Epidemiology and impact of campylobacter infection in children in 8 low-resource settings: Results from the MAL-ED Study

Authors

Shahida Qureshi, Aga Khan UniversityFollow
Aneeta Hotwani, Aga Khan UniversityFollow
Sadia Shakoor, Aga Khan UniversityFollow
(MAL-ED) Network Investigators
Imran Ahmed, Aga Khan UniversityFollow
Didar Alam, Aga Khan UniversityFollow
Syed Asad Ali, Aga Khan UniversityFollow
Zulfiqar Ahmed Bhutta, Aga Khan UniversityFollow
Muneera Rasheed, Aga Khan UniversityFollow
Sajid Bashir Soofi, Aga Khan UniversityFollow
Ali Turab, Aga Khan University
Anita K. M. Zaidi, Aga Khan UniversityFollow

Document Type

Article

Department

Women and Child Health; Paediatrics and Child Health; Pathology and Microbiology; Pathology and Laboratory Medicine; Centre of Excellence in Women and Child Health

Abstract

Background: Enteropathogen infections have been associated with enteric dysfunction and impaired growth in children in low-resource settings. In a multisite birth cohort study (MAL-ED), we describe the epidemiology and impact of Campylobacter infection in the first 2 years of life.
Methods: Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter Stool and blood samples were assayed for markers of intestinal permeability and inflammation.
Results: A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval, .47-.67), treatment of drinking water (0.76; 0.70-0.83), access to an improved latrine (0.89; 0.82-0.97), and recent macrolide antibiotic use (0.68; 0.63-0.74). A high Campylobacter burden was associated with a lower length-for-age Z score at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -1.38). This association was robust to confounders and consistent across sites. Campylobacter infection was also associated with increased intestinal permeability and intestinal and systemic inflammation.
Conclusions: Campylobacter was prevalent across diverse settings and associated with growth shortfalls. Promotion of exclusive breastfeeding, drinking water treatment, improved latrines, and targeted antibiotic treatment may reduce the burden of Campylobacter infection and improve growth in children in these settings.

Publication (Name of Journal)

Clinical Infectious Diseases

Recommended Citation

Qureshi, S., Hotwani, A., Shakoor, S., (MAL-ED) Network Investigators, ., Ahmed, I., Alam, D., Ali, S. A., Bhutta, Z. A., Rasheed, M., Soofi, S., Turab, A., Zaidi, A. (2016). Epidemiology and impact of campylobacter infection in children in 8 low-resource settings: Results from the MAL-ED Study. Clinical Infectious Diseases, 63(9), 1171-1179.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/1188

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.