Abstract
BackgroundStool consistency is an important diagnostic criterion in both research and clinical medicine and is often used to define diarrheal disease.MethodsWe examine the pediatric enteric virome across stool consistencies to evaluate differences in richness and community composition using fecal samples collected from children aged 0 to 5 years participating in a clinical trial in the Amhara region of Ethiopia. The consistency of each sample was graded according to the modified Bristol Stool Form Scale for children (mBSFS-C) before a portion of stool was preserved for viral metagenomic analysis. Stool samples were grouped into 29 pools according to stool consistency type. Differential abundance was determined using negative-binomial modeling.ResultsOf 446 censused children who were eligible to participate, 317 presented for the study visit examination and 269 provided stool samples. The median age of children with stool samples was 36 months. Species richness was highest in watery-consistency stool and decreased as stool consistency became firmer (Spearman’s r = − 0.45, p = 0.013). The greatest differential abundance comparing loose or watery to formed stool was for norovirus GII (7.64, 95% CI 5.8, 9.5) followed by aichivirus A (5.93, 95% CI 4.0, 7.89) and adeno-associated virus 2 (5.81, 95%CI 3.9, 7.7).ConclusionsIn conclusion, we documented a difference in pediatric enteric viromes according to mBSFS-C stool consistency category, both in species richness and composition.
Highlights
Stool consistency is an important diagnostic criterion in both research and clinical medicine and is often used to define diarrheal disease
Characteristics of study population Of 446 censured children who were eligible to participate, 317 children presented for the study visit examination and 269 provided stool samples
Richness and alpha diversity Species richness was highest in watery-consistency stool and decreased consistently as stool consistency became firmer (Spearman’s r = − 0.45, p = 0.013)
Summary
Stool consistency is an important diagnostic criterion in both research and clinical medicine and is often used to define diarrheal disease. Stool consistency is an important diagnostic criterion in both research and clinical medicine [1]. Changes in stool consistency are used to measure many gastrointestinal disorders such as ulcerative colitis, irritable bowel syndrome and diarrhea [2,3,4,5,6]. Most epidemiologic studies of diarrheal disease internationally use stool consistency, ‘loose or watery stool’ to classify diarrhea cases [2, 7]. The most widely used stool form scale, The. Bristol Stool Form Scale (BSFS), was developed in the late 1980s to measure gut transit time [8, 9]. The BSFS classifies stool form into seven categories according to stool cohesion, surface cracking and consistency
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