A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children.
Background Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of m...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2022
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0010508 https://doaj.org/article/3a6b9080c0164b4abf6c37bf0979ee46 |
id |
ftdoajarticles:oai:doaj.org/article:3a6b9080c0164b4abf6c37bf0979ee46 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:3a6b9080c0164b4abf6c37bf0979ee46 2023-05-15T15:12:44+02:00 A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. Øystein Haarklau Johansen Alemseged Abdissa Mike Zangenberg Zeleke Mekonnen Beza Eshetu Bizuwarek Sharew Sabrina Moyo Halvor Sommerfelt Nina Langeland Lucy J Robertson Kurt Hanevik 2022-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010508 https://doaj.org/article/3a6b9080c0164b4abf6c37bf0979ee46 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010508 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010508 https://doaj.org/article/3a6b9080c0164b4abf6c37bf0979ee46 PLoS Neglected Tropical Diseases, Vol 16, Iss 6, p e0010508 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010508 2022-12-31T02:24:01Z Background Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. Methodology/principal findings We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. Conclusions/significance Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 6 e0010508 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Øystein Haarklau Johansen Alemseged Abdissa Mike Zangenberg Zeleke Mekonnen Beza Eshetu Bizuwarek Sharew Sabrina Moyo Halvor Sommerfelt Nina Langeland Lucy J Robertson Kurt Hanevik A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. Methodology/principal findings We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. Conclusions/significance Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of ... |
format |
Article in Journal/Newspaper |
author |
Øystein Haarklau Johansen Alemseged Abdissa Mike Zangenberg Zeleke Mekonnen Beza Eshetu Bizuwarek Sharew Sabrina Moyo Halvor Sommerfelt Nina Langeland Lucy J Robertson Kurt Hanevik |
author_facet |
Øystein Haarklau Johansen Alemseged Abdissa Mike Zangenberg Zeleke Mekonnen Beza Eshetu Bizuwarek Sharew Sabrina Moyo Halvor Sommerfelt Nina Langeland Lucy J Robertson Kurt Hanevik |
author_sort |
Øystein Haarklau Johansen |
title |
A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
title_short |
A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
title_full |
A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
title_fullStr |
A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
title_full_unstemmed |
A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children. |
title_sort |
comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: a case-case-control study in ethiopian children. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010508 https://doaj.org/article/3a6b9080c0164b4abf6c37bf0979ee46 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 6, p e0010508 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010508 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010508 https://doaj.org/article/3a6b9080c0164b4abf6c37bf0979ee46 |
op_doi |
https://doi.org/10.1371/journal.pntd.0010508 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
16 |
container_issue |
6 |
container_start_page |
e0010508 |
_version_ |
1766343379105349632 |