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    Clinical, environmental, and behavioral characteristics associated with Cryptosporidium infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008-2012: The Global Enteric Multicenter Study (GEMS)

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    Author
    Delahoy, M.J.
    Omore, R.
    Ayers, T.L.
    Date
    2018
    Journal
    PLoS Neglected Tropical Diseases
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
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    See at
    https://dx.doi.org/10.1371/journal.pntd.0006640
    Abstract
    Background Cryptosporidium is a leading cause of moderate-to-severe diarrhea (MSD) in young children in Africa. We examined factors associated with Cryptosporidium infection in MSD cases enrolled at the rural western Kenya Global Enteric Multicenter Study (GEMS) site from 2008-2012. Methodology/Principal findings At health facility enrollment, stool samples were tested for enteric pathogens and data on clinical, environmental, and behavioral characteristics collected. Each child’s health status was recorded at 60-day follow-up. Data were analyzed using logistic regression. Of the 1,778 children with MSD enrolled as cases in the GEMS-Kenya case-control study, 11% had Cryptosporidium detected in stool by enzyme immunoassay; in a genotyped subset, 81% were C. hominis. Among MSD cases, being an infant, having mucus in stool, and having prolonged/persistent duration diarrhea were associated with being Cryptosporidium-positive. Both boiling drinking water and using rainwater as the main drinking water source were protective factors for being Cryptosporidium-positive. At follow-up, Cryptosporidium-positive cases had increased odds of being stunted (adjusted odds ratio [aOR] = 1.65, 95% CI: 1.06–2.57), underweight (aOR = 2.08, 95% CI: 1.34–3.22), or wasted (aOR = 2.04, 95% CI: 1.21–3.43), and had significantly larger negative changes in height- and weight-for-age z-scores from enrollment. Conclusions/Significance Cryptosporidium contributes significantly to diarrheal illness in young children in western Kenya. Advances in point of care detection, prevention/control approaches, effective water treatment technologies, and clinical management options for children with cryptosporidiosis are needed. Copyright 2018, Public Library of Science. All rights reserved. https://creativecommons.org/publicdomain/zero/1.0/.
    Keyword
    Case-Control Studies
    Child, Preschool
    Cryptosporidiosis
    Cryptosporidium
    Diarrhea
    Humans
    Infant
    Kenya
    Prospective Studies
    Rural Population
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85051281686&doi=10.1371%2fjournal.pntd.0006640&partnerID=40&md5=b0c4dad780b42d39a4df7d11c509646d; http://hdl.handle.net/10713/9752
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pntd.0006640
    Scopus Count
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    UMB Open Access Articles 2018

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