Enterotoxigenic Escherichia coli diarrhea among young children in Jakarta, Indonesia.

ABSTRACT

PIP: During a 4-month period in 1994, 408 children 6 months to 5 years of age (mean, 2.4 years) from a densely populated slum section (Kapuk) of West Jakarta, Indonesia, were monitored in their homes for diarrheal disease. Many homes in this community lack running water or toilet facilities. Overall, 148 (36%) of these children had at least one diarrhea episode during the study period. 29 children (19.6%) with diarrhea had enterotoxigenic Escherichia coli (ETEC) isolated from a rectal swab sample at least once during the surveillance period and five children had ETEC isolated from two distinct diarrhea episodes, for a total of 34 episodes of ETEC-positive diarrhea. 10 of the 34 episodes were associated with heat-labile toxin, 15 with heat-stable toxin, and 7 with both toxins. Annualized rates of diarrhea and ETEC infections were estimated at 2.2 and 0.3 per child, respectively. The rate of children with diarrhea declined steadily with increasing age: 52% at 6-11 months, 48% at 12-23 months, 28% at 24-35 months, 30% at 36-47 months, and 12% at 48-60 months. 82% of children with ETEC were under 2 years of age. The high incidence of ETEC diarrhea recorded in this study suggests the feasibility of ETEC vaccine efficacy trials in this population.