Diarrhea, enteric pathogen detection, and nutritional indicators among controls in the Global Enteric Multicenter Study, Kenya site: An opportunity to understand reference populations in case-control studies of diarrhea.

Details

• Alternative Title:
  Epidemiol Infect
• Personal Author:
  Berendes, D. M. ; O’Reilly, C. E. ; Kim, S. ; Omore, R. ; Ochieng, J. B. ; Ayers, T. ; Fagerli, K. ; Farag, T. H. ; Nasrin, D. ; Panchalingam, S. ; Nataro, J. P. ; Kotloff, K. L. ; Levine, M. M. ; Oundo, J. ; Laserson, K. ; Breiman, R. F. ; Mintz, E. D.
• Description:
  Given the challenges in accurately identifying unexposed controls in case-control studies of diarrhoea, we examined diarrhoea incidence, subclinical enteric infections and growth stunting within a reference population in the Global Enteric Multicenter Study, Kenya site. Within 'control' children (0-59 months old without diarrhoea in the 7 days before enrolment, n = 2384), we examined surveys at enrolment and 60-day follow-up, stool at enrolment and a 14-day post-enrolment memory aid for diarrhoea incidence. At enrolment, 19% of controls had ⩾1 enteric pathogen associated with moderate-to-severe diarrhoea ('MSD pathogens') in stool; following enrolment, many reported diarrhoea (27% in 7 days, 39% in 14 days). Controls with and without reported diarrhoea had similar carriage of MSD pathogens at enrolment; however, controls reporting diarrhoea were more likely to report visiting a health facility for diarrhoea (27% vs. 7%) or fever (23% vs. 16%) at follow-up than controls without diarrhoea. Odds of stunting differed by both MSD and 'any' (including non-MSD pathogens) enteric pathogen carriage, but not diarrhoea, suggesting control classification may warrant modification when assessing long-term outcomes. High diarrhoea incidence following enrolment and prevalent carriage of enteric pathogens have implications for sequelae associated with subclinical enteric infections and for design and interpretation of case-control studies examining diarrhoea.
• Subjects:
  Article
• Source:
  Epidemiol Infect. 147:e44
• Pubmed ID:
  30428944
• Pubmed Central ID:
  PMC6518569
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Place as Subject:
  Kenya
• Volume:
  147
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6795e07835f77e303c1d284a229e2bb3279e2cf5a8548069591c8edc1c0f1f3a
• Download URL:
  https://stacks.cdc.gov/view/cdc/78523/cdc_78523_DS1.pdf
• File Type:
  [PDF - 444.73 KB ]