{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:07:19Z","timestamp":1788318439580,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Knowledge of etiology causes of diarrheal illness is essential for development and implementation of public health measures to prevent and control this disease syndrome. There are few published studies examining diarrhea in children aged &lt;5 years in Iraq. This study aims to investigate the occurrences and epidemiology of selected bacterial (Salmonella spp. and Campylobacter spp.), viral (adenovirus, norovirus GI and GII, and astrovirus), and parasitic (Entamoeba spp. and Giardia spp.) agents in stool samples from 155 child diarrheal cases enrolled between March and August 2017, in a hospital-based cross-sectional study in Thi-Qar, southeastern Iraq. Using molecular techniques and sequence-based characterization, adenovirus was the most frequently detected enteropathogen (53\/155 (34.2%)), followed by Salmonella spp. (23\/155 (14.8%)), Entamoeba spp. (21\/155 (13.5%)), and Campylobacter spp. (17\/155 (10.9%)). Mixed infection with Salmonella spp. and Campylobacter spp. was evident, and the same was revealed between various enteric viruses, particularly adenovirus and norovirus. The most frequent co-infection pattern was between adenovirus and Campylobacter spp., in seven cases (7\/155 (4.5%)). Whole-genome sequencing-derived typing data for Salmonella isolates (n = 23) revealed that sequence type 49 was the most prevalent in this sample set (15\/23 (65.2%)). To the best of our knowledge, this study provides the first report on detection and identification of floR, blaCARB-2, and mphA antimicrobial resistance genes in Salmonella isolated from children in the Middle East region. Logistic regression analysis pointed to few enteropathogen-specific correlations between child age, household water source, and breastfeeding patterns in relation to the outcome of detection of individual enteropathogens. This study presents the first published molecular investigation of multiple enteropathogens among children &lt;5 years of age in Iraq. Our data provide supporting evidence for planning of childhood diarrhea management programs. It is important to build on this study and develop future longitudinal case-control research in order to elaborate the epidemiology of enteropathogens in childhood diarrhea in Iraq.<\/jats:p>","DOI":"10.3390\/ijerph16091573","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T08:19:59Z","timestamp":1557389999000},"page":"1573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Molecular Detection and Epidemiological Features of Selected Bacterial, Viral, and Parasitic Enteropathogens in Stool Specimens from Children with Acute Diarrhea in Thi-Qar Governorate, Iraq"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4782-5029","authenticated-orcid":false,"given":"Ali","family":"Harb","sequence":"first","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"},{"name":"Thi-Qar Public Health Division, Ministry of Health, Nassriya 64001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0950-2317","authenticated-orcid":false,"given":"Sam","family":"Abraham","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertha","family":"Rusdi","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5539-1139","authenticated-orcid":false,"given":"Tanya","family":"Laird","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"O\u2019Dea","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-0607","authenticated-orcid":false,"given":"Ihab","family":"Habib","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth 6150, Australia"},{"name":"High Institute of Public Health, Alexandria University, Alexandria 0203, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"key":"ref_1","unstructured":"United Nations International Children\u2019s Emergency Fund (2018, March 17). Diarrhoeal Diseases. UNICEF Data: Monitoring the Situation of Children and Women. Available online: https:\/\/data.unicef.org\/topic\/child-health\/diarrhoeal-disease\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.mpmed.2015.02.005","article-title":"Infectious diarrhoea","volume":"43","author":"Kelly","year":"2015","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Khoury, H., Ogilvie, I., El Khoury, A.C., Duan, Y., and Goetghebeur, M.M. (2011). Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population. BMC Infect. Dis., 11.","DOI":"10.1186\/1471-2334-11-9"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.meegid.2012.12.003","article-title":"Characterization of human rotaviruses circulating in Iraq in 2008: Atypical G8 and high prevalence of P [6] strains","volume":"16","author":"Ahmed","year":"2013","journal-title":"Infect. Genet. Evol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1128\/jcm.28.8.1780-1784.1990","article-title":"Adenovirus types 40 and 41 and rotaviruses associated with diarrhea in children from Guatemala","volume":"28","author":"Cruz","year":"1990","journal-title":"J. Clin. