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Campylobacter linked to growth shortfalls among low-resource children
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Campylobacter infection contributed to linear growth deficiencies among children in resource-limited areas, according to published study findings.
“Recent work has implicated Campylobacter, with the putative mechanism being environmental enteric dysfunction, a condition characterized by altered intestinal function and inflammation,” James A Platts-Mills, MD, assistant professor at the University of Virginia Health System, and colleagues wrote. “In high-resource settings, Campylobacter infection is sporadic and associated with exposure to undercooked chicken, or less frequently, common-source outbreaks, often due to contaminated dairy products. In contrast, in low-resource settings, Campylobacter infection is frequently endemic. While exposure to poultry may be important, identified determinants are varied.”
In the multisite birth cohort MAL-ED study, Platts-Mills and colleagues analyzed a cohort of 1,892 children from eight disadvantaged communities in Asia, sub-Saharan Africa and South America who were followed from birth to age 24 months. The researchers collected and tested 7,601 diarrheal and 26,267 nondiarrheal stools for Campylobacter using enzyme immunoassays.
Almost 85% of the cohort developed infection with a positive Campylobacter stool by 1 year. Children who were breast-fed exclusively (RR = 0.57; 95% CI, 0.47-0.67), exposed to treated drinking water (RR = 0.76; 95% CI, 0.7-0.83), had access to cleaner latrines (RR = 0.89; 95% CI, 0.82–0.97) and recently used macrolide antibiotics (RR = 0.68; 95% CI, 0.63–0.74) displayed a reduced risk for infection. High-burden risk for infection correlated with a lower length-for-age z score at 24 months (–1.82; 95% CI, –1.94 to –1.7), in addition to intestinal and systemic inflammation and increased intestinal permeability.
“Promotion of exclusive breast-feeding, routine treatment of drinking water, access to improved latrines and judicious antibiotic administration may reduce Campylobacter infection and improve linear growth in children in these settings,” the researchers wrote. “We recommend that, in addition to vaccine development, clinical trials be undertaken to reduce Campylobacter infections via such interventions, with both subclinical pathogen infection and linear growth as outcomes of interest.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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