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)

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.

doi:10.1371/journal.pntd.0004729

- Add this to...
- Twitter
- Facebook
- Google Bookmarks
- LinkedIn

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)

Published Date:

May 24 2016

Publisher's site:

http://dx.doi.org/10.1371/journal.pntd.0004729 New Site Icon

Source:

PLoS Negl Trop Dis. 10(5).

[PDF - 963.41 KB]

Details:

Personal Authors:

Sow, Samba O. ; Muhsen, Khitam ; Nasrin, Dilruba ; Blackwelder, William C. ; Wu, Yukun ; ... More ▼

Keywords:

[+]

Pubmed ID:

27219054

Pubmed Central ID:

PMC4878811

Description:

Background

The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.

Methods

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.

Findings

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.

Conclusions

The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Supporting Files:

license.txt	text/plain
pntd.0004729.g001.gif	image/gif
pntd.0004729.g001.jpg	image/jpeg
pntd.0004729.nxml	application/octet-stream
pntd.0004729.t001.gif	image/gif
pntd.0004729.t001.jpg	image/jpeg
pntd.0004729.t002.gif	image/gif
pntd.0004729.t002.jpg	image/jpeg
pntd.0004729.t003.gif	image/gif
pntd.0004729.t003.jpg	image/jpeg
pntd.0004729.t004.gif	image/gif
pntd.0004729.t004.jpg	image/jpeg
pntd.0004729.t005.gif	image/gif
pntd.0004729.t005.jpg	image/jpeg

No Related Documents.

You May Also Like:

Epidemiology, Seasonality and Factors Associated with Rotavirus Infection among Children with Moderate-to-Severe Diarrhea in Rural Western Kenya, 2008–2012: The Global Enteric Multicenter Study (GEMS)

Personal Author:

Omore, Richard; Tate, Jacqueline E.; O’Reilly, Ciara E.; Ayers, Tracy; Williamson, John; Moke, Feny; Schilling, Katie A.; Awuor, Alex O.; Jaron, Peter; Ochieng, John B.; Oundo, Joseph; Parashar, Umesh D.; Parsons, Michele B.; Bopp, Cheryl C.; Nasrin, Dilruba; Farag, Tamer H.; Kotloff, Karen L.; Nataro, James P.; Panchalingam, Sandra; Levine, Myron M.; Laserson, Kayla F.; Nuorti, J. Pekka; Mintz, Eric D.; Breiman, Robert F.;

Published:

Aug 05 2016

Source:

PLoS One. 11(8).

Description:

Objective : To evaluate factors associated with rotavirus diarrhea and to describe severity of illness among children <5 years old with non-dysenteric, moderate-to-severe diarrhea (MSD) in rural western Kenya. : Methods : We analyzed data from childr...

File Type:

[PDF - 1.08 MB]
Quality of Piped and Stored Water in Households with Children Under Five Years of Age Enrolled in the Mali Site of the Global Enteric Multi-Center Study (GEMS)

Personal Author:

Baker, Kelly K.; Sow, Samba O.; Kotloff, Karen L.; Nataro, James P.; Farag, Tamer H.; Tamboura, Boubou; Doumbia, Mama; Sanogo, Doh; Diarra, Drissa; O'Reilly, Ciara E.; Mintz, Eric; Panchalingam, Sandra; Wu, Yukun; Blackwelder, William C.; Levine, Myron M.;

Published:

Jul 08 2013

Source:

Am J Trop Med Hyg. 2013; 89(2):214-222.

Description:

Water, sanitation, and hygiene information was collected during a matched case-control study of moderate and severe diarrhea (MSD) among 4,096 children < 5 years of age in Bamako, Mali. Primary use of piped water (conditional odds ratio [cOR] = 0.45;...

File Type:

[PDF - 648.62 KB]
Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study

Personal Author:

Baker, Kelly K.; O’Reilly, Ciara E.; Levine, Myron M.; Kotloff, Karen L.; Nataro, James P.; Ayers, Tracy L.; Farag, Tamer H.; Nasrin, Dilruba; Blackwelder, William C.; Wu, Yukun; Alonso, Pedro L.; Breiman, Robert F.; Omore, Richard; Faruque, Abu S. G.; Das, Sumon Kumar; Ahmed, Shahnawaz; Saha, Debasish; Sow, Samba O.; Sur, Dipika; Zaidi, Anita K. M.; Quadri, Fahreen; Mintz, Eric D.;

Published:

May 03 2016

Source:

PLoS Med. 13(5).

Description:

Background : Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimate...

File Type:

[PDF - 288.82 KB]
Severe Acute Respiratory Illness Deaths in Sub-Saharan Africa and the Role of Influenza: A Case Series From 8 Countries

Personal Author:

McMorrow, Meredith L.; Okitolonda Wemakoy, Emile; Tshilobo, Joelle Kabamba; Emukule, Gideon O.; Mott, Joshua A.; Njuguna, Henry; Waiboci, Lilian; Heraud, Jean-Michel; Rajatonirina, Soatianana; Razanajatovo, Norosoa H.; Chilombe, Moses; Everett, Dean; Heyderman, Robert S.; Barakat, Amal; Nyatanyi, Thierry; Rukelibuga, Joseph; Cohen, Adam L.; Cohen, Cheryl; Tempia, Stefano; Thomas, Juno; Venter, Marietjie; Mwakapeje, Elibariki; Mponela, Marcelina; Lutwama, Julius; Duque, Jazmin; Lafond, Kathryn; Nzussouo, Ndahwouh Talla; Williams, Thelma; Widdowson, Marc-Alain;

Published:

Feb 23 2015

Source:

J Infect Dis. 212(6):853-860.

Description:

Background : Data on causes of death due to respiratory illness in Africa are limited. : Methods : From January to April 2013, 28 African countries were invited to participate in a review of severe acute respiratory illness (SARI)–associated deaths...

File Type:

[PDF - 125.10 KB]
Immediate and longer term impact of the varicella shortage on children 18 and 24 months of age in a community population

Personal Author:

Yawn, Barbara P; Schroeder, Clayton; Wollan, Peter; Rocca, Liliana; Zimmerman, Rick; Bardenheier, Barbara;

Published:

Aug 15 2006

Source:

BMC Fam Pract. 2006; 7:51.

Description:

Background : Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the r...

File Type:

[PDF - 271.78 KB]