1921
Volume 101, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Diarrheal disease is a leading cause of childhood morbidity and mortality worldwide, but particularly in low-income countries in sub-Saharan Africa and South Asia. The Global Enteric Multicenter Study (GEMS) examined the infectious etiologies as well as associated demographics, socioeconomic markers, health-care–seeking behaviors, and handwashing practices of the households of children with diarrhea and their age- and gender-matched controls in seven countries over a 3-year period (December 2007–December 2010). Stool studies to determine diarrheal etiologies and anthropometry were performed at baseline and at 60-day follow-up visits, along with surveys to record demographics and living conditions of the children. We performed secondary analyses of the GEMS data derived from the Bangladesh portion of the study in children with diarrhea associated with viral enteropathogens and explored pathogen-specific features of disease burden. Rotavirus and norovirus were the most prevalent pathogens (39.3% and 35%, respectively). Disease due to rotavirus and adenovirus was more common in infants than in older children ( < 0.001 and = 0.001, respectively). Height for age decreased from baseline to follow-up in children with diarrhea associated with rotavirus, norovirus, and adenovirus ( < 0.001). Based on these analyses, preventive measures targeted at rotavirus, norovirus, and adenovirus will be expected to have meaningful clinical impact. Cost of treatment was highest for rotavirus as well, making it an obvious target for intervention. Association of specific viruses with stunting is particularly notable, as stunting is an attributable risk factor for poor cognitive development and future productivity and economic potential.

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References

  1. GBD Diarrhoeal Diseases Collaborators, 2017. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the global burden of disease study 2015. Lancet Infect Dis 17: 909948.
    [Google Scholar]
  2. Kotloff KL et al., 2013. Burden and aetiology of diarrheal disease in infants and young children in developing countries (the global enteric multicenter study, GEMS): a prospective, case-control study. Lancet 382: 209222.
    [Google Scholar]
  3. Rheingans R, Kukla M, Faruque AS, Sur D, Zaidi AK, Nasrin D, Farag TH, Levine MM, Kotloff KL, 2013. Determinants of household costs associated with childhood diarrhea in 3 south Asian settings. Clin Infect Dis 55 (Suppl 4): S327S335.
    [Google Scholar]
  4. Baker KK et al., 2014. Association between moderate-to-severe diarrhea in young children in the global enteric multicenter study (GEMS) and types of handwashing materials used by caretakers in Mirzapur, Bangladesh. Am J Trop Med Hyg 91: 181189.
    [Google Scholar]
  5. Nasrin D et al., 2013. Health care seeking for childhood diarrhea in developing countries: evidence from seven sites in Africa and Asia. Am J Trop Med Hyg 89: 312.
    [Google Scholar]
  6. Baker KK et al., 2016. Sanitation and hygiene-specific risk factors for moderate-to-severe diarrhea in young children in the global enteric multicenter study, 2007–2011: case-control study. PLoS Med 13: e1002010.
    [Google Scholar]
  7. Berendes D et al., 2017. Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India. Trop Med Int Health 22: 11191129.
    [Google Scholar]
  8. National Institute of Population Research and Training (NIPORT) MaAaI, 2016. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh: NIPORT, Mitra and Associates, and ICF International. Available at: https://dhsprogram.com/pubs/pdf/FR311/FR311.pdf. Accessed July 18, 2017.
    [Google Scholar]
  9. Checkley W, Buckley G, Gilman RH, Assis AMO, Guerrant RL, Morris SS, Mølbak K, Valentiner-Branth P, Lanata CF, Black RE; Childhood Malnutrition and Infection Network, 2008. Multi-country analysis of the effects of diarrhoea on childhood stunting. Int J Epidemiol 37: 816830.
    [Google Scholar]
  10. Lin A et al., 2013. Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh. Am J Trop Med Hyg 89: 130137.
    [Google Scholar]
  11. Mbuya MN, Humphrey JH, 2016. Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries. Matern Child Nutr 12 (Suppl 1): 106120.
    [Google Scholar]
  12. Biswas K, Carty C, Horney R, Nasrin D, Farag TH, Kotloff KL, Levine MM, 2012. Data management and other logistical challenges for the GEMS: the data coordinating center perspective. Clin Infect Dis 55 (Suppl 4): S254S261.
    [Google Scholar]
  13. Prüss-Ustün A, Bos R, Gore F, Bartram J; World Health Organization, 2008. Safer Water, Better Health. Geneva, Switzerland: WHO. Available at: http://www.who.int/quantifying_ehimpacts/publications/saferwater/en/. Accessed July 18, 2017.
    [Google Scholar]
  14. Islam MS, Siddika A, Khan MNH, Goldar MM, Sadique MA, Kabir ANMH, Anwar H, Colwell RR, 2001. Microbiological analysis of tube-well water in a rural area of Bangladesh. Appl Environ Microbiol 67: 33283330.
    [Google Scholar]
  15. Luby SP, Gupta SK, Sheikh MA, Johnston RB, Ram PK, Islam MS, 2008. Tubewell water quality and predictors of contamination in three flood-prone areas in Bangladesh. J Appl Microbiol 105: 10021008.
    [Google Scholar]
  16. Borchardt MA, Bertz PD, Spencer SK, Battigelli DA, 2003. Incidence of enteric viruses in groundwater from household wells in Wisconsin. Appl Environ Microbiol 69: 11721180.
    [Google Scholar]
  17. Clasen T, Brown J, Suntura O, Collin S, Cairncross S, 2004. Reducing diarrhoea through household-based ceramic filtration of drinking water: a randomized, controlled trial in Bolivia. Am J Trop Med Hyg 70: 651657.
    [Google Scholar]
  18. Clasen TF, Garcia Parra G, Boisson S, Collin S, 2005. Household-based ceramic water filters for the prevention of diarrhea: a randomized, controlled trial of a pilot program in Colombia. Am J Trop Med Hyg 73: 790795.
    [Google Scholar]
  19. Ercumen A, Naser AM, Unicomb L, Arnold BF, Colford JM Jr., Luby SP, 2005. Effects of source-versus household contamination of tubewell water on child diarrhea in rural Bangladesh: a randomized controlled trial. PLoS One 10: e0121907.
    [Google Scholar]
  20. Mokomane M, Kasvosve I, de Melo E, Pernica JM, Goldfarb DM, 2017. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management. Ther Adv Infect Dis 5: 2943.
    [Google Scholar]
  21. Sarker AR et al., Economic costs of hospitalized diarrheal disease in Bangladesh: a societal perspective. Glob Health Res Policy 3: 1.
    [Google Scholar]
  22. Humphrey JH, 2009. Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet 374: 10321035.
    [Google Scholar]
  23. Prendergast A, Kelly P, 2012. Enteropathies in the developing world: neglected effects on global health. Am J Trop Med Hyg 86: 756763.
    [Google Scholar]
  24. World Health Organization, 2014. Global Nutrition Targets 2025: Stunting Policy Brief. WHO/NMH/NHD/14.3. Geneva, Switzerland: WHO.
    [Google Scholar]
  25. Moyo SJ, Kommedal Ø, Blomberg B, Hanevik K, Tellevik MG, Maselle SY, Langeland N, 2017. Comprehensive analysis of prevalence, epidemiologic characteristics, and clinical characteristics of monoinfection and coinfection in diarrheal diseases in children in Tanzania. Am J Epidemiol 186: 10741083.
    [Google Scholar]
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  • Received : 20 Feb 2019
  • Accepted : 24 May 2019
  • Published online : 01 Jul 2019
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