The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)
The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized. Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) wer...
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| creator | Sow, Samba O Muhsen, Khitam Nasrin, Dilruba Blackwelder, William C Wu, Yukun Farag, Tamer H Panchalingam, Sandra Sur, Dipika Zaidi, Anita K M Faruque, Abu S G Saha, Debasish Adegbola, Richard Alonso, Pedro L Breiman, Robert F Bassat, Quique Tamboura, Boubou Sanogo, Doh Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Hossain, Anowar Das, Sumon K Antonio, Martin Hossain, M Jahangir Mandomando, Inacio Nhampossa, Tacilta Acácio, Sozinho Omore, Richard Oundo, Joseph O Ochieng, John B Mintz, Eric D O'Reilly, Ciara E Berkeley, Lynette Y Livio, Sofie Tennant, Sharon M Sommerfelt, Halvor Nataro, James P Ziv-Baran, Tomer Robins-Browne, Roy M Mishcherkin, Vladimir Zhang, Jixian Liu, Jie Houpt, Eric R Kotloff, Karen L Levine, Myron M |
| description | The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.
Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged |
| doi_str_mv | 10.1371/journal.pntd.0004729 |
| format | Article |
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Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated.
Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative.
The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0004729</identifier><identifier>PMID: 27219054</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Afghanistan - epidemiology ; Africa South of the Sahara - epidemiology ; Asia - epidemiology ; Biology and Life Sciences ; Care and treatment ; Case-Control Studies ; Child, Preschool ; Children ; Cost of Illness ; Cryptosporidiosis - epidemiology ; Cryptosporidiosis - mortality ; Cryptosporidiosis - parasitology ; Cryptosporidium ; Cryptosporidium - classification ; Cryptosporidium - genetics ; Cryptosporidium - immunology ; Cryptosporidium - isolation & purification ; Data Mining - methods ; Developing countries ; Developing Countries - economics ; Developing Countries - statistics & numerical data ; Diagnosis ; Diarrea ; Diarrhea ; Diarrhea - epidemiology ; Diarrhea - mortality ; Diarrhea - parasitology ; Feces - parasitology ; Female ; Gastrointestinal Diseases - epidemiology ; Gastrointestinal Diseases - mortality ; Gastrointestinal Diseases - parasitology ; Genotypes ; Health aspects ; Humans ; Immunoassay ; Incidence ; India - epidemiology ; Infant ; Infant, Newborn ; Infants ; LDCs ; Male ; Medicine and Health Sciences ; Mortality ; People and Places ; Polymerase Chain Reaction ; Protozoa ; Risk factors ; Tropical diseases ; Vaccines</subject><ispartof>PLoS neglected tropical diseases, 2016-05, Vol.10 (5), p.e0004729</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS). PLoS Negl Trop Dis 10(5): e0004729. doi:10.1371/journal.pntd.0004729</rights><rights>cc0 (c) Sow et al., 2016 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</a></rights><rights>2016 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS). PLoS Negl Trop Dis 10(5): e0004729. doi:10.1371/journal.pntd.0004729</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c660t-366240c02f594870c2759f39fb1aaeb4b955618f8854da5d0ee009ed2bff74073</citedby><cites>FETCH-LOGICAL-c660t-366240c02f594870c2759f39fb1aaeb4b955618f8854da5d0ee009ed2bff74073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878811/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878811/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,26951,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27219054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sow, Samba O</creatorcontrib><creatorcontrib>Muhsen, Khitam</creatorcontrib><creatorcontrib>Nasrin, Dilruba</creatorcontrib><creatorcontrib>Blackwelder, William C</creatorcontrib><creatorcontrib>Wu, Yukun</creatorcontrib><creatorcontrib>Farag, Tamer H</creatorcontrib><creatorcontrib>Panchalingam, Sandra</creatorcontrib><creatorcontrib>Sur, Dipika</creatorcontrib><creatorcontrib>Zaidi, Anita