Effects of Shigella-, Campylobacter- and ETEC- associated Diarrhea on Childhood Growth
Effects of Shigella-, Campylobacter- and ETEC- associated Diarrhea on Childhood Growth
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DOI：
10.1097/inf.0000000000000351
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发表时间：
2014-10-01
影响因子：
3.6
通讯作者：
Kosek, Margaret
中科院分区：
文献类型：
--
作者：
Lee, Gwenyth;Paredes Olortegui, Maribel;Kosek, Margaret
背景：检查腹泻病对生长的病因特异性影响的研究是有限的，其分析方法是可变的，这使得比较困难，并且基于这些发现确定优先级具有挑战性。Black等人（Black RE, Brown KH, Becker S.）的一项研究：与特定肠道病原体相关的腹泻对孟加拉国农村儿童生长发育的影响。儿科。1984;（33: 1004-1009）研究了孟加拉国0-5岁儿童的志贺氏菌和产肠毒素大肠杆菌相关疾病与体重增加和线性生长之间的关系。我们在2002年秘鲁亚马逊地区的一组0- 6岁儿童中估计了类似的关联。方法：每周3次家访进行腹泻监测。每月收集人体测量数据。混合效应模型用于估计志贺氏菌、ETEC和弯曲杆菌腹泻与2个月期间体重增加和9个月期间线性增长之间的关系。腹泻疾病负担和生长间隔被量化，以便尽可能与原始报告相比较。结果：志贺氏菌和ETEC相关性腹泻与体重增加减少无关，尽管ETEC腹泻与体重增加之间的相关性（ETEC治疗天数为-4.5 g/ %, P = 0.098）是其他病因的两倍，并且在程度上与原始报告相似。志贺氏菌相关性腹泻与线性生长下降相关（生长减少0.055厘米/百分比天，P = 0.008），也与原始研究相似。结论：我们的研究结果表明，肠道病原体特异性腹泻发作与生长之间的关联，特别是志贺氏菌，在地理和流行病学背景下具有可比性。
Background: Studies examining the etiology-specific effects of diarrheal disease on growth are limited and variable in their analytic methods, making comparisons difficult and priority setting based on these findings challenging. A study by Black et al (Black RE, Brown KH, Becker S. Effects of diarrhea associated with specific enteropathogens on the growth of children in rural Bangladesh. Pediatrics. 1984; 33: 1004-1009.) examined the association between Shigella and enterotoxigenic Escherichia coli-related disease and weight gain and linear growth in Bangladeshi children aged 0-5 years. We estimated similar associations in a 2002 cohort of 0- to 6-year-old children in the Peruvian Amazon.Methods: Diarrheal surveillence was conducted using household visits 3 times per week. Anthropometry was collected monthly. Mixed-effect models were used to estimate the association between Shigella, ETEC and Campylobacter diarrhea and weight gain in a 2-month period and linear growth over a 9-month period. Diarrheal disease burdens and growth intervals were quantified so as to be as comparable as possible to the original report.Results: Shigella-and ETEC-associated diarrhea were not associated with diminished weight gain, although the association between ETEC diarrhea and weight gain (-4.5 g/percent of days spent with ETEC, P = 0.098) was twice that of other etiologic agents, as well as similar in magnitude to the original report. Shigella-associated diarrhea was associated with decreased linear growth (0.055 cm less growth/percent days, P = 0.008), also similar to the original study.Conclusions: Our findings suggest that associations between enteropathogen-specific diarrheal episodes and growth, particularly Shigella, are comparable across geographic and epidemiological contexts.