Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings

Results from the MAL-ED Study

MAL-ED Network Investigators

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background. 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 2 years of life. Methods. Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter. Stool and blood samples were assayed for markers of intestinal permeability and inflammation. Results. A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter. We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval,. 47-.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 at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -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. Conclusions. 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.

Original languageEnglish (US)
Pages (from-to)1171-1179
Number of pages9
JournalClinical Infectious Diseases
Volume63
Issue number9
DOIs
StatePublished - Nov 1 2016

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Campylobacter Infections
Campylobacter
Epidemiology
Toilet Facilities
Water Purification
Breast Feeding
Drinking Water
Permeability
Growth
Confidence Intervals
Anti-Bacterial Agents
Inflammation
Macrolides
Infection
Immunoenzyme Techniques
Cohort Studies
Odds Ratio
Parturition

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{5c514ded596f4730b9c0b19c717456d3,
title = "Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results from the MAL-ED Study",
abstract = "Background. 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 2 years of life. Methods. Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter. Stool and blood samples were assayed for markers of intestinal permeability and inflammation. Results. A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter. We describe a high prevalence of infection, with most children (n = 1606; 84.9{\%}) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95{\%} confidence interval,. 47-.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 at 24 months (-1.82; 95{\%} confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -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. Conclusions. 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.",
author = "{MAL-ED Network Investigators} and Caroline Amour and Jean Gratz and Mduma, {Estomih R.} and Erling Svensen and Rogawski, {Elizabeth T.} and Monica McGrath and Seidman, {Jessica C.} and McCormick, {Benjamin J.J.} and Sanjaya Shrestha and Amidou Samie and Mustafa Mahfuz and Shahida Qureshi and Aneeta Hotwani and Sudhir Babji and Trigoso, {Dixner Rengifo} and Lima, {Aldo A.M.} and Ladaporn Bodhidatta and Pascal Bessong and Tahmeed Ahmed and Sadia Shakoor and Gagandeep Kang and Kosek, {Margaret N.} and Guerrant, {Richard L.} and Lang, {Dennis R.} and Michael Gottlieb and Houpt, {Eric R.} and Platts-Mills, {James A.} and Acosta, {Angel Mendez} and {de Burga}, {Rosa Rios} and Chavez, {Cesar Banda} and Flores, {Julian Torres} and Olotegui, {Maribel Paredes} and Pinedo, {Silvia Rengifo} and Salas, {Mery Siguas} and Vasquez, {Angel Orbe} and Imran Ahmed and Didar Alam and Asad Ali and Bhutta, {Zulfiqar A.} and Muneera Rasheed and Sajid Soofi and Ali Turab and Zaidi, {Anita K.M.} and Mason, {Carl J.} and Anuradha Bose and George, {Ajila T.} and Dinesh Hariraju and Murray-Kolb, {Laura E.} and Ross, {A. Catharine} and Barbara Schaefer",
year = "2016",
month = "11",
day = "1",
doi = "10.1093/cid/ciw542",
language = "English (US)",
volume = "63",
pages = "1171--1179",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "9",

}

Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings : Results from the MAL-ED Study. / MAL-ED Network Investigators.

In: Clinical Infectious Diseases, Vol. 63, No. 9, 01.11.2016, p. 1171-1179.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings

T2 - Results from the MAL-ED Study

AU - MAL-ED Network Investigators

AU - Amour, Caroline

AU - Gratz, Jean

AU - Mduma, Estomih R.

AU - Svensen, Erling

AU - Rogawski, Elizabeth T.

AU - McGrath, Monica

AU - Seidman, Jessica C.

AU - McCormick, Benjamin J.J.

AU - Shrestha, Sanjaya

AU - Samie, Amidou

AU - Mahfuz, Mustafa

AU - Qureshi, Shahida

AU - Hotwani, Aneeta

AU - Babji, Sudhir

AU - Trigoso, Dixner Rengifo

AU - Lima, Aldo A.M.

AU - Bodhidatta, Ladaporn

AU - Bessong, Pascal

AU - Ahmed, Tahmeed

AU - Shakoor, Sadia

AU - Kang, Gagandeep

AU - Kosek, Margaret N.

AU - Guerrant, Richard L.

AU - Lang, Dennis R.

AU - Gottlieb, Michael

AU - Houpt, Eric R.

AU - Platts-Mills, James A.

AU - Acosta, Angel Mendez

AU - de Burga, Rosa Rios

AU - Chavez, Cesar Banda

AU - Flores, Julian Torres

AU - Olotegui, Maribel Paredes

AU - Pinedo, Silvia Rengifo

AU - Salas, Mery Siguas

AU - Vasquez, Angel Orbe

AU - Ahmed, Imran

AU - Alam, Didar

AU - Ali, Asad

AU - Bhutta, Zulfiqar A.

AU - Rasheed, Muneera

AU - Soofi, Sajid

AU - Turab, Ali

AU - Zaidi, Anita K.M.

AU - Mason, Carl J.

AU - Bose, Anuradha

AU - George, Ajila T.

AU - Hariraju, Dinesh

AU - Murray-Kolb, Laura E.

AU - Ross, A. Catharine

AU - Schaefer, Barbara

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background. 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 2 years of life. Methods. Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter. Stool and blood samples were assayed for markers of intestinal permeability and inflammation. Results. A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter. We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval,. 47-.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 at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -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. Conclusions. 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.

AB - Background. 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 2 years of life. Methods. Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter. Stool and blood samples were assayed for markers of intestinal permeability and inflammation. Results. A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter. We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval,. 47-.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 at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -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. Conclusions. 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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U2 - 10.1093/cid/ciw542

DO - 10.1093/cid/ciw542

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VL - 63

SP - 1171

EP - 1179

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SN - 1058-4838

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