent relative risk of infection across geographic strata, suggesting either method can identify high-versus low-transmission settings.
Source: medRxiv
Authors: Nikolina Walas, Lesly Simbaña Vivanco, Stuart Torres Ayala, Chabier Coleman, E. Brook Goodhew, Kelsey J. Jesser, Nicolette A. Zou, Christine S. Fagnant-Sperati, Jesse Contreras, Caitlin Hemlock, Jeffrey W. Priest, Richelle C. Charles, Edward T. Ryan, Claire Munroe, Robert L. Atmar, Julianna Colado, Hadley Burroughs, Manuel Calvopiña, William Cevallos, Josefina Coloma, Gwenyth O. Lee, Gabriel Trueba, Joseph N.S. Eisenberg, Karen Levy, Benjamin F. Arnold
Institutions: University of California, San Francisco, Universidad San Francisco de Quito, University of Washington, University of Michigan, Harvard University, Massachusetts General Hospital, Baylor College of Medicine, Universidad de Las Américas, Central University of Ecuador, University of California, Berkeley, Rutgers, The State University of New Jersey, UCSF Institute for Global Health Sciences
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Gut microbiome, enteric infections and child growth across a rurual urban gradient, G7179353334, Environmental Pathology/Toxicology Training Program, G7766542355, Enteric Pathogen Force of Infection among Children using Serology, Functional profiling of OSP-specific and other antibodies during shigella infection, Biostatistics, Epidemiologic, and Bioinformatic Training in Environmental Health (BEBTEH)
OpenAlex ID: W7220429124