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dc.contributor.authorFarag, Tamer
dc.contributor.authorDilruba, Nasrin
dc.contributor.authorLevine, Myron M.
dc.contributor.authorKotloff, Karen L.
dc.creatorAcácio, S.
dc.date.accessioned2019-07-08T18:55:09Z
dc.date.available2019-07-08T18:55:09Z
dc.date.issued2018-08-01
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85048576914&origin=inward
dc.identifier.urihttp://hdl.handle.net/10713/9861
dc.description.abstractBackground: Diarrhea is an important health problem among HIV-infected patients. This study evaluated the role of HIV in the epidemiology, etiology, and severity of diarrheal disease among children. Methods: The Global Enteric Multicenter Study enrolled children with moderate-to-severe diarrhea (MSD) and less-severe diarrhea (LSD) between December 2007 and November 2012. One to three controls for MSD cases and one per LSD case were enrolled and matched by age, sex, and neighborhood. All children were tested for HIV. Clinical data, anthropometric data, and stool samples were collected. Follow-up was performed at 60 days. Results: Two hundred and fourteen MSD cases and 418 controls, together with 349 LSD cases and 214 controls were tested. HIV prevalence was 25% among MSD cases (4% for matched controls) and 6% among LSD cases (6% among matched controls). HIV-infected children were more likely to have MSD (odds ratio 5.6, p < 0.0001). Mortality rates were higher among HIV-infected children than among the uninfected (34 vs. 5 per 1000 child-weeks at risk; p = 0.0039). Cryptosporidium, Giardia, and enteroaggregative Escherichia coli (aatA only) were more prevalent among HIV-infected MSD cases than among uninfected ones. Conclusion: HIV is an important risk factor for MSD. The high mortality rate implies that children with MSD should be screened for HIV and managed accordingly. © 2018 The Author(s)en_US
dc.description.sponsorshipThe study on which this work was based (Project GEMS) was supported by the Bill & Melinda Gates Foundation (Project OPP 38874 ). Core funding for CISM is provided by the Spanish Agency for International Cooperation and Development (AECID).en_US
dc.description.urihttps://www.doi.org/10.1016/j.ijid.2018.05.012en_US
dc.language.isoen_USen_US
dc.publisherElsevier B.V.en_US
dc.relation.ispartofInternational Journal of Infectious Diseasesen_US
dc.subjectChildrenen_US
dc.subjectEtiologyen_US
dc.subjectHIVen_US
dc.subjectLess-severe diarrheaen_US
dc.subjectModerate-to-severe diarrheaen_US
dc.subjectMortalityen_US
dc.titleThe role of HIV infection in the etiology and epidemiology of diarrheal disease among children aged 0–59 months in Manhiça District, Rural Mozambiqueen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.ijid.2018.05.012
dc.identifier.pmid29852260
dc.relation.volume73


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