EClinicalMedicine (Oct 2024)

The epidemiology and impact of persistent Campylobacter infections on childhood growth among children 0–24 months of age in resource-limited settingsResearch in context

  • Francesca Schiaffino,
  • Josh M. Colston,
  • Maribel Paredes Olortegui,
  • Pablo Peñataro Yori,
  • Evangelos Mourkas,
  • Ben Pascoe,
  • Aldo A.M. Lima,
  • Carl J. Mason,
  • Tahmeed Ahmed,
  • Gagandeep Kang,
  • Estomih Mduma,
  • Amidou Samie,
  • Anita Zaidi,
  • Jie Liu,
  • Kerry K. Cooper,
  • Eric R. Houpt,
  • Craig T. Parker,
  • Gwenyth O. Lee,
  • Margaret N. Kosek

Journal volume & issue
Vol. 76
p. 102841

Abstract

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Summary: Background: Campylobacter is the leading cause of bacterial gastroenteritis worldwide. It is generally associated with an acute gastrointestinal infection causing a self-limiting diarrheal episode. However, there is evidence that persistent/recurrent carriage of Campylobacter also occurs. In hyperendemic settings the epidemiology and consequences of persistent Campylobacter enteric infections is poorly studied. Methods: Risk factors for and growth consequences of persistent Campylobacter infections detected by polymerase chain reaction (qPCR) were evaluated with data from the MAL-ED birth cohort study in children 0–24 months of age between November 2009 and February 2012. A persistent Campylobacter infection was defined as three or more consecutive Campylobacter positive monthly stools. Findings: Across all study sites, 45.5% (781/1715) of children experienced at least one persistent Campylobacter episode. The average cumulative duration of days in which children with persistent Campylobacter were positive for Campylobacter spp. was 150 days (inter-quartile range: 28–236 days). Children who experienced a persistent Campylobacter episode had an attained 24-month length-for-age (LAZ) score that was 0.23 (95% (CI): −0.31, −0.15) less than children without a persistent Campylobacter episode. Among children who had at least one episode of Campylobacter over a 3-month or 9-month window, persistent episodes were not significantly associated with poorer 3-month weight gain (−28.7 g, 95% CI: −63.4 g, 6.0 g) but were associated with poorer 9-month linear growth (−0.134 cm 95% CI: −0.246, −0.022) compared to children with an episode that resolved within 31 days. Interpretation: Persistent/recurrent Campylobacter infection is common among children and has a measurable negative impact on linear growth in early childhood. Funding: Funding for this study was provided by the Bill and Melinda Gates Foundation (OPP1066146 and OPP1152146), the National Institutes of Health United States (R01AI158576 and R21AI163801 to MNK and CTP; K43TW012298 to FS; K01AI168493 to JMC; GOL was supported by K01AI145080. This research was also supported in part by USDA-ARS CRIS project 2030-42000-055-00D. The funders had no role in study design, study implementation, data analysis, or interpretation of the results.

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