Viral pathogen-specific clinical and demographic characteristics of children with moderate-to-severe diarrhea in Rural Bangladesh

Abigail E. Bray, Shahnawaz Ahmed, Sumon Kumar Das, Soroar Hossain Khan, Mohammad Jobayer Chisti, Tahmeed Ahmed, Abu S.G. Faruque, George J. Fuchs

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Diarrheal disease is a leading cause of childhood morbidity and mortality worldwide, but particularly in lowincome countries in sub-Saharan Africa and South Asia. The Global Enteric Multicenter Study (GEMS) examined the infectious etiologies as well as associated demographics, socioeconomic markers, health-care-seeking behaviors, and handwashing practices of the households of children with diarrhea and their age- and gender-matched controls in seven countries over a 3-year period (December 2007-December 2010). Stool studies to determine diarrheal etiologies and anthropometry were performed at baseline and at 60-day follow-up visits, along with surveys to record demographics and living conditions of the children. We performed secondary analyses of the GEMS data derived from the Bangladesh portion of the study in children with diarrhea associated with viral enteropathogens and explored pathogen-specific features of disease burden. Rotavirus and norovirus were the most prevalent pathogens (39.3% and 35%, respectively). Disease due to rotavirus and adenovirus was more common in infants than in older children (P < 0.001 and P = 0.001, respectively). Height for age decreased from baseline to follow-up in children with diarrhea associated with rotavirus, norovirus, and adenovirus (P< 0.001). Based on these analyses, preventive measures targeted at rotavirus, norovirus, and adenovirus will be expected to have meaningful clinical impact. Cost of treatment was highest for rotavirus as well, making it an obvious target for intervention. Association of specific viruses with stunting is particularly notable, as stunting is an attributable risk factor for poor cognitive development and future productivity and economic potential.

Original languageEnglish
Pages (from-to)304-309
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume101
Issue number2
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
Acknowledgments: The project described was supported by the National Center for Advancing Translational Sciences, through Grant UL1TR001998 and UK Health Care. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The Global Enteric Multicenter Study was funded by grant no. 38874 from the Bill & Melinda Gates Foundation. The authors are grateful to the staff of icddr,b and Kumudini Hospital and to the families of Mirzapur for their contributions to this work.

Publisher Copyright:
© 2019 by The American Society of Tropical Medicine and Hygiene.

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

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