Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls: A prospective cohort study among children in northeastern Brazil

A. A M Lima, S. R. Moore, M. S. Barboza, A. M. Soares, M. A. Schleupner, R. D. Newman, Cynthia Louise Sears, J. P. Nataro, D. P. Fedorko, T. Wuhib, J. B. Schorling, R. L. Guerrant

Research output: Contribution to journalArticle

Abstract

Persistent diarrhea (PD; duration ≥ 14 days) is a growing part of the global burden of diarrheal diseases. A 45-month prospective cohort study (with illness, nutritional, and microbiologic surveillance) was conducted in a shantytown in northeastern Brazil, to elucidate the epidemiology, nutritional impact, and causes of PD in early childhood (0-3 years of age). A nested case-control design was used to examine children's diarrhea burden and nutritional status before and after a first PD illness. PD illnesses accounted for 8% of episodes and 34% of days of diarrhea. First PD illnesses were preceded by a doubling of acute diarrhea burdens, were followed by further 2.6-3.5-fold increased diarrhea burdens for 18 months, and were associated with acute weight shortfalls. Exclusively breast-fed children had 8-fold lower diarrhea rates than did weaned children. PD-associated etiologic agents included Cryptosporