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Identification of Etiology-Specific Diarrhea Associated With Linear Growth Faltering in Bangladeshi Infants

Amanda E Schnee1, Rashidul Haque2, Mami Taniuchi1

  • 1Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia.

American Journal of Epidemiology
|May 17, 2018
PubMed

Insights

Childhood diarrhea in low-resource settings impacts growth, but specific pathogens like Cryptosporidium and Campylobacter jejuni/coli cause significant linear growth deficits. Pathogen-specific interventions are crucial for improving child development.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Pediatrics

Background:

  • Childhood diarrhea in low-resource settings is linked to impaired linear growth.
  • The specific impact of different diarrhea-causing pathogens on child growth requires further investigation.

Purpose of the Study:

  • To characterize diarrhea etiology in Dhaka, Bangladesh.
  • To examine the association between pathogen-specific diarrhea and linear growth (length-for-age z scores) and systemic inflammation (C-reactive protein).

Main Methods:

  • Diarrheal stools from children were analyzed using quantitative polymerase chain reaction to identify enteropathogens.
  • Attributable fractions were used to determine pathogen-specific diarrhea burdens.
  • Linear regression models assessed the relationship between pathogen-specific diarrhea and LAZ and CRP.

Main Results:

  • No association was found between all-cause diarrhea and linear growth at 12 months.
  • Diarrhea caused by Cryptosporidium, Campylobacter jejuni/coli, and Shigella/enteroinvasive E. coli were significantly associated with linear growth deficits.
  • Campylobacter jejuni/coli and Shigella/enteroinvasive E. coli-attributable diarrhea were linked to elevated C-reactive protein levels.

Conclusions:

  • The impact of childhood diarrhea on linear growth is pathogen-specific.
  • Targeting specific enteropathogens through interventions is essential for mitigating growth shortfalls and inflammation in children.

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