Factors Associated with the Duration of Moderate-to-Severe Diarrhea among Children in Rural Western Kenya Enrolled in the Global Enteric Multicenter Study, 2008-2012.

Autor: Schilling KA; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Omore R; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.; Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya., Derado G; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Ayers T; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Ochieng JB; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.; Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya., Farag TH; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Nasrin D; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Panchalingam S; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Nataro JP; Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia.; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Kotloff KL; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Levine MM; Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland., Oundo J; Centers for Disease Control and Prevention, Nairobi, Kenya., Parsons MB; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Bopp C; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Laserson K; Centers for Disease Control and Prevention, Delhi, India.; Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya., Stauber CE; School of Public Health, Georgia State University, Atlanta, Georgia., Rothenberg R; School of Public Health, Georgia State University, Atlanta, Georgia., Breiman RF; Emory Global Health Institute, Emory University, Atlanta, Georgia.; Centers for Disease Control and Prevention, Nairobi, Kenya., O'Reilly CE; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia., Mintz ED; Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2017 Jul; Vol. 97 (1), pp. 248-258.
DOI: 10.4269/ajtmh.16-0898
Abstrakt: Diarrheal disease is a leading cause of death among young children worldwide. As rates of acute diarrhea (AD; 1-6 days duration) have decreased, persistent diarrhea (PD; > 14 days duration) accounts for a greater proportion of the diarrheal disease burden. We describe factors associated with the duration of moderate-to-severe diarrhea in Kenyan children < 5 years old enrolled in the Global Enteric Multicenter Study. We found 587 (58%) children experienced AD, 360 (35%) had prolonged acute diarrhea (ProAD; 7-13 days duration), and 73 (7%) had PD. We constructed a Cox proportional hazards model to identify factors associated with diarrheal duration. Risk factors independently associated with longer diarrheal duration included infection with Cryptosporidium (hazard ratio [HR]: 0.868, P = 0.035), using an unimproved drinking water source (HR: 0.87, P = 0.035), and being stunted at enrollment (HR: 0.026, P < 0.0001). Diarrheal illness of extended duration appears to be multifactorial; given its association with adverse health and development outcomes, effective strategies should be implemented to reduce the duration and severity of diarrheal illness. Effective treatments for Cryptosporidium should be identified, interventions to improve drinking water are imperative, and nutrition should be improved through exclusive breastfeeding in infants ≤ 6 months and appropriate continued feeding practices for ill children.
Databáze: MEDLINE