Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS).
BACKGROUND:Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. METHODOLOGY/PRIN...
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ftdoajarticles:oai:doaj.org/article:ef79645eb5e54db5adb4d19c56820b8a 2023-05-15T15:12:38+02:00 Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). Miranda J Delahoy Richard Omore Tracy L Ayers Katharine A Schilling Anna J Blackstock J Benjamin Ochieng Feny Moke Peter Jaron Alex Awuor Caleb Okonji Jane Juma Tamer H Farag Dilruba Nasrin Sandra Panchalingam James P Nataro Karen L Kotloff Myron M Levine Joseph Oundo Dawn M Roellig Lihua Xiao Michele B Parsons Kayla Laserson Eric D Mintz Robert F Breiman Ciara E O'Reilly 2018-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006640 https://doaj.org/article/ef79645eb5e54db5adb4d19c56820b8a EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6057667?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006640 https://doaj.org/article/ef79645eb5e54db5adb4d19c56820b8a PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006640 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006640 2022-12-31T12:07:05Z BACKGROUND:Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. METHODOLOGY/PRINCIPAL FINDINGS:At health facility enrollment, stool samples were tested for enteric pathogens and data on clinical, environmental, and behavioral characteristics collected. Each child's health status was recorded at 60-day follow-up. Data were analyzed using logistic regression. Of the 1,778 children with MSD enrolled as cases in the GEMS-Kenya case-control study, 11% had Cryptosporidium detected in stool by enzyme immunoassay; in a genotyped subset, 81% were C. hominis. Among MSD cases, being an infant, having mucus in stool, and having prolonged/persistent duration diarrhea were associated with being Cryptosporidium-positive. Both boiling drinking water and using rainwater as the main drinking water source were protective factors for being Cryptosporidium-positive. At follow-up, Cryptosporidium-positive cases had increased odds of being stunted (adjusted odds ratio [aOR] = 1.65, 95% CI: 1.06-2.57), underweight (aOR = 2.08, 95% CI: 1.34-3.22), or wasted (aOR = 2.04, 95% CI: 1.21-3.43), and had significantly larger negative changes in height- and weight-for-age z-scores from enrollment. CONCLUSIONS/SIGNIFICANCE:Cryptosporidium contributes significantly to diarrheal illness in young children in western Kenya. Advances in point of care detection, prevention/control approaches, effective water treatment technologies, and clinical management options for children with cryptosporidiosis are needed. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 7 e0006640 |
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Open Polar |
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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 Miranda J Delahoy Richard Omore Tracy L Ayers Katharine A Schilling Anna J Blackstock J Benjamin Ochieng Feny Moke Peter Jaron Alex Awuor Caleb Okonji Jane Juma Tamer H Farag Dilruba Nasrin Sandra Panchalingam James P Nataro Karen L Kotloff Myron M Levine Joseph Oundo Dawn M Roellig Lihua Xiao Michele B Parsons Kayla Laserson Eric D Mintz Robert F Breiman Ciara E O'Reilly Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. METHODOLOGY/PRINCIPAL FINDINGS:At health facility enrollment, stool samples were tested for enteric pathogens and data on clinical, environmental, and behavioral characteristics collected. Each child's health status was recorded at 60-day follow-up. Data were analyzed using logistic regression. Of the 1,778 children with MSD enrolled as cases in the GEMS-Kenya case-control study, 11% had Cryptosporidium detected in stool by enzyme immunoassay; in a genotyped subset, 81% were C. hominis. Among MSD cases, being an infant, having mucus in stool, and having prolonged/persistent duration diarrhea were associated with being Cryptosporidium-positive. Both boiling drinking water and using rainwater as the main drinking water source were protective factors for being Cryptosporidium-positive. At follow-up, Cryptosporidium-positive cases had increased odds of being stunted (adjusted odds ratio [aOR] = 1.65, 95% CI: 1.06-2.57), underweight (aOR = 2.08, 95% CI: 1.34-3.22), or wasted (aOR = 2.04, 95% CI: 1.21-3.43), and had significantly larger negative changes in height- and weight-for-age z-scores from enrollment. CONCLUSIONS/SIGNIFICANCE:Cryptosporidium contributes significantly to diarrheal illness in young children in western Kenya. Advances in point of care detection, prevention/control approaches, effective water treatment technologies, and clinical management options for children with cryptosporidiosis are needed. |
format |
Article in Journal/Newspaper |
author |
Miranda J Delahoy Richard Omore Tracy L Ayers Katharine A Schilling Anna J Blackstock J Benjamin Ochieng Feny Moke Peter Jaron Alex Awuor Caleb Okonji Jane Juma Tamer H Farag Dilruba Nasrin Sandra Panchalingam James P Nataro Karen L Kotloff Myron M Levine Joseph Oundo Dawn M Roellig Lihua Xiao Michele B Parsons Kayla Laserson Eric D Mintz Robert F Breiman Ciara E O'Reilly |
author_facet |
Miranda J Delahoy Richard Omore Tracy L Ayers Katharine A Schilling Anna J Blackstock J Benjamin Ochieng Feny Moke Peter Jaron Alex Awuor Caleb Okonji Jane Juma Tamer H Farag Dilruba Nasrin Sandra Panchalingam James P Nataro Karen L Kotloff Myron M Levine Joseph Oundo Dawn M Roellig Lihua Xiao Michele B Parsons Kayla Laserson Eric D Mintz Robert F Breiman Ciara E O'Reilly |
author_sort |
Miranda J Delahoy |
title |
Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
title_short |
Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
title_full |
Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
title_fullStr |
Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
title_full_unstemmed |
Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS). |
title_sort |
clinical, environmental, and behavioral characteristics associated with cryptosporidium infection among children with moderate-to-severe diarrhea in rural western kenya, 2008-2012: the global enteric multicenter study (gems). |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006640 https://doaj.org/article/ef79645eb5e54db5adb4d19c56820b8a |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006640 (2018) |
op_relation |
http://europepmc.org/articles/PMC6057667?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006640 https://doaj.org/article/ef79645eb5e54db5adb4d19c56820b8a |
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https://doi.org/10.1371/journal.pntd.0006640 |
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PLOS Neglected Tropical Diseases |
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12 |
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7 |
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e0006640 |
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