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To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural\u2013urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection. Most children (89%) carried at least one pathogen, and 72% carried two or more. Bacterial infections (82% of participants) were more common than viruses (58%) or parasites (9.1%). Infants living in the urban site had decreased infection risks compared to those in rural locations. Improved water and sanitation were most predictive of reduced infection risk. Improved water was associated with decreased enterotoxigenic E. coli prevalence, and improved sanitation was associated with lower prevalence of any infection and specifically norovirus. Animal exposure was associated with increased Salmonella prevalence. Children measured during the rainy season had fewer viral and more bacterial infections. Identifying environmental exposures associated with specific pathogen outcomes provides insights into transmission pathways, which contribute critical information for developing effective strategies to improve child health.<\/jats:p>","DOI":"10.1021\/acs.est.4c07753","type":"journal-article","created":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T10:02:21Z","timestamp":1735552941000},"page":"103-118","source":"Crossref","is-referenced-by-count":13,"title":["Environmental Exposures\nAssociated with Enteropathogen\nInfection in Six-Month-Old Children Enrolled in the ECoMiD Cohort\nalong a Rural\u2013Urban Gradient in Northern Ecuador"],"prefix":"10.1021","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4074-3170","authenticated-orcid":true,"given":"Kelsey\nJ.","family":"Jesser","sequence":"first","affiliation":[{"name":"University of Washington , , , ,","place":["Seattle, Washington, United States, 98195"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette A.","family":"Zhou","sequence":"additional","affiliation":[{"name":"University of Washington , , , ,","place":["Seattle, Washington, United States, 98195"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Hemlock","sequence":"additional","affiliation":[{"name":"University of Washington , , , ,","place":["Seattle, Washington, United States, 98195"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly K.","family":"Miller-Petrie","sequence":"additional","affiliation":[{"name":"University of Washington , , , ,","place":["Seattle, Washington, United States, 98195"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse D.","family":"Contreras","sequence":"additional","affiliation":[{"name":"University of Michigan , , , ,","place":["Ann Arbor, Michigan, United States, 48109"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Ballard","sequence":"additional","affiliation":[{"name":"Emory University , , , ,","place":["Atlanta, Georgia, United States, 30329"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sosa-Moreno","sequence":"additional","affiliation":[{"name":"University of Michigan , , , ,","place":["Ann Arbor, Michigan, United States, 48109"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Calvopin\u0303a","sequence":"additional","affiliation":[{"name":"Universidad De Las Ame\u0301ricas (UDLA) , , ,","place":["Quito, Ecuador, 17901"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F.","family":"Arnold","sequence":"additional","affiliation":[{"name":"University of California at San Francisco , , , ,","place":["San Francisco, California, United States, 94158"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Cevallos","sequence":"additional","affiliation":[{"name":"Universidad Central del Ecuador , , ,","place":["Quito, Ecuador, 170136"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Trueba","sequence":"additional","affiliation":[{"name":"Universidad San Francisco de Quito , , ,","place":["Quito, Ecuador, 170901"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-3852","authenticated-orcid":true,"given":"Gwenyth O.","family":"Lee","sequence":"additional","affiliation":[{"name":"Rutgers University , , , ,","place":["New Brunswick, New Jersey, United States, 08901"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N.S.","family":"Eisenberg","sequence":"additional","affiliation":[{"name":"University of Michigan , , , ,","place":["Ann Arbor, Michigan, United States, 48109"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-9401","authenticated-orcid":true,"given":"Karen","family":"Levy","sequence":"additional","affiliation":[{"name":"University of Washington , , , ,","place":["Seattle, Washington, United States, 98195"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2024,12,30]]},"reference":[{"issue":"11","key":"2026081211064006000_cit1","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/S1473-3099(18)30362-1","article-title":"Estimates of the Global, Regional, and National Morbidity,\nMortality, and Aetiologies of Diarrhoea in 195 Countries: A Systematic\nAnalysis for the Global Burden of Disease Study 2016","volume":"18","author":"Troeger","year":"2018","journal-title":"Lancet Infect. 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