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.meegid.2006.11.005","article-title":"An outbreak of adenovirus serotype 41 infection in infants and children with acute gastroenteritis in Maizuru City, Japan","volume":"7","author":"Shimizu","year":"2007","journal-title":"Infect. Genet. Evol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1128\/JCM.01834-10","article-title":"Circulation of a novel pattern of infections by enteric adenovirus serotype 41 among children below 5 years of age in Kolkata, India","volume":"49","author":"Dey","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jegh.2012.11.004","article-title":"Gastrointestinal pathogen distribution in symptomatic children in Sydney, Australia","volume":"3","author":"Fletcher","year":"2013","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jviromet.2016.12.016","article-title":"The development of a multiplex real-time RT-PCR for the detection of adenovirus, astrovirus, rotavirus and sapovirus from stool samples","volume":"242","author":"Bennett","year":"2017","journal-title":"J. Virol. Methods"},{"key":"ref_10","unstructured":"Cherry, F. (1998). Textbook of Pediatric Infectious Diseases, W.B Saunders Company. [4th ed.]."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1086\/650733","article-title":"The global burden of nontyphoidal Salmonella gastroenteritis","volume":"50","author":"Majowicz","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4147","DOI":"10.1128\/JCM.01959-14","article-title":"Multilocus sequence typing (MLST) and whole-genome MLST of Campylobacter jejuni isolates from human infections in three districts during a seasonal peak in Finland","volume":"52","author":"Kovanen","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/00001432-200210000-00009","article-title":"Salmonellosis in children in developing and developed countries and populations","volume":"15","author":"Graham","year":"2002","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1042\/EBC20160055","article-title":"Development and transmission of antimicrobial resistance among Gram-negative bacteria in animals and their public health impact","volume":"61","author":"Mukerji","year":"2017","journal-title":"Essays Biochem."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3347\/kjp.2010.48.2.113","article-title":"Infection status of hospitalized diarrhea patients with gastrointestinal protozoa, bacteria, and viruses in the Republic of Korea","volume":"48","author":"Cheun","year":"2010","journal-title":"Korean J. Parasitol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.bjid.2012.08.021","article-title":"Prevalence and characters of Entamoeba histolytica infection in Saudi infants and children admitted with diarrhea at 2 main hospitals at South Jeddah: A re-emerging serious infection with unusual presentation","volume":"17","author":"Hegazi","year":"2013","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"32088","DOI":"10.3402\/ljm.v11.32088","article-title":"Prevalence of Entamoeba histolytica, Giardia lamblia, and Cryptosporidium spp. in Libya: 2000\u20132015","volume":"11","author":"Ghenghesh","year":"2016","journal-title":"Libyan J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3486","DOI":"10.1017\/S0950268817002400","article-title":"Prevalence, risk factors and antimicrobial resistance of Salmonella diarrhoeal infection among children in Thi-Qar Governorate, Iraq","volume":"145","author":"Harb","year":"2017","journal-title":"Epidemiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1089\/cmb.2012.0021","article-title":"SPAdes: A new genome assembly algorithm and its applications to single-cell sequencing","volume":"19","author":"Bankevich","year":"2012","journal-title":"J. Comput. Biol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3768","DOI":"10.1128\/aem.62.10.3768-3771.1996","article-title":"Virulence determinants invA and spvC in Salmonellae isolated from poultry products, wastewater, and human sources","volume":"62","author":"Swamy","year":"1996","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2822","DOI":"10.1128\/JCM.01397-13","article-title":"Multiplex Real-Time PCR for Detection of Campylobacter, Salmonella, and Shigella","volume":"51","author":"Barletta","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jviromet.2003.08.009","article-title":"Detection of norovirus (GI, GII) Sapovirus and astrovirus in fecal samples using reverse transcription single-round multiplex PCR","volume":"114","author":"Yan","year":"2003","journal-title":"J. Virol. Methods"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"699","DOI":"10.11150\/kansenshogakuzasshi1970.78.699","article-title":"Development of RT-multiplex PCR assay for detection of adenovirus and group A and C rotaviruses in diarrheal fecal specimens from children in China","volume":"78","author":"Yan","year":"2004","journal-title":"Kansenshogaku Zasshi"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/tmi.12848","article-title":"First molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections in Yemen: Different species-specific associated risk factors","volume":"22","author":"Sady","year":"2017","journal-title":"Trop. Med. Int. