1921
Volume 95, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Abstract

We report the clinical findings, epidemiology, and risk factors for moderate-to-severe diarrhea (MSD) associated with species in children 0–59 months of age, from the Global Enteric Multicenter Study, conducted at three sites in south Asia and four sites in sub-Saharan Africa. Children with MSD were enrolled along with controls matched for age, gender, and neighborhood. Pooled, age-stratified conditional logistic regression models were applied to evaluate the association of infection controlling for coinfecting pathogens and sociodemographic variables. A pooled, age-stratified, multivariate logistic regression analysis was done to identify risk factors associated with positivity in MSD cases. A total of 12,110 cases and 17,291 matched controls were enrolled over a period of 48 months. was identified as a significant pathogen in 736 cases of MSD in Pakistan and Bangladesh (22.2%). remained a significant pathogen even after adjustment for the presence of other pathogens and sociodemographic factors. Odds ratio (OR) for were higher in the presence of (matched OR: 6.2, 95% confidence interval [CI]: 1.9–20.2). Cases of were likely to present with dysentery, particularly in the 0–11 months (OR: 1.4, 95% CI 1.0–2.0) and 12–23 months (OR: 1.8, 95% CI: 1.3–2.5) age group. The odds of increased with increasing degree of stunting, being highest for severe stunting (OR: 10.1, 95% CI: 3.6–28.9). is a significant pathogen for MSD in Pakistan and Bangladesh. Presence of dysentery and co-occurrence with other pathogens, notably spp. are significant features of -associated diarrhea.

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/content/journals/10.4269/ajtmh.16-0321
2016-10-05
2017-09-26
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Supplementary Data

Supplementary PDF

  • Received : 25 Apr 2016
  • Accepted : 15 Jun 2016

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