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The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)

PLoS neglected tropical diseases, 2016-05, Vol.10 (5), p.e0004729 [Peer Reviewed Journal]

COPYRIGHT 2016 Public Library of Science ;COPYRIGHT 2016 Public Library of Science ;2016 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS). PLoS Negl Trop Dis 10(5): e0004729. doi:10.1371/journal.pntd.0004729 ;cc0 (c) Sow et al., 2016 info:eu-repo/semantics/openAccess http://creativecommons.org/publicdomain/zero/1.0/ ;2016 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS). PLoS Negl Trop Dis 10(5): e0004729. doi:10.1371/journal.pntd.0004729 ;ISSN: 1935-2735 ;ISSN: 1935-2727 ;EISSN: 1935-2735 ;DOI: 10.1371/journal.pntd.0004729 ;PMID: 27219054

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Title:
The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)
Author: Sow, Samba O ; Muhsen, Khitam ; Nasrin, Dilruba ; Blackwelder, William C ; Wu, Yukun ; Farag, Tamer H ; Panchalingam, Sandra ; Sur, Dipika ; Zaidi, Anita K M ; Faruque, Abu S G ; Saha, Debasish ; Adegbola, Richard ; Alonso, Pedro L ; Breiman, Robert F ; Bassat, Quique ; Tamboura, Boubou ; Sanogo, Doh ; Onwuchekwa, Uma ; Manna, Byomkesh ; Ramamurthy, Thandavarayan ; Kanungo, Suman ; Ahmed, Shahnawaz ; Qureshi, Shahida ; Quadri, Farheen ; Hossain, Anowar ; Das, Sumon K ; Antonio, Martin ; Hossain, M Jahangir ; Mandomando, Inacio ; Nhampossa, Tacilta ; Acácio, Sozinho ; Omore, Richard ; Oundo, Joseph O ; Ochieng, John B ; Mintz, Eric D ; O'Reilly, Ciara E ; Berkeley, Lynette Y ; Livio, Sofie ; Tennant, Sharon M ; Sommerfelt, Halvor ; Nataro, James P ; Ziv-Baran, Tomer ; Robins-Browne, Roy M ; Mishcherkin, Vladimir ; Zhang, Jixian ; Liu, Jie ; Houpt, Eric R ; Kotloff, Karen L ; Levine, Myron M
Kosek, Margaret
Subjects: Afghanistan - epidemiology ; Africa South of the Sahara - epidemiology ; Asia - epidemiology ; Biology and Life Sciences ; Care and treatment ; Case-Control Studies ; Child, Preschool ; Children ; Cost of Illness ; Cryptosporidiosis - epidemiology ; Cryptosporidiosis - mortality ; Cryptosporidiosis - parasitology ; Cryptosporidium ; Cryptosporidium - classification ; Cryptosporidium - genetics ; Cryptosporidium - immunology ; Cryptosporidium - isolation & purification ; Data Mining - methods ; Developing countries ; Developing Countries - economics ; Developing Countries - statistics & numerical data ; Diagnosis ; Diarrea ; Diarrhea ; Diarrhea - epidemiology ; Diarrhea - mortality ; Diarrhea - parasitology ; Feces - parasitology ; Female ; Gastrointestinal Diseases - epidemiology ; Gastrointestinal Diseases - mortality ; Gastrointestinal Diseases - parasitology ; Health aspects ; Humans ; Immunoassay ; Incidence ; India - epidemiology ; Infant ; Infant, Newborn ; Infants ; LDCs ; Male ; Medicine and Health Sciences ; People and Places ; Polymerase Chain Reaction ; Protozoa ; Risk factors ; Vaccines
Is Part Of: PLoS neglected tropical diseases, 2016-05, Vol.10 (5), p.e0004729
Description: The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized. Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated. Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative. The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.
Publisher: United States: Public Library of Science
Language: English
Identifier: ISSN: 1935-2735
ISSN: 1935-2727
EISSN: 1935-2735
DOI: 10.1371/journal.pntd.0004729
PMID: 27219054
Source: Recercat
GFMER Free Medical Journals
MEDLINE
PubMed Central
Public Library of Science (PLoS)
ProQuest Central
DOAJ Directory of Open Access Journals

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The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)

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