K M</creatorcontrib><creatorcontrib>Faruque, Abu S G</creatorcontrib><creatorcontrib>Saha, Debasish</creatorcontrib><creatorcontrib>Adegbola, Richard</creatorcontrib><creatorcontrib>Alonso, Pedro L</creatorcontrib><creatorcontrib>Breiman, Robert F</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Tamboura, Boubou</creatorcontrib><creatorcontrib>Sanogo, Doh</creatorcontrib><creatorcontrib>Onwuchekwa, Uma</creatorcontrib><creatorcontrib>Manna, Byomkesh</creatorcontrib><creatorcontrib>Ramamurthy, Thandavarayan</creatorcontrib><creatorcontrib>Kanungo, Suman</creatorcontrib><creatorcontrib>Ahmed, Shahnawaz</creatorcontrib><creatorcontrib>Qureshi, Shahida</creatorcontrib><creatorcontrib>Quadri, Farheen</creatorcontrib><creatorcontrib>Hossain, Anowar</creatorcontrib><creatorcontrib>Das, Sumon K</creatorcontrib><creatorcontrib>Antonio, Martin</creatorcontrib><creatorcontrib>Hossain, M Jahangir</creatorcontrib><creatorcontrib>Mandomando, Inacio</creatorcontrib><creatorcontrib>Nhampossa, Tacilta</creatorcontrib><creatorcontrib>Acácio, Sozinho</creatorcontrib><creatorcontrib>Omore, Richard</creatorcontrib><creatorcontrib>Oundo, Joseph O</creatorcontrib><creatorcontrib>Ochieng, John B</creatorcontrib><creatorcontrib>Mintz, Eric D</creatorcontrib><creatorcontrib>O'Reilly, Ciara E</creatorcontrib><creatorcontrib>Berkeley, Lynette Y</creatorcontrib><creatorcontrib>Livio, Sofie</creatorcontrib><creatorcontrib>Tennant, Sharon M</creatorcontrib><creatorcontrib>Sommerfelt, Halvor</creatorcontrib><creatorcontrib>Nataro, James P</creatorcontrib><creatorcontrib>Ziv-Baran, Tomer</creatorcontrib><creatorcontrib>Robins-Browne, Roy M</creatorcontrib><creatorcontrib>Mishcherkin, Vladimir</creatorcontrib><creatorcontrib>Zhang, Jixian</creatorcontrib><creatorcontrib>Liu, Jie</creatorcontrib><creatorcontrib>Houpt, Eric R</creatorcontrib><creatorcontrib>Kotloff, Karen L</creatorcontrib><creatorcontrib>Levine, Myron M</creatorcontrib><title>The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.
Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated.
Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative.
The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.</description><subject>Afghanistan - epidemiology</subject><subject>Africa South of the Sahara - epidemiology</subject><subject>Asia - epidemiology</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cost of Illness</subject><subject>Cryptosporidiosis - epidemiology</subject><subject>Cryptosporidiosis - mortality</subject><subject>Cryptosporidiosis - parasitology</subject><subject>Cryptosporidium</subject><subject>Cryptosporidium - classification</subject><subject>Cryptosporidium - genetics</subject><subject>Cryptosporidium - immunology</subject><subject>Cryptosporidium - isolation & purification</subject><subject>Data Mining - methods</subject><subject>Developing countries</subject><subject>Developing Countries - economics</subject><subject>Developing Countries - statistics & numerical data</subject><subject>Diagnosis</subject><subject>Diarrea</subject><subject>Diarrhea</subject><subject>Diarrhea - epidemiology</subject><subject>Diarrhea - mortality</subject><subject>Diarrhea - parasitology</subject><subject>Feces - parasitology</subject><subject>Female</subject><subject>Gastrointestinal Diseases - epidemiology</subject><subject>Gastrointestinal Diseases - mortality</subject><subject>Gastrointestinal Diseases - parasitology</subject><subject>Genotypes</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immunoassay</subject><subject>Incidence</subject><subject>India - epidemiology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>LDCs</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>People and Places</subject><subject>Polymerase Chain Reaction</subject><subject>Protozoa</subject><subject>Risk factors</subject><subject>Tropical 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Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)</title><author>Sow, Samba