Enteropathogen-specific diarrhea decreased adolescent growth
Enteropathogen-specific diarrhea, particularly Shigella, negatively affects growth among adolescents, according to study findings in The Pediatric Infectious Disease Journal.
Gwenyth Lee, PhD, of the Johns Hopkins Bloomberg School of Public Health, and colleagues assessed diarrheal episodes and weight gain of 433 Peruvian children aged 0 to 72 months from 2002 to 2006. Trained field workers visited participants three times a week to document the number and consistency of stool.
Overall, there were 3,973 diarrheal episodes. Of those, 320 were Campylobacter-associated, 314 were Shigella-associated and 387 were related to enterotoxigenic Escherichia coli. The mean diarrheal prevalence, defined by researchers as the percentage of days spent with diarrhea, was 4.59% overall, 0.37% for Shigella-associated diarrhea, 0.45% for enterotoxigenic E. coli-associated diarrhea and 0.39% for Campylobacter-associated diarrhea.
Absolute incidence rates for diarrhea caused by Shigella, Campylobacterand enterotoxigenic E. coli were highest among children aged approximately 2 years. Shigella and enterotoxigenic E. coliwere most common among older children, whereas younger children were more likely to have Campylobacter-related diarrhea.
Regarding weight gain, researchers found that children gained 55.3 g less per Campylobacter episode. Shigella and enterotoxigenic E. coli were not associated with poor weight gain during a 2-month period. Shigella had the strongest association with linear growth. Children’s linear growth decreased by 0.081 cm per Shigella-related diarrheal episode during a 9-month period.
“Poor linear growth in early childhood is associated with cognitive deficits, lower adult work capacity, and poor maternal outcomes, and is therefore a marker for human potential lost. The consistent and differential long-term effects attributable to select enteropathogens provide support for prioritization of accelerated vaccines, diagnostics and treatments targeted at those pathogens causing the greatest degree of long-term morbidity, as well as those causing actual mortality,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.