Details:

Alternative Title:
PLoS Negl Trop Dis
Personal Author:
Delahoy, Miranda J. ; Omore, Richard ; Ayers, Tracy L. ; Schilling, Katharine A. ; Blackstock, Anna J. ; ... More +
Delahoy, Miranda J. ; Omore, Richard ; Ayers, Tracy L. ; Schilling, Katharine A. ; Blackstock, Anna J. ; Ochieng, J. Benjamin ; Moke, Feny ; Jaron, Peter ; Awuor, Alex ; Okonji, Caleb ; Juma, Jane ; Farag, Tamer H. ; Nasrin, Dilruba ; Panchalingam, Sandra ; Nataro, James P. ; Kotloff, Karen L. ; Levine, Myron M. ; Oundo, Joseph ; Roellig, Dawn M. ; Xiao, Lihua ; Parsons, Michele B. ; Laserson, Kayla ; Mintz, Eric D. ; Breiman, Robert F. ; O'Reilly, Ciara E. Less -
Description:
Background

Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012.

Methodology/Principal findings

At health facility enrollment, stool samples were tested for enteric pathogens and data on clinical, environmental, and behavioral characteristics collected. Each child’s health status was recorded at 60-day follow-up. Data were analyzed using logistic regression. Of the 1,778 children with MSD enrolled as cases in the GEMS-Kenya case-control study, 11% had Cryptosporidium detected in stool by enzyme immunoassay; in a genotyped subset, 81% were C. hominis. Among MSD cases, being an infant, having mucus in stool, and having prolonged/persistent duration diarrhea were associated with being Cryptosporidium-positive. Both boiling drinking water and using rainwater as the main drinking water source were protective factors for being Cryptosporidium-positive. At follow-up, Cryptosporidium-positive cases had increased odds of being stunted (adjusted odds ratio [aOR] = 1.65, 95% CI: 1.06–2.57), underweight (aOR = 2.08, 95% CI: 1.34–3.22), or wasted (aOR = 2.04, 95% CI: 1.21–3.43), and had significantly larger negative changes in height- and weight-for-age z-scores from enrollment.

Conclusions/Significance

Cryptosporidium contributes significantly to diarrheal illness in young children in western Kenya. Advances in point of care detection, prevention/control approaches, effective water treatment technologies, and clinical management options for children with cryptosporidiosis are needed.


Subjects:
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Case-Control Studies Child, Preschool Cryptosporidiosis Cryptosporidium Diarrhea Feces Female Humans Infant Male Prospective Studies Rural Population
Source:
PLoS Negl Trop Dis. 12(7).
Pubmed ID:
30001340
Pubmed Central ID:
PMC6057667
Document Type:
Journal Article
Place as Subject:
Kenya
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:479231f97586b0910256229bca94c67834d3b60192cf6635011714a5f688ddf7
Download URL:
https://stacks.cdc.gov/view/cdc/58243/cdc_58243_DS1.pdf
File Type:

Supporting Files

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  	pntd.0006640.s002.docx	docx
  	pntd.0006640.s003.docx	docx

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