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Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018
Diarrheal diseases are a leading cause of mortality and morbidity, disproportionally affecting persons residing in low and middle-income countries. Accessing high-resolution surveillance data to understand community-level etiology and risk remains challenging, particularly in remote and resource lim...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065300/ https://www.ncbi.nlm.nih.gov/pubmed/37000848 http://dx.doi.org/10.1371/journal.pone.0283871 |
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author | Kelly, Gerard C. Rachmat, Agus Hontz, Robert D. Sklar, Marvin J. Tran, Long Khanh Supaprom, Chonthida Luy, Malen Lina, Sin Gregory, Michael J. Sopheab, Heng Brooks, John S. Sutherland, Ian W. Corson, Karen S. Letizia, Andrew G. |
author_facet | Kelly, Gerard C. Rachmat, Agus Hontz, Robert D. Sklar, Marvin J. Tran, Long Khanh Supaprom, Chonthida Luy, Malen Lina, Sin Gregory, Michael J. Sopheab, Heng Brooks, John S. Sutherland, Ian W. Corson, Karen S. Letizia, Andrew G. |
author_sort | Kelly, Gerard C. |
collection | PubMed |
description | Diarrheal diseases are a leading cause of mortality and morbidity, disproportionally affecting persons residing in low and middle-income countries. Accessing high-resolution surveillance data to understand community-level etiology and risk remains challenging, particularly in remote and resource limited populations. A multi-year prospective cohort study was conducted in two rural and two peri-urban villages in Cambodia from 2012 to 2018 to describe the epidemiology and etiology of acute diarrheal diseases within the population. Suspected diarrheal episodes among participants were self-reported or detected via routine weekly household visits. Fresh stool and fecal swabs were tested, and acute-illness and follow-up participant questionnaires collected. Of 5027 enrolled participants, 1450 (28.8%) reported at least one diarrheal incident. A total of 4266 individual diarrhea case events were recorded. Diarrhea incidence rate was calculated to be 281.5 persons per 1000 population per year, with an event rate of 664.3 individual diarrhea events occurring per 1000 population per year. Pathogenic Escherichia coli, Aeromonas spp., and Plesiomonas shigelloides were the most prevalent bacterial infections identified. Hookworm and Strongyloides stercoralis were the predominant helminth species, while Blastocystis hominis and Giardia lamblia were the predominant protozoan species found. Norovirus genotype 2 was the predominant virus identified. Mixed infections of two or more pathogens were detected in 36.2% of positive cases. Risk analyses identified unemployed status increased diarrhea risk by 63% (HR = 1.63 [95% CI 1.46, 1.83]). Individuals without access to protected water sources or sanitation facilities were 59% (HR = 1.59 [95% CI 1.49, 1.69]) and 19% (HR = 1.19 [95% CI 1.12, 1.28]) greater risk of contracting diarrhea, respectively. Patient-level surveillance data captured in this long-term study has generated a unique spatiotemporal profile of diarrheal disease in Cambodia. Understanding etiologies, together with associated epidemiological and community-level risk, provides valuable public health insight to support effective planning and delivery of appropriate local population-targeted interventions. |
format | Online Article Text |
id | pubmed-10065300 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100653002023-04-01 Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 Kelly, Gerard C. Rachmat, Agus Hontz, Robert D. Sklar, Marvin J. Tran, Long Khanh Supaprom, Chonthida Luy, Malen Lina, Sin Gregory, Michael J. Sopheab, Heng Brooks, John S. Sutherland, Ian W. Corson, Karen S. Letizia, Andrew G. PLoS One Research Article Diarrheal diseases are a leading cause of mortality and morbidity, disproportionally affecting persons residing in low and middle-income countries. Accessing high-resolution surveillance data to understand community-level etiology and risk remains challenging, particularly in remote and resource limited populations. A multi-year prospective cohort study was conducted in two rural and two peri-urban villages in Cambodia from 2012 to 2018 to describe the epidemiology and etiology of acute diarrheal diseases within the population. Suspected diarrheal episodes among participants were self-reported or detected via routine weekly household visits. Fresh stool and fecal swabs were tested, and acute-illness and follow-up participant questionnaires collected. Of 5027 enrolled participants, 1450 (28.8%) reported at least one diarrheal incident. A total of 4266 individual diarrhea case events were recorded. Diarrhea incidence rate was calculated to be 281.5 persons per 1000 population per year, with an event rate of 664.3 individual diarrhea events occurring per 1000 population per year. Pathogenic Escherichia coli, Aeromonas spp., and Plesiomonas shigelloides were the most prevalent bacterial infections identified. Hookworm and Strongyloides stercoralis were the predominant helminth species, while Blastocystis hominis and Giardia lamblia were the predominant protozoan species found. Norovirus genotype 2 was the predominant virus identified. Mixed infections of two or more pathogens were detected in 36.2% of positive cases. Risk analyses identified unemployed status increased diarrhea risk by 63% (HR = 1.63 [95% CI 1.46, 1.83]). Individuals without access to protected water sources or sanitation facilities were 59% (HR = 1.59 [95% CI 1.49, 1.69]) and 19% (HR = 1.19 [95% CI 1.12, 1.28]) greater risk of contracting diarrhea, respectively. Patient-level surveillance data captured in this long-term study has generated a unique spatiotemporal profile of diarrheal disease in Cambodia. Understanding etiologies, together with associated epidemiological and community-level risk, provides valuable public health insight to support effective planning and delivery of appropriate local population-targeted interventions. Public Library of Science 2023-03-31 /pmc/articles/PMC10065300/ /pubmed/37000848 http://dx.doi.org/10.1371/journal.pone.0283871 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Kelly, Gerard C. Rachmat, Agus Hontz, Robert D. Sklar, Marvin J. Tran, Long Khanh Supaprom, Chonthida Luy, Malen Lina, Sin Gregory, Michael J. Sopheab, Heng Brooks, John S. Sutherland, Ian W. Corson, Karen S. Letizia, Andrew G. Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title | Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title_full | Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title_fullStr | Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title_full_unstemmed | Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title_short | Etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in Cambodia, 2012–2018 |
title_sort | etiology and risk factors for diarrheal disease amongst rural and peri-urban populations in cambodia, 2012–2018 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065300/ https://www.ncbi.nlm.nih.gov/pubmed/37000848 http://dx.doi.org/10.1371/journal.pone.0283871 |
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