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.exppara.2013.12.004","article-title":"Development of a quantitative PCR (qPCR) for Giardia and analysis of the prevalence, cyst shedding and genotypes of Giardia present in sheep across four states in Australia","volume":"137","author":"Yang","year":"2014","journal-title":"Exp. Parasitol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/tropej\/fmu027","article-title":"Health trends in Iraq with a focus on children: No cause for optimism","volume":"60","author":"Burkle","year":"2014","journal-title":"J. Trop. Pediatr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S0140-6736(12)62196-5","article-title":"Civilian mortality after the 2003 invasion of Iraq","volume":"381","author":"Burkle","year":"2013","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/00006454-198909000-00005","article-title":"Microbial etiology of acute gastroenteritis in hospitalized children in Kuwait","volume":"8","author":"Sethi","year":"1989","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Al-Thani, A., Baris, M., Al-Lawati, N., and Al-Dhahry, S. (2013). Characterising the aetiology of severe acute gastroenteritis among patients visiting a hospital in Qatar using real-time polymerase chain reaction. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-329"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.apjtb.2017.10.003","article-title":"Molecular study of astrovirus, adenovirus and norovirus in community acquired diarrhea in children: One Egyptian center study","volume":"7","year":"2017","journal-title":"Asian. Pac. J. Trop. Biomed."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1111\/zph.12358","article-title":"Novel coronaviruses, astroviruses, adenoviruses and circoviruses in insectivorous bats from northern China","volume":"64","author":"Han","year":"2017","journal-title":"Zoonoses Public Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/jmv.25008","article-title":"Detection of enteric- and non-enteric adenoviruses in gastroenteritis patients, Bangladesh, 2012\u20132015","volume":"90","author":"Afrad","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijid.2015.03.009","article-title":"Molecular epidemiology of enteric viruses and genotyping of rotavirus A, adenovirus and astrovirus among children under 5 years old in Gabon","volume":"34","author":"Nkoghe","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_34","first-page":"315","article-title":"Salmonella responsible for infantile gastroenteritis in Mosul, Iraq","volume":"91","author":"Alrajab","year":"1988","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_35","first-page":"85","article-title":"Bacterial and viral causes of acute diarrhoea in children in Kuwait","volume":"7","author":"Sethi","year":"1989","journal-title":"J. Diarrhoeal. Dis. Res."},{"key":"ref_36","first-page":"60","article-title":"Epidemiology and Antimicrobial Resistance of Enteric Pathogens in Dhahira Region, Oman. Iran","volume":"37","author":"Prakash","year":"2008","journal-title":"J. Public Health"},{"key":"ref_37","unstructured":"Joint Analysis Unit (2013, October 05). Thi-Qar Governorate Profile. Iraq: United Nations. Available online: http:\/\/www.cybermanual.com\/thi-qar-ir-joint-analysis-unit-jau.html?page=5."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1016\/S0140-6736(16)31529-X","article-title":"Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children: A reanalysis of the GEMS case-control study","volume":"388","author":"Liu","year":"2016","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lengerh, A., Moges, F., Unakal, C., and Anagaw, B. (2013). Prevalence, associated risk factors and antimicrobial susceptibility pattern of Campylobacter species among under five diarrheic children at Gondar University Hospital, Northwest Ethiopia. BMC Pediatr., 13.","DOI":"10.1186\/1471-2431-13-82"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/QCO.0000000000000364","article-title":"Campylobacter jejuni and associated immune mechanisms: Short-term effects and long-term implications for infants in low-income countries","volume":"30","author":"Schnee","year":"2017","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1007\/s00705-005-0540-y","article-title":"Existence of multiple outbreaks of viral gastroenteritis among infants in a day care center in Japan","volume":"150","author":"Akihara","year":"2005","journal-title":"Arch. Virol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zheng, S., Yu, F., Chen, X., Cui, D., Cheng, Y., Xie, G., Yang, X., Han, D., Wang, Y., and Zhang, W. (2016). Enteropathogens in children less than 5 years of age with acute diarrhea: A 5-year surveillance study in the Southeast Coast of China. