Diarrheal Pathogens Associated With Growth and Neurodevelopment.
diarrhea
low-income countries
neurodevelopment
stunting
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
02 08 2021
02 08 2021
Historique:
received:
10
09
2020
accepted:
04
01
2021
pubmed:
6
1
2021
medline:
7
8
2021
entrez:
5
1
2021
Statut:
ppublish
Résumé
Diarrheal pathogens have been associated with linear growth deficits. The effect of diarrheal pathogens on growth is likely due to inflammation, which also adversely affects neurodevelopment. We hypothesized that diarrheagenic pathogens would be negatively associated with both growth and neurodevelopment. We conducted a longitudinal birth cohort study of 250 children with diarrheal surveillance and measured pathogen burden in diarrheal samples using quantitative polymerase chain reaction. Pathogen attributable fraction estimates of diarrhea over the first 2 years of life, corrected for socioeconomic variables, were used to predict both growth and scores on the Bayley-III Scales of Infant and Toddler Development. One hundred eighty children were analyzed for growth and 162 for neurodevelopmental outcomes. Rotavirus, Campylobacter, and Shigella were the leading causes of diarrhea in year 1 while Shigella, Campylobacter, and heat-stable toxin-producing enterotoxigenic Escherichia coli were the leading causes in year 2. Norovirus was the only pathogen associated with length-for-age z score at 24 months and was positively associated (regression coefficient [RC], 0.42 [95% confidence interval {CI}, .04 to .80]). Norovirus (RC, 2.46 [95% CI, .05 to 4.87]) was also positively associated with cognitive scores while sapovirus (RC, -2.64 [95% CI, -4.80 to -.48]) and typical enteropathogenic E. coli (RC, -4.14 [95% CI, -8.02 to -.27]) were inversely associated. No pathogens were associated with language or motor scores. Significant maternal, socioeconomic, and perinatal predictors were identified for both growth and neurodevelopment. Maternal, prenatal, and socioeconomic factors were common predictors of growth and neurodevelopment. Only a limited number of diarrheal pathogens were associated with these outcomes.
Sections du résumé
BACKGROUND
Diarrheal pathogens have been associated with linear growth deficits. The effect of diarrheal pathogens on growth is likely due to inflammation, which also adversely affects neurodevelopment. We hypothesized that diarrheagenic pathogens would be negatively associated with both growth and neurodevelopment.
METHODS
We conducted a longitudinal birth cohort study of 250 children with diarrheal surveillance and measured pathogen burden in diarrheal samples using quantitative polymerase chain reaction. Pathogen attributable fraction estimates of diarrhea over the first 2 years of life, corrected for socioeconomic variables, were used to predict both growth and scores on the Bayley-III Scales of Infant and Toddler Development.
RESULTS
One hundred eighty children were analyzed for growth and 162 for neurodevelopmental outcomes. Rotavirus, Campylobacter, and Shigella were the leading causes of diarrhea in year 1 while Shigella, Campylobacter, and heat-stable toxin-producing enterotoxigenic Escherichia coli were the leading causes in year 2. Norovirus was the only pathogen associated with length-for-age z score at 24 months and was positively associated (regression coefficient [RC], 0.42 [95% confidence interval {CI}, .04 to .80]). Norovirus (RC, 2.46 [95% CI, .05 to 4.87]) was also positively associated with cognitive scores while sapovirus (RC, -2.64 [95% CI, -4.80 to -.48]) and typical enteropathogenic E. coli (RC, -4.14 [95% CI, -8.02 to -.27]) were inversely associated. No pathogens were associated with language or motor scores. Significant maternal, socioeconomic, and perinatal predictors were identified for both growth and neurodevelopment.
CONCLUSIONS
Maternal, prenatal, and socioeconomic factors were common predictors of growth and neurodevelopment. Only a limited number of diarrheal pathogens were associated with these outcomes.
Identifiants
pubmed: 33399861
pii: 6064336
doi: 10.1093/cid/ciaa1938
pmc: PMC8326554
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e683-e691Subventions
Organisme : NICHD NIH HHS
ID : K23 HD097282
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI043596
Pays : United States
Organisme : NIAID NIH HHS
ID : R37 AI026649
Pays : United States
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
N Engl J Med. 2020 Jul 23;383(4):321-333
pubmed: 32706533
Vaccine. 2016 Jun 8;34(27):3068-3075
pubmed: 27154394
PLoS Negl Trop Dis. 2018 May 29;12(5):e0006363
pubmed: 29813057
PLoS One. 2016 Jun 23;11(6):e0158199
pubmed: 27336160
Neuroimage. 2020 Apr 15;210:116540
pubmed: 31945509
Trends Mol Med. 2012 Jun;18(6):328-36
pubmed: 22633998
Lancet. 2016 Sep 24;388(10051):1291-301
pubmed: 27673470
Lancet Glob Health. 2015 Sep;3(9):e564-75
pubmed: 26202075
PLoS Pathog. 2017 Jul 27;13(7):e1006471
pubmed: 28750066
Pediatrics. 2017 Apr;139(Suppl 1):S59-S71
pubmed: 28562249
Lancet Infect Dis. 2014 Aug;14(8):716-724
pubmed: 25022434
Lancet Glob Health. 2018 Dec;6(12):e1319-e1328
pubmed: 30287125
Pediatr Infect Dis J. 2006 Jun;25(6):513-20
pubmed: 16732149
EBioMedicine. 2015 Sep 25;2(11):1759-66
pubmed: 26870801
Lancet Infect Dis. 2018 Nov;18(11):1211-1228
pubmed: 30243583
Clin Infect Dis. 2016 Sep 15;63(6):792-7
pubmed: 27313261
Clin Infect Dis. 2018 Oct 15;67(9):1347-1355
pubmed: 29897482
Lancet. 2013 Apr 20;381(9875):1405-1416
pubmed: 23582727
Am J Trop Med Hyg. 2016 Nov 2;95(5):1004-1010
pubmed: 27601523
Am J Epidemiol. 2018 Oct 1;187(10):2210-2218
pubmed: 29767678
Lancet. 2008 Jan 19;371(9608):243-60
pubmed: 18207566
Lancet Glob Health. 2018 Dec;6(12):e1309-e1318
pubmed: 30287127
PLoS One. 2013 May 29;8(5):e64636
pubmed: 23734210
Nutr J. 2011 Mar 20;10(1):25
pubmed: 21418600
Am J Clin Nutr. 2013 May;97(5):1129-33
pubmed: 23553156
Int J Epidemiol. 2008 Aug;37(4):816-30
pubmed: 18567626
Pediatrics. 2017 Apr;139(Suppl 1):S50-S58
pubmed: 28562248
Am J Trop Med Hyg. 2013 Feb;88(2):390-396
pubmed: 23185075
Neuroimage. 2019 Nov 15;202:116110
pubmed: 31449973
J Pediatric Infect Dis Soc. 2017 Jun 1;6(2):153-160
pubmed: 28204556
J Infect Dis. 2013 Dec 1;208(11):1794-802
pubmed: 24041797
J Clin Virol. 2011 Apr;50(4):308-13
pubmed: 21256076
Am J Trop Med Hyg. 2002 May;66(5):590-3
pubmed: 12201596
J Glob Health. 2019 Jun;9(1):010101
pubmed: 30701067
Nat Rev Gastroenterol Hepatol. 2013 Apr;10(4):220-9
pubmed: 23229327
Am J Trop Med Hyg. 1999 Nov;61(5):707-13
pubmed: 10586898
BMC Pediatr. 2014 Feb 18;14:50
pubmed: 24548288
Am J Trop Med Hyg. 2017 Sep;97(3):974-979
pubmed: 28722635
Cell Host Microbe. 2014 Jun 11;15(6):668-80
pubmed: 24922570