Title |
Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results From the MAL-ED Study
|
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Published in |
Clinical Infectious Diseases, August 2016
|
DOI | 10.1093/cid/ciw542 |
Pubmed ID | |
Authors |
Caroline Amour, Jean Gratz, Estomih Mduma, Erling Svensen, Elizabeth T. Rogawski, Monica McGrath, Jessica C. Seidman, Benjamin J. J. McCormick, Sanjaya Shrestha, Amidou Samie, Mustafa Mahfuz, Shahida Qureshi, Aneeta Hotwani, Sudhir Babji, Dixner Rengifo Trigoso, Aldo A. M. Lima, Ladaporn Bodhidatta, Pascal Bessong, Tahmeed Ahmed, Sadia Shakoor, Gagandeep Kang, Margaret Kosek, Richard L. Guerrant, Dennis Lang, Michael Gottlieb, Eric R. Houpt, James A. Platts-Mills, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project Network Investigators for the Etiology Risk Factors, Angel Mendez Acosta, Rosa Rios de Burga, Cesar Banda Chavez, Julian Torres Flores, Maribel Paredes Olotegui, Silvia Rengifo Pinedo, Mery Siguas Salas, Dixner Rengifo Trigoso, Angel Orbe Vasquez, Imran Ahmed, Didar Alam, Asad Ali, Zulfiqar A. Bhutta, Shahida Qureshi, Muneera Rasheed, Sajid Soofi, Ali Turab, Anita K.M. Zaidi, Ladaporn Bodhidatta, Carl J. Mason, Sudhir Babji, Anuradha Bose, Ajila T. George, Dinesh Hariraju, M. Steffi Jennifer, Sushil John, Shiny Kaki, Gagandeep Kang, Priyadarshani Karunakaran, Beena Koshy, Robin P. Lazarus, Jayaprakash Muliyil, Mohan Venkata Raghava, Sophy Raju, Anup Ramachandran, Rakhi Ramadas, Karthikeyan Ramanujam, Anuradha Rose, Reeba Roshan, Srujan L. Sharma, Shanmuga Sundaram, Rahul J. Thomas, William K. Pan, Ramya Ambikapathi, J. Daniel Carreon, Vivek Charu, Viyada Doan, Jhanelle Graham, Christel Hoest, Stacey Knobler, Dennis R. Lang, Benjamin J.J. McCormick, Monica McGrath, Mark A. Miller, Archana Mohale, Gaurvika Nayyar, Stephanie Psaki, Zeba Rasmussen, Stephanie A. Richard, Jessica C. Seidman, Vivian Wang, Rebecca Blank, Michael Gottlieb, Karen H. Tountas, Caroline Amour, Eliwaza Bayyo, Estomih R. Mduma, Regisiana Mvungi, Rosemary Nshama, John Pascal, Buliga Mujaga Swema, Ladislaus Yarrot, Tahmeed Ahmed, A.M. Shamsir Ahmed, Rashidul Haque, Iqbal Hossain, Munirul Islam, Mustafa Mahfuz, Dinesh Mondal, Fahmida Tofail, Ram Krishna Chandyo, Prakash Sunder Shrestha, Rita Shrestha, Manjeswori Ulak, Aubrey Bauck, Robert Black, Laura Caulfield, William Checkley, Margaret N. Kosek, Gwenyth Lee, Kerry Schulze, Pablo Peñataro Yori, Laura E. Murray-Kolb, A. Catharine Ross, Barbara Schaefer, Suzanne Simons, Laura Pendergast, Cláudia B. Abreu, Hilda Costa, Alessandra Di Moura, José Quirino Filho, Alexandre Havt, Álvaro M. Leite, Aldo A.M. Lima, Noélia L. Lima, Ila F. Lima, Bruna L.L. Maciel, Pedro H.Q.S. Medeiros, Milena Moraes, Francisco S. Mota, Reinaldo B. Oriá, Josiane Quetz, Alberto M. Soares, Rosa M.S. Mota, Crystal L. Patil, Pascal Bessong, Cloupas Mahopo, Angelina Maphula, Emanuel Nyathi, Amidou Samie, Leah Barrett, Rebecca Dillingham, Jean Gratz, Richard L. Guerrant, Eric Houpt, William A. Petri, James Platts-Mills, Rebecca Scharf, Binob Shrestha, Sanjaya Kumar Shrestha, Tor Strand, Erling Svensen |
Abstract |
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 two years of life. Children were actively followed until 24 months of age. Diarrheal and non-diarrheal stools were collected and tested by enzyme immunoassay for Campylobacter Stool and blood specimens were assayed for markers of intestinal permeability and inflammation. 1892 children had 7601 diarrheal and 26267 non-diarrheal stools tested for Campylobacter We describe a high prevalence of infection, with most children (n=1606, 84.9%) having a Campylobacter-positive stool by one year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (RR 0.57; 95% CI 0.47 - 0.67), 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 (LAZ) at 24 months (-1.82; 95% CI -1.94 - -1.70) compared to a low burden (-1.49; -1.60 - -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. 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. |
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