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Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S220-4. doi: 10.1093/cid/ciu435.

Disease surveillance methods used in the 8-site MAL-ED cohort study.

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Fogarty International Center, National Institutes of Health, Bethesda, Maryland.
Center for Global Health, University of Virginia School of Medicine, Charlottesville.
Fogarty International Center, National Institutes of Health, Bethesda, Maryland Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.


Describing the early life associations between infectious disease episodes and growth, cognitive development, and vaccine response in the first 2 years of life is one of the primary goals of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study. To collect high-resolution data during a critical early period of development, field staff visit each study participant at their house twice weekly from birth to 2 years of age to collect daily reported illness and treatment data from caregivers. Detailed infectious disease histories will not only allow us to relate the overall burden of infectious disease with the primary outcomes of the study, but will also allow us to describe the ages at which infectious diseases have the greatest effect on child health. In addition, twice-weekly visits allow for sample collection when diarrhea episodes are identified. This article describes the methods used to collect illness and treatment history data and discusses the a priori definitions of diarrhea and acute lower respiratory illness episodes.


MAL-ED; diarrhea; infectious disease; respiratory infection; surveillance

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