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Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results From the MAL-ED Study.


ABSTRACT:

Background

Enteropathogen infections have been associated with enteric dysfunction and impaired growth in children in low-resource settings. In a multisite birth cohort study (MAL-ED), we describe the epidemiology and impact of Campylobacter infection in the first 2 years of life.

Methods

Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter Stool and blood samples were assayed for markers of intestinal permeability and inflammation.

Results

A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval, .47-.67), treatment of drinking water (0.76; 0.70-0.83), access to an improved latrine (0.89; 0.82-0.97), and recent macrolide antibiotic use (0.68; 0.63-0.74). A high Campylobacter burden was associated with a lower length-for-age Z score at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -1.38). This association was robust to confounders and consistent across sites. Campylobacter infection was also associated with increased intestinal permeability and intestinal and systemic inflammation.

Conclusions

Campylobacter was prevalent across diverse settings and associated with growth shortfalls. Promotion of exclusive breastfeeding, drinking water treatment, improved latrines, and targeted antibiotic treatment may reduce the burden of Campylobacter infection and improve growth in children in these settings.

SUBMITTER: Amour C 

PROVIDER: S-EPMC5064165 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Publications

Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results From the MAL-ED Study.

Amour Caroline C   Gratz Jean J   Mduma Estomih E   Svensen Erling E   Rogawski Elizabeth T ET   McGrath Monica M   Seidman Jessica C JC   McCormick Benjamin J J BJ   Shrestha Sanjaya S   Samie Amidou A   Mahfuz Mustafa M   Qureshi Shahida S   Hotwani Aneeta A   Babji Sudhir S   Trigoso Dixner Rengifo DR   Lima Aldo A M AA   Bodhidatta Ladaporn L   Bessong Pascal P   Ahmed Tahmeed T   Shakoor Sadia S   Kang Gagandeep G   Kosek Margaret M   Guerrant Richard L RL   Lang Dennis D   Gottlieb Michael M   Houpt Eric R ER   Platts-Mills James A JA  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20160807 9


<h4>Background</h4>Enteropathogen infections have been associated with enteric dysfunction and impaired growth in children in low-resource settings. In a multisite birth cohort study (MAL-ED), we describe the epidemiology and impact of Campylobacter infection in the first 2 years of life.<h4>Methods</h4>Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter Stool and blood samples were  ...[more]

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