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Clin Infect Dis. 2016 Nov 1;63(9):1171-1179. Epub 2016 Aug 7.

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

Author information

1
Haydom Lutheran Hospital, Haydom, Tanzania.
2
Haydom Lutheran Hospital, Haydom, Tanzania Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
3
Haukeland University Hospital, Bergen, Norway.
4
Division of Infectious Diseases and International Health, University of Virginia, Charlottesville.
5
Fogarty International Center, National Institutes of Health.
6
Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
7
University of Venda, Thohoyandou, South Africa.
8
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
9
Aga Khan University, Karachi, Pakistan.
10
Christian Medical College, Vellore, India.
11
Asociación Benéfica PRISMA, Iquitos, Peru.
12
Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil.
13
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru.
14
Foundation for the National Institutes of Health, Bethesda.

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.

KEYWORDS:

Campylobacter; children; growth; inflammation; risk factors

PMID:
27501842
PMCID:
PMC5064165
DOI:
10.1093/cid/ciw542
[Indexed for MEDLINE]
Free PMC Article

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