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Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors
BACKGROUND: Cryptosporidium is a major pathogen associated with diarrheal disease in young children. We studied Cryptosporidium diarrhea in children enrolled in the Global Enteric Multicenter Study (GEMS) in rural Gambia. METHODS: We recruited children <5 years of age with moderate-to-severe diar...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685629/ https://www.ncbi.nlm.nih.gov/pubmed/31348795 http://dx.doi.org/10.1371/journal.pntd.0007607 |
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author | Hossain, M. Jahangir Saha, Debasish Antonio, Martin Nasrin, Dilruba Blackwelder, William C. Ikumapayi, Usman N. Mackenzie, Grant A. Adeyemi, Mitchell Jasseh, Momodou Adegbola, Richard A. Roose, Anna W. Kotloff, Karen L. Levine, Myron M. |
author_facet | Hossain, M. Jahangir Saha, Debasish Antonio, Martin Nasrin, Dilruba Blackwelder, William C. Ikumapayi, Usman N. Mackenzie, Grant A. Adeyemi, Mitchell Jasseh, Momodou Adegbola, Richard A. Roose, Anna W. Kotloff, Karen L. Levine, Myron M. |
author_sort | Hossain, M. Jahangir |
collection | PubMed |
description | BACKGROUND: Cryptosporidium is a major pathogen associated with diarrheal disease in young children. We studied Cryptosporidium diarrhea in children enrolled in the Global Enteric Multicenter Study (GEMS) in rural Gambia. METHODS: We recruited children <5 years of age with moderate-to-severe diarrhea (MSD) for 3 years (2008–2010), and children with either MSD or less severe diarrhea (LSD) for one year (November 2011-November 2012) at sentinel health centers. One or more randomly selected controls were matched to each case. Stool samples were tested to identify Cryptosporidium by immunoassay. A subset of randomly selected case-controls pairs were tested for Cryptosporidium species. We investigated the epidemiology of, and evaluated possible risk factors for, Cryptosporidium-positive diarrhea. RESULTS: We enrolled 1938 cases (1381 MSD, 557 LSD) and 2969 matched controls; 231/1929 (12.0%) of diarrhea cases and 141/2962 (4.8%) of controls were positive for Cryptosporidium. Most Cryptosporidium diarrhea cases (85.7%, 198/231) were aged 6–23 months, and most (81.4%, 188/231) occurred during the rainy season. Cryptosporidium hominis (C. hominis) was the predominant (82.6%) species. We found associations between increased risk of Cryptosporidium-positive MSD or LSD, or both, with consumption of stored drinking water and certain animals living in the compound—cow, cat (MSD only) and rodents (LSD only). Larger households, fowl living in the compound, and the presence of Giardia infection were associated with decreased risk of Cryptosporidium MSD and LSD. CONCLUSION: Cryptosporidium-positive diarrhea is prevalent in this setting, especially at 6–23 months of age. The preponderance of Cryptosporidium infection in the rainy season and increased risk of Cryptosporidium-positive diarrhea with consumption of stored drinking water suggest water-borne transmission. Further investigation is needed to clarify the role of animals and contamination of stored drinking water in Cryptosporidium transmission. |
format | Online Article Text |
id | pubmed-6685629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-66856292019-08-15 Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors Hossain, M. Jahangir Saha, Debasish Antonio, Martin Nasrin, Dilruba Blackwelder, William C. Ikumapayi, Usman N. Mackenzie, Grant A. Adeyemi, Mitchell Jasseh, Momodou Adegbola, Richard A. Roose, Anna W. Kotloff, Karen L. Levine, Myron M. PLoS Negl Trop Dis Research Article BACKGROUND: Cryptosporidium is a major pathogen associated with diarrheal disease in young children. We studied Cryptosporidium diarrhea in children enrolled in the Global Enteric Multicenter Study (GEMS) in rural Gambia. METHODS: We recruited children <5 years of age with moderate-to-severe diarrhea (MSD) for 3 years (2008–2010), and children with either MSD or less severe diarrhea (LSD) for one year (November 2011-November 2012) at sentinel health centers. One or more randomly selected controls were matched to each case. Stool samples were tested to identify Cryptosporidium by immunoassay. A subset of randomly selected case-controls pairs were tested for Cryptosporidium species. We investigated the epidemiology of, and evaluated possible risk factors for, Cryptosporidium-positive diarrhea. RESULTS: We enrolled 1938 cases (1381 MSD, 557 LSD) and 2969 matched controls; 231/1929 (12.0%) of diarrhea cases and 141/2962 (4.8%) of controls were positive for Cryptosporidium. Most Cryptosporidium diarrhea cases (85.7%, 198/231) were aged 6–23 months, and most (81.4%, 188/231) occurred during the rainy season. Cryptosporidium hominis (C. hominis) was the predominant (82.6%) species. We found associations between increased risk of Cryptosporidium-positive MSD or LSD, or both, with consumption of stored drinking water and certain animals living in the compound—cow, cat (MSD only) and rodents (LSD only). Larger households, fowl living in the compound, and the presence of Giardia infection were associated with decreased risk of Cryptosporidium MSD and LSD. CONCLUSION: Cryptosporidium-positive diarrhea is prevalent in this setting, especially at 6–23 months of age. The preponderance of Cryptosporidium infection in the rainy season and increased risk of Cryptosporidium-positive diarrhea with consumption of stored drinking water suggest water-borne transmission. Further investigation is needed to clarify the role of animals and contamination of stored drinking water in Cryptosporidium transmission. Public Library of Science 2019-07-26 /pmc/articles/PMC6685629/ /pubmed/31348795 http://dx.doi.org/10.1371/journal.pntd.0007607 Text en © 2019 Hossain et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hossain, M. Jahangir Saha, Debasish Antonio, Martin Nasrin, Dilruba Blackwelder, William C. Ikumapayi, Usman N. Mackenzie, Grant A. Adeyemi, Mitchell Jasseh, Momodou Adegbola, Richard A. Roose, Anna W. Kotloff, Karen L. Levine, Myron M. Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title | Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title_full | Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title_fullStr | Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title_full_unstemmed | Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title_short | Cryptosporidium infection in rural Gambian children: Epidemiology and risk factors |
title_sort | cryptosporidium infection in rural gambian children: epidemiology and risk factors |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685629/ https://www.ncbi.nlm.nih.gov/pubmed/31348795 http://dx.doi.org/10.1371/journal.pntd.0007607 |
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