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Published on: March 10, 2020
Campylobacter diarrhea in children in South Asia: A systematic review
Malathi Murugesan1, Dilip Abraham1, Prasanna Samuel2
1The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Insights
Campylobacter bacteria frequently cause diarrhea in young South Asian children, leading to malabsorption and stunting. Further research is needed to understand infection sources and epidemiology.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Campylobacter species are a leading cause of diarrhea in children under five.
- In resource-limited settings, Campylobacter infections contribute to malabsorption and stunting.
- This review focuses on Campylobacter-associated diarrhea in children within South Asia.
Purpose of the Study:
- To systematically review and understand the burden of Campylobacter species-associated diarrhea among children in South Asian countries.
- To consolidate existing data on Campylobacter infection rates and prevalence in the region.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Searched databases using defined keywords for publications from 1998-2018.
- Extracted data on the proportion of positive samples to compare infection rates in children under 19.
Main Results:
- 27 eligible articles were included from 359 screened publications.
- Campylobacter was detected more frequently in diarrheal cases (3.2-17.4%) than non-diarrheal cases (0-13%).
- Children under two years old were more frequently affected; PCR methods increased detection rates; Campylobacter jejuni was the most common species.
Conclusions:
- Campylobacter species are common bacterial diarrheal pathogens in South Asian children.
- There is a lack of comprehensive data on Campylobacter species, risk factors, and sources of infection.
- More detailed studies integrating human, animal, and environmental data with advanced diagnostic tools are required to ascertain the true burden and origins of campylobacteriosis.
Background:
Campylobacter spp. are one of the commonest causes of diarrhea in children under five and in resource poor settings also lead to malabsorption and stunting. The purpose of this systematic review was to understand the burden of Campylobacter spp. associated diarrhea among children in the South Asian countries.
Methods:
This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines. Databases were searched with defined keywords for publications from the years 1998-2018. Data on proportion of positive samples was extracted to compare the rates of Campylobacter infection among children (under the age of 19) from different study populations.
Results:
Of the 359 publications screened, 27 eligible articles were included in this systematic review and categorized based on study design. In 8 case-control studies, Campylobacter spp. was detected more frequently among diarrheal cases (range, 3.2-17.4%) than non-diarrheal cases (0-13%). Although there were variations in the study population, overall, children under the age of two years experienced Campylobacter diarrhea more often than older children. Most studies reported stool culture as the method used to detect Campylobacter spp. however retesting using PCR-based methods significantly increased detection rates. Limited data were available on Campylobacter species. In 4 studies that provided species data, C. jejuni (3.2-11.2%) was shown to be the most common species, followed by C. coli.
Conclusion:
In South Asia, Campylobacter spp. are one of the most common bacterial diarrheal pathogens affecting children but there is a paucity of data on species, risk factors and attributable sources. Although a few studies were available, the epidemiology of campylobacteriosis remains uncertain. To understand the true burden and sources of infection, more detailed studies are needed collecting data from human, animal and environmental sources and using both culture and genomic tools.
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