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Environmental Factors Associated with High Fly Densities and Diarrhea in Vellore, India

机译：印度韦洛尔的高飞行密度和腹泻相关的环境因素

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Diarrhea causes significant morbidity and mortality in Indian children under 5 years of age. Flies carry enteric pathogens and may mediate foodborne infections. In this study, we characterized fly densities as a determinant of infectious diarrhea in a longitudinal cohort of 160 urban and 80 rural households with 1,274 individuals (27% under 5 years of age) in Vellore, India. Household questionnaires on living conditions were completed at enrollment. Fly abundance was measured during the wet and dry seasons using fly ribbons placed in kitchens. PCRs for enteric bacteria, viruses, and protozoa were performed on 60 fly samples. Forty-three (72%) fly samples were positive for the following pathogens: norovirus (50%), Salmonella spp. (46.7%), rotavirus (6.7%), and Escherichia coli (6.7%). Ninety-one episodes of diarrhea occurred (89% in children under 5 years of age). Stool pathogens isolated in 24 of 77 (31%) samples included E. coli , Shigella spp., Vibrio spp., Giardia , Cryptosporidium , and rotavirus. Multivariate log-linear models were used to explore the relationships between diarrhea and fly densities, controlling for demographics, hygiene, and human-animal interactions. Fly abundance was 6 times higher in rural than urban sites ( P < 0.0001). Disposal of garbage close to homes and rural living were significant risk factors for high fly densities. The presence of latrines was protective against high fly densities and diarrhea. The adjusted relative risks of diarrheal episodes and duration of diarrhea, associated with fly density at the 75th percentile, were 1.18 (95% confidence interval [CI], 1.03 to 1.34) and 1.15 (95% CI, 1.02 to 1.29), respectively. Flies harbored enteric pathogens, including norovirus, a poorly documented pathogen on flies.
机译：在5岁以下的印度儿童中，腹泻会导致明显的发病率和死亡率。蝇携带肠道病原体，并可能介导食源性感染。在这项研究中，我们在印度韦洛尔（Vellore）的160个城市和80个农村家庭的纵向队列中，将蝇密度确定为传染性腹泻的决定因素，这些家庭有1,274个人（5岁以下的27％），有1,274个人。入学时填写家庭生活状况调查表。在潮湿和干燥季节，使用放置在厨房中的防蝇丝带来测量蝇的丰度。对60个果蝇样品进行了肠道细菌，病毒和原生动物的PCR。 43份（72％）果蝇样品对以下病原体呈阳性：诺如病毒（50％），沙门氏菌。 （46.7％），轮状病毒（6.7％）和大肠杆菌（6.7％）。发生了91次腹泻（5岁以下儿童中占89％）。在77个样本中，有24个（31％）分离出的粪便病原体包括大肠杆菌，志贺氏菌属，弧菌属，贾第虫，隐孢子虫和轮状病毒。多变量对数线性模型用于研究腹泻和果蝇密度之间的关系，控制人口统计学，卫生状况和人与动物的相互作用。农村地区的蝇类丰度比城市地区高6倍（P <0.0001）。靠近家和农村生活的垃圾处理是高蝇密度的重要危险因素。厕所的存在可以防止蝇密度高和腹泻。调整后的腹泻发作和腹泻持续时间的相对危险度，与第75个百分位数的蝇密度相关，分别为1.18（95％置信区间[CI]，1.03至1.34）和1.15（95％CI，1.02至1.29）。苍蝇带有肠道病原体，其中包括诺如病毒，这种病原体在苍蝇上的文献记载很少。

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