Proportional hazards analysis of diarrhea due to enterotoxigenic escherichia Coli and breast feeding in a cohort of urban mexican children

Kurt Z. Long, James W. Wood, Edgar Vasquez Gariby, Kenneth M. Weiss, John J. Mathewson, Francisco J. De La Cabada, Herbert L. Dupont, Richard A. Wilson

Research output: Contribution to journalArticle

34 Scopus citations


Ninety-eight women-infant pairs were followed for up to 50 weeks in the northern part of Guadalajara, Mexico, from August 1986 to July 1987 as part of a community-based, prospective study of the relation between infant feeding patterns and enterotoxigenic Escherichia coli producing heat-labile toxin (LT-ETEC) diarrheal disease. Strictly formula-fed children had an incidence of diarrhea over three times that of strictly breast fed infants and twice that of breast-fed and supplementally fed children. Strictly formula fed infants colonized by LT-ETEC were symptomatic for diarrhea nearly three times as often as strictly breast-fed infants and twice as often as infants receiving a mixed diet. The fitting of parametric hazard models to durations until LT-ETEC colonization revealed that the hazard for the first colonization was time invariant. The hazard of diarrhea increased by 400-500% during the rainy season or among children 3 months of age or older who received avena, a barley drink. The best-fitting hazard models to durations until symptomatic expression of LT-ETEC infection all increased through time. This hazard was inversely impacted by the overall amount of LT-ETEC-specific, immunoglobulin A antibodies the infant received via the mother's breast milk and by the provision of traditional medicinal teas. Am J Epidemiol 1994;139:193-205.

Original languageEnglish (US)
Pages (from-to)193-205
Number of pages13
JournalAmerican journal of epidemiology
Issue number2
Publication statusPublished - Jan 15 1994


All Science Journal Classification (ASJC) codes

  • Epidemiology

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