Abstract
Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. However, it remains unclear whether that association is specific to Campylobacter jejuni/coli. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children aged 1–24 months. We analyzed data from 1715 children followed from birth until 24 months of age in the MAL-ED birth cohort study, including detection of Campylobacter species by enzyme immunoassay and Campylobacter jejuni/coli by quantitative PCR in stool samples. Myeloperoxidase (MPO) concentration in stool, used as a quantitative index of enteric inflammation, was measured. The incidence rate per 100 child-months of infections with Campylobacter jejuni/coli and Campylobacter species during 1–24 month follow up were 17.7 and 29.6 respectively. Female sex of child, shorter duration of exclusive breastfeeding, lower maternal age, mother having less than 3 living children, maternal educational level of <6 years, lack of routine treatment of drinking water, and unimproved sanitation were associated with Campylobacter jejuni/coli infection. The cumulative burden of both Campylobacter jejuni/coli infections and Campylobacter species were associated with poor growth and increased intestinal inflammation.
Highlights
Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings
34,622 surveillance stool samples tested for Campylobacter jejuni/coli by quantitative PCR whereas Campylobacter species done by enzyme immunoassay (EIA) was tested during 1–12, 15, 18, 21, 24 months on 22,614 surveillance stool samples
After controlling for infection with enteroaggregative E. coli (EAEC), heat-labile enterotoxin-producing E. coli (LT-ETEC), heat-stable enterotoxin-producing E. coli (ST-ETEC), Shigella/enteroinvasive E. coli (Shigella/EIEC), both Campylobacter species and Campylobacter jejuni/coli infections were clearly and consistently associated with increased enteric inflammation as measured by MPO, with a stronger association seen for Campylobacter jejuni/coli (Table 5). In this prospective multisite birth cohort study, we documented a high burden of Campylobacter infections, with most of the children having Campylobacter detected in a monthly surveillance stool sample by one year of age at seven of the eight sites
Summary
Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children aged 1–24 months. We analyzed data from 1715 children followed from birth until 24 months of age in the MAL-ED birth cohort study, including detection of Campylobacter species by enzyme immunoassay and Campylobacter jejuni/coli by quantitative PCR in stool samples. We sought to identify risk factors for Campylobacter jejuni/coli infection and assess the association with enteric inflammation and linear growth in children and compare these associations with the burden of infestation by Campylobacter species by EIA
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