Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/45672
Title: Duration of Postdiarrheal Enteric Pathogen Carriage in Young Children in Low-resource Settings
Authors: McMurry, Timothy L.
McQuade, Elizabeth T. Rogawski
Liu, Jie
Kang, Gagandeep
Kosek, Margaret N.
LIma, Aldo A. M.
Bessong, Pascal O.
Samie, Amidou
Haque, Rashidul
Mduma, Estomih R.
Leite, José Paulo G.
Bodhidatta, Ladaporn
Iqbal, Najeeha T.
Page, Nicola
Kiwelu, Ireen
Bhutta, Zulfiqar A.
Ahmed, Tahmeed
Houpt, Eric R.
Platts-Mills, James A.
Affilliation: Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA,
Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA / Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, Virginia. USA.
Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, Virginia. USA.
Christian Medical College. Vellore, India.
Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, Virginia. USA / Asociación Benéfica PRISMA. Iquitos, Peru.
Universidade Federal do Ceará. Fortaleza, CE, Brasil.
University of Venda. Thohoyandou, South Africa.
University of Venda. Thohoyandou, South Africa.
International Centre for Diarrhoeal Disease Research. Bangladesh, Dhaka, Bangladesh.
8Haydom Global Health Research Centre. Haydom, Tanzania.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.
Armed Forces Research Institute of Medical Sciences. Bangkok, Thailand.
Aga Khan University. Karachi, Pakistan.
National Institute for Communicable Diseases. Johannesburg, South Africa.
Kilimanjaro Clinical Research Institute. Moshi, Tanzania.
Aga Khan University. Karachi, Pakistan.
International Centre for Diarrhoeal Disease Research. Bangladesh, Dhaka, Bangladesh.
Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, Virginia. USA.
Division of Infectious Diseases and International Health, University of Virginia. Charlottesville, Virginia. USA.
Abstract: Background. Prolonged enteropathogen shedding after diarrhea complicates the identification of etiology in subsequent episodes and is an important driver of pathogen transmission. A standardized approach has not been applied to estimate the duration of shedding for a wide range of pathogens. Methods. We used a multisite birth cohort of children 0–24 months of age from whom diarrheal and monthly nondiarrheal stools were previously tested by quantitative polymerase chain reaction for 29 enteropathogens. We modeled the probability of detection of the etiologic pathogen before and after diarrhea using a log-normal accelerated failure time survival model and estimated the median duration of pathogen carriage as well as differences in subclinical pathogen carriage 60 days after diarrhea onset in comparison to a prediarrhea baseline. Results. We analyzed 3247 etiologic episodes of diarrhea for the 9 pathogens with the highest attributable burdens of diarrhea. The median duration of postdiarrheal carriage varied widely by pathogen, from about 1 week for rotavirus (median, 8.1 days [95% confidence interval {CI}, 6.2–9.6]) to >1 month for Cryptosporidium (39.5 days [95% CI, 30.6–49.0]). The largest increases in subclinical pathogen carriage before and after diarrhea were seen for Cryptosporidium (prevalence difference between 30 days prior and 60 days after diarrhea onset, 0.30 [95% CI, .23–.39]) and Shigella (prevalence difference, 0.21 [95% CI, .16–.27]). Conclusions. Postdiarrheal shedding was widely variable between pathogens, with strikingly prolonged shedding seen for Cryptosporidium and Shigella. Targeted antimicrobial therapy and vaccination for these pathogens may have a relatively large impact on transmission.
Keywords: Diarrhea
Asymptomatic carriage
Incubation period
Children
Shedding
keywords: Diarréia
Crianças
Período de incubação
Derramamento
Asymptomatic Diseases
Issue Date: 2020
Publisher: Oxford University Press
Citation: McMURRY, Thimothy L. et al. Duration of Postdiarrheal Enteric Pathogen Carriage in Young Children in Low-resource Settings. Clinical Infectious Diseases, XX(XX), p.1–9, 2020.
DOI: 10.1093/cid/ciaa1528
ISSN: 1537-6591
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos
Files in This Item:
File Description SizeFormat 
JosePauloG_Leite_etal_IOC_2020.pdf1.26 MBAdobe PDFView/Open



FacebookTwitterDeliciousLinkedInGoogle BookmarksBibTex Format mendeley Endnote DiggMySpace

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.