O ; Muhsen, Khitam ; Nasrin, Dilruba ; Blackwelder, William C ; Wu, Yukun ; Farag, Tamer H ; Panchalingam, Sandra ; Sur, Dipika ; Zaidi, Anita K M ; Faruque, Abu S G ; Saha, Debasish ; Adegbola, Richard ; Alonso, Pedro L ; Breiman, Robert F ; Bassat, Quique ; Tamboura, Boubou ; Sanogo, Doh ; Onwuchekwa, Uma ; Manna, Byomkesh ; Ramamurthy, Thandavarayan ; Kanungo, Suman ; Ahmed, Shahnawaz ; Qureshi, Shahida ; Quadri, Farheen ; Hossain, Anowar ; Das, Sumon K ; Antonio, Martin ; Hossain, M Jahangir ; Mandomando, Inacio ; Nhampossa, Tacilta ; Acácio, Sozinho ; Omore, Richard ; Oundo, Joseph O ; Ochieng, John B ; Mintz, Eric D ; O'Reilly, Ciara E ; Berkeley, Lynette Y ; Livio, Sofie ; Tennant, Sharon M ; Sommerfelt, Halvor ; Nataro, James P ; Ziv-Baran, Tomer ; Robins-Browne, Roy M ; Mishcherkin, Vladimir ; Zhang, Jixian ; Liu, Jie ; Houpt, Eric R ; Kotloff, Karen L ; Levine, Myron M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c660t-366240c02f594870c2759f39fb1aaeb4b955618f8854da5d0ee009ed2bff74073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Afghanistan - epidemiology</topic><topic>Africa South of the Sahara - epidemiology</topic><topic>Asia - epidemiology</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cost of Illness</topic><topic>Cryptosporidiosis - epidemiology</topic><topic>Cryptosporidiosis - mortality</topic><topic>Cryptosporidiosis - parasitology</topic><topic>Cryptosporidium</topic><topic>Cryptosporidium - classification</topic><topic>Cryptosporidium - genetics</topic><topic>Cryptosporidium - immunology</topic><topic>Cryptosporidium - isolation & purification</topic><topic>Data Mining - methods</topic><topic>Developing countries</topic><topic>Developing Countries - economics</topic><topic>Developing Countries - statistics & numerical data</topic><topic>Diagnosis</topic><topic>Diarrea</topic><topic>Diarrhea</topic><topic>Diarrhea - epidemiology</topic><topic>Diarrhea - mortality</topic><topic>Diarrhea - parasitology</topic><topic>Feces - parasitology</topic><topic>Female</topic><topic>Gastrointestinal Diseases - epidemiology</topic><topic>Gastrointestinal Diseases - mortality</topic><topic>Gastrointestinal Diseases - parasitology</topic><topic>Genotypes</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immunoassay</topic><topic>Incidence</topic><topic>India - epidemiology</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>LDCs</topic><topic>Male</topic><topic>Medicine and Health 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Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sow, Samba O</au><au>Muhsen, Khitam</au><au>Nasrin, Dilruba</au><au>Blackwelder, William C</au><au>Wu, Yukun</au><au>Farag, Tamer H</au><au>Panchalingam, Sandra</au><au>Sur, Dipika</au><au>Zaidi, Anita K M</au><au>Faruque, Abu S G</au><au>Saha, Debasish</au><au>Adegbola, Richard</au><au>Alonso, Pedro L</au><au>Breiman, Robert F</au><au>Bassat, Quique</au><au>Tamboura, Boubou</au><au>Sanogo, Doh</au><au>Onwuchekwa, Uma</au><au>Manna, Byomkesh</au><au>Ramamurthy, Thandavarayan</au><au>Kanungo, Suman</au><au>Ahmed, Shahnawaz</au><au>Qureshi, Shahida</au><au>Quadri, Farheen</au><au>Hossain, Anowar</au><au>Das, Sumon K</au><au>Antonio, Martin</au><au>Hossain, M Jahangir</au><au>Mandomando, Inacio</au><au>Nhampossa, Tacilta</au><au>Acácio, Sozinho</au><au>Omore, Richard</au><au>Oundo, Joseph O</au><au>Ochieng, John B</au><au>Mintz, Eric D</au><au>O'Reilly, Ciara E</au><au>Berkeley, Lynette Y</au><au>Livio, Sofie</au><au>Tennant, Sharon M</au><au>Sommerfelt, Halvor</au><au>Nataro, James P</au><au>Ziv-Baran, Tomer</au><au>Robins-Browne, Roy M</au><au>Mishcherkin, Vladimir</au><au>Zhang, Jixian</au><au>Liu, Jie</au><au>Houpt, Eric R</au><au>Kotloff, Karen L</au><au>Levine, Myron M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2016-05-24</date><risdate>2016</risdate><volume>10</volume><issue>5</issue><spage>e0004729</spage><pages>e0004729-</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized.
Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-severe diarrhea [LSD]) were analyzed. Stools from 12,110 MSD and 3,174 LSD cases among children aged <60 months and from 21,527 randomly-selected controls matched by age, sex and community were immunoassay-tested for Cryptosporidium. Species of a subset of Cryptosporidium-positive specimens were identified by PCR; GP60 sequencing identified anthroponotic C. parvum. Combined annual Cryptosporidium-attributable diarrhea incidences among children aged <24 months for African and Asian GEMS sites were extrapolated to sub-Saharan Africa and South Asian regions to estimate region-wide MSD and LSD burdens. Attributable and excess mortality due to Cryptosporidium diarrhea were estimated.
Cryptosporidium was significantly associated with MSD and LSD below age 24 months. Among Cryptosporidium-positive MSD cases, C. hominis was detected in 77.8% (95% CI, 73.0%-81.9%) and C. parvum in 9.9% (95% CI, 7.1%-13.6%); 92% of C. parvum tested were anthroponotic genotypes. Annual Cryptosporidium-attributable MSD incidence was 3.48 (95% CI, 2.27-4.67) and 3.18 (95% CI, 1.85-4.52) per 100 child-years in African and Asian infants, respectively, and 1.41 (95% CI, 0.73-2.08) and 1.36 (95% CI, 0.66-2.05) per 100 child-years in toddlers. Corresponding Cryptosporidium-attributable LSD incidences per 100 child-years were 2.52 (95% CI, 0.33-5.01) and 4.88 (95% CI, 0.82-8.92) in infants and 4.04 (95% CI, 0.56-7.51) and 4.71 (95% CI, 0.24-9.18) in toddlers. We estimate 2.9 and 4.7 million Cryptosporidium-attributable cases annually in children aged <24 months in the sub-Saharan Africa and India/Pakistan/Bangladesh/Nepal/Afghanistan regions, respectively, and ~202,000 Cryptosporidium-attributable deaths (regions combined). ~59,000 excess deaths occurred among Cryptosporidium-attributable diarrhea cases over expected if cases had been Cryptosporidium-negative.
The enormous African/Asian Cryptosporidium disease burden warrants investments to develop vaccines, diagnostics and therapies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27219054</pmid><doi>10.1371/journal.pntd.0004729</doi><tpages>20</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2016-05, Vol.10 (5), p.e0004729 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_1797501695 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Recercat; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Afghanistan - epidemiology Africa South of the Sahara - epidemiology Asia - epidemiology Biology and Life Sciences Care and treatment Case-Control Studies Child, Preschool Children Cost of Illness Cryptosporidiosis - epidemiology Cryptosporidiosis - mortality Cryptosporidiosis - parasitology Cryptosporidium Cryptosporidium - classification Cryptosporidium - genetics Cryptosporidium - immunology Cryptosporidium - isolation & purification Data Mining - methods Developing countries Developing Countries - economics Developing Countries - statistics & numerical data Diagnosis Diarrea Diarrhea Diarrhea - epidemiology Diarrhea - mortality Diarrhea - parasitology Feces - parasitology Female Gastrointestinal Diseases - epidemiology Gastrointestinal Diseases - mortality Gastrointestinal Diseases - parasitology Genotypes Health aspects Humans Immunoassay Incidence India - epidemiology Infant Infant, Newborn Infants LDCs Male Medicine and Health Sciences Mortality People and Places Polymerase Chain Reaction Protozoa Risk factors Tropical diseases Vaccines |
| title | The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS) |
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