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dc.contributor.authorNasrin, Dilruba
dc.contributor.authorBlackwelder, William C
dc.contributor.authorSommerfelt, Halvor
dc.contributor.authorWu, Yukun
dc.contributor.authorFarag, Tamer H
dc.contributor.authorPanchalingam, Sandra
dc.contributor.authorBiswas, Kousick
dc.contributor.authorSaha, Debasish
dc.contributor.authorJahangir Hossain, M
dc.contributor.authorSow, Samba O
dc.contributor.authorReiman, Robert F B
dc.contributor.authorSur, Dipika
dc.contributor.authorFaruque, Abu S G
dc.contributor.authorZaidi, Anita K M
dc.contributor.authorSanogo, Doh
dc.contributor.authorTamboura, Boubou
dc.contributor.authorOnwuchekwa, Uma
dc.contributor.authorManna, Byomkesh
dc.contributor.authorRamamurthy, Thandavarayan
dc.contributor.authorKanungo, Suman
dc.contributor.authorOmore, Richard
dc.contributor.authorOchieng, John B
dc.contributor.authorOundo, Joseph O
dc.contributor.authorDas, Sumon K
dc.contributor.authorAhmed, Shahnawaz
dc.contributor.authorQureshi, Shahida
dc.contributor.authorQuadri, Farheen
dc.contributor.authorAdegbola, Richard A
dc.contributor.authorAntonio, Martin
dc.contributor.authorMandomando, Inacio
dc.contributor.authorNhampossa, Tacilta
dc.contributor.authorBassat, Quique
dc.contributor.authorRoose, Anna
dc.contributor.authorO'Reilly, Ciara E
dc.contributor.authorMintz, Eric D
dc.contributor.authorRamakrishnan, Usha
dc.contributor.authorPowell, Helen
dc.contributor.authorLiang, Yuanyuan
dc.contributor.authorNataro, James P
dc.contributor.authorLevine, Myron M
dc.contributor.authorKotloff, Karen L
dc.date.accessioned2022-01-24T15:50:38Z
dc.date.available2022-01-24T15:50:38Z
dc.date.issued2021-12
dc.identifier.urihttp://hdl.handle.net/10713/17762
dc.description.abstractBACKGROUND: The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment. METHODS: The Global Enteric Multicenter Study enrolled children with moderate to severe diarrhea (MSD) seeking healthcare at 7 sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, approximately 60 days later, to calculate change in height-for-age z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested using linear mixed effects regression models. RESULTS: Among 8077 MSD cases analyzed, the proportion with stunting (HAZ below -1) increased from 59% at enrollment to 65% at follow-up (P < .0001). Pathogens significantly associated with linear growth decline included Cryptosporidium (P < .001), typical enteropathogenic Escherichia coli (P = .01), and untreated Shigella (P = .009) among infants (aged 0-11 months) and enterotoxigenic E. coli encoding heat-stable toxin (P < .001) and Cryptosporidium (P = .03) among toddlers (aged 12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (P = .02). CONCLUSIONS: Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella. © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.en_US
dc.description.urihttps://doi.org/10.1093/infdis/jiab434en_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.ispartofJournal of Infectious Diseasesen_US
dc.rights© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.en_US
dc.subjectDiarrheaen_US
dc.subjectantibioticsen_US
dc.subjectchildrenen_US
dc.subjectgrowth falteringen_US
dc.subjectpathogensen_US
dc.subjectstuntingen_US
dc.titlePathogens Associated With Linear Growth Faltering in Children With Diarrhea and Impact of Antibiotic Treatment: The Global Enteric Multicenter Study.en_US
dc.typeArticleen_US
dc.identifier.doi10.1093/infdis/jiab434
dc.identifier.pmid34528677
dc.source.journaltitleThe Journal of infectious diseases
dc.source.volume224
dc.source.issue12 Suppl 2
dc.source.beginpageS848
dc.source.endpageS855
dc.source.countryUnited States


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