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Stunting Following Moderate-to-Severe Diarrhea Among Children Aged <5 Years in Africa Before and After Rotavirus Vaccine Introduction: A Comparison of the Global Enteric Multicenter Study and the Vaccine Impact on Diarrhea in Africa (VIDA) Study.
Nasrin, Dilruba; Liang, Yuanyuan; Verani, Jennifer R; Powell, Helen; Sow, Samba O; Omore, Richard; Hossain, M Jahangir; Doh, Sanogo; Zaman, Syed M A; Jones, Joquina Chiquita M; Awuor, Alex O; Kasumba, Irene N; Tennant, Sharon M; Ramakrishnan, Usha; Kotloff, Karen L.
Afiliación
  • Nasrin D; Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Liang Y; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Verani JR; Division of Global Health Protection, US Centers for Disease Control and Prevention, Nairobi, Kenya.
  • Powell H; Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Sow SO; Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Omore R; Centre pour le Développement des Vaccins du Mali, Bamako, Mali.
  • Hossain MJ; Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya.
  • Doh S; Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.
  • Zaman SMA; Centre pour le Développement des Vaccins du Mali, Bamako, Mali.
  • Jones JCM; Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.
  • Awuor AO; Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia.
  • Kasumba IN; Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Kenya.
  • Tennant SM; Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Ramakrishnan U; Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
  • Kotloff KL; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Clin Infect Dis ; 76(76 Suppl1): S49-S57, 2023 04 19.
Article en En | MEDLINE | ID: mdl-37074437
BACKGROUND: Studies conducted before rotavirus vaccine introduction found that moderate-to-severe diarrhea (MSD) in children aged <5 years was associated with stunting at follow-up. It is unknown whether the reduction in rotavirus-associated MSD following vaccine introduction decreased the risk of stunting. METHODS: The Global Enteric Multicenter Study (GEMS) and the Vaccine Impact on Diarrhea in Africa (VIDA) study, two comparable matched case-control studies, were conducted during 2007-2011 and 2015-2018, respectively. We analyzed data from 3 African sites where rotavirus vaccine was introduced after GEMS and before starting VIDA. Children with acute MSD (<7 days onset) were enrolled from a health center and children without MSD (diarrhea-free for ≥7 days) were enrolled at home within 14 days of the index MSD case. The odds of being stunted at a follow-up visit 2-3 months after enrollment for an episode of MSD was compared between GEMS and VIDA using mixed-effects logistic regression models controlling for age, sex, study site, and socioeconomic status. RESULTS: We analyzed data from 8808 children from GEMS and 10 579 from VIDA. Among those who were not stunted at enrollment in GEMS, 8.6% with MSD and 6.4% without MSD became stunted during the follow-up period. In VIDA, 8.0% with MSD and 5.5% children without MSD developed stunting. An episode of MSD was associated with higher odds of being stunted at follow-up compared with children without MSD in both studies (adjusted odds ratio [aOR], 1.31; 95% confidence interval [CI]: 1.04-1.64 in GEMS and aOR, 1.30; 95% CI: 1.04-1.61 in VIDA). However, the magnitude of association was not significantly different between GEMS and VIDA (P = .965). CONCLUSIONS: The association of MSD with subsequent stunting among children aged <5 years in sub-Saharan Africa did not change after rotavirus vaccine introduction. Focused strategies are needed for prevention of specific diarrheal pathogens that cause childhood stunting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotavirus / Vacunas contra Rotavirus Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans / Infant País/Región como asunto: Africa Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rotavirus / Vacunas contra Rotavirus Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans / Infant País/Región como asunto: Africa Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos