TY - JOUR
T1 - Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings
T2 - Results from the MAL-ED Study
AU - Amour, Caroline
AU - Gratz, Jean
AU - Mduma, Estomih R.
AU - Svensen, Erling
AU - Rogawski, Elizabeth T.
AU - McGrath, Monica
AU - Seidman, Jessica C.
AU - McCormick, Benjamin J.J.
AU - Shrestha, Sanjaya
AU - Samie, Amidou
AU - Mahfuz, Mustafa
AU - Qureshi, Shahida
AU - Hotwani, Aneeta
AU - Babji, Sudhir
AU - Trigoso, Dixner Rengifo
AU - Lima, Aldo A.M.
AU - Bodhidatta, Ladaporn
AU - Bessong, Pascal
AU - Ahmed, Tahmeed
AU - Shakoor, Sadia
AU - Kang, Gagandeep
AU - Kosek, Margaret N.
AU - Guerrant, Richard L.
AU - Lang, Dennis R.
AU - Gottlieb, Michael
AU - Houpt, Eric R.
AU - Platts-Mills, James A.
AU - Acosta, Angel Mendez
AU - de Burga, Rosa Rios
AU - Chavez, Cesar Banda
AU - Flores, Julian Torres
AU - Olotegui, Maribel Paredes
AU - Pinedo, Silvia Rengifo
AU - Salas, Mery Siguas
AU - Vasquez, Angel Orbe
AU - Ahmed, Imran
AU - Alam, Didar
AU - Ali, Asad
AU - Bhutta, Zulfiqar A.
AU - Rasheed, Muneera
AU - Soofi, Sajid
AU - Turab, Ali
AU - Zaidi, Anita K.M.
AU - Mason, Carl J.
AU - Bose, Anuradha
AU - George, Ajila T.
AU - Hariraju, Dinesh
AU - Jennifer, M. Steffi
AU - John, Sushil
AU - Kaki, Shiny
AU - MAL-ED Network Investigators
N1 - Funding Information:
Financial support. The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the National Institutes of Health, and the National Institutes of Health, Fogarty International Center. J. A. P. receives support from the National Institutes of Health (5K23-AI114888-02).
Publisher Copyright:
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - 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.
AB - 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.
KW - Campylobacter
KW - children
KW - growth
KW - inflammation
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=84994500731&partnerID=8YFLogxK
U2 - 10.1093/cid/ciw542
DO - 10.1093/cid/ciw542
M3 - Article
C2 - 27501842
AN - SCOPUS:84994500731
SN - 1058-4838
VL - 63
SP - 1171
EP - 1179
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 9
ER -