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1760-3"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2548","DOI":"10.1016\/0043-1354(95)00070-2","article-title":"Survival of the enteric andenoviruses 40 and 41 in tap, sea, and waste water","volume":"29","author":"Enriquez","year":"1995","journal-title":"Water Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/j.1365-2672.2005.02617.x","article-title":"Prevalence, quantification and typing of adenoviruses detected in river and treated drinking water in South Africa","volume":"99","author":"Ehlers","year":"2005","journal-title":"J. Appl. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Bronowski, C., Mustafa, K., Goodhead, I., James, C.E., Nelson, C., Lucaci, A., Wigley, P., Humphrey, T.J., Williams, N.J., and Winstanley, C. (2017). Campylobacter jejuni transcriptome changes during loss of culturability in water. PLoS ONE, 12.","DOI":"10.1101\/150383"},{"key":"ref_46","first-page":"1171","article-title":"Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results From the MAL-ED Study","volume":"63","author":"Amour","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jiph.2015.10.013","article-title":"Distribution and factors associated with Salmonella enterica genotypes in a diverse population of humans and animals in Qatar using multi-locus sequence typing (MLST)","volume":"9","author":"Chang","year":"2016","journal-title":"J. Infect. Public. Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3400","DOI":"10.1093\/jac\/dkw318","article-title":"WGS for surveillance of antimicrobial resistance: A pilot study to detect the prevalence and mechanism of resistance to azithromycin in a UK population of non-typhoidal Salmonella","volume":"71","author":"Nair","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"4520","DOI":"10.1128\/AEM.00468-11","article-title":"Subtyping Salmonella enterica serovar enteritidis isolates from different sources by using sequence typing based on virulence genes and clustered regularly interspaced short palindromic repeats (CRISPRs)","volume":"77","author":"Liu","year":"2011","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.fm.2011.04.001","article-title":"Diversity of Salmonella isolates using serotyping and multilocus sequence typing","volume":"28","author":"Liu","year":"2011","journal-title":"Food Microbiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5001\/omj.2010.25","article-title":"In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq","volume":"25","author":"Jassim","year":"2010","journal-title":"Oman. Med. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s12223-012-0099-4","article-title":"Antimicrobial resistance in Salmonella spp. recovered from patients admitted to six different hospitals in Tehran, Iran from 2007 to 2008","volume":"57","author":"Tajbakhsh","year":"2012","journal-title":"Folia Microbiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.3389\/fmicb.2017.01300","article-title":"Characterization of Integrons and Resistance Genes in Salmonella Isolates from Farm Animals in Shandong Province, China","volume":"8","author":"Zhao","year":"2017","journal-title":"Front. Microbiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jfma.2012.02.011","article-title":"Multidrug-resistant Salmonella enterica serovar Panama carrying class 1 integrons is invasive in Taiwanese children","volume":"112","author":"Huang","year":"2013","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1093\/jac\/dkh070","article-title":"Antibiotic resistance genes, integrons and multiple antibiotic resistance in thirty-five serotypes of Salmonella enterica isolated from humans and animals in the UK","volume":"53","author":"Randall","year":"2004","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"304","DOI":"10.4315\/0362-028X.JFP-15-342","article-title":"Adequate hand washing and glove use are necessary to reduce cross-contamination from hands with high bacterial loads","volume":"79","author":"Robinson","year":"2016","journal-title":"J. Food Prot."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"S685","DOI":"10.1093\/cid\/civ844","article-title":"The sanitation hygiene infant nutrition efficacy (SHINE) trial: Rationale, design, and methods","volume":"61","author":"Humphrey","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"685","DOI":"10.4315\/0362-028X.JFP-14-245","article-title":"Quantifying the effect of hand wash duration, soap use, ground beef debris, and drying methods on the removal of enterobacter aerogenes on hands","volume":"78","author":"Jensen","year":"2015","journal-title":"J. Food Prot."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/9\/1573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:49:20Z","timestamp":1760186960000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/9\/1573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,6]]},"references-count":58,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["ijerph16091573"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16091573","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,6]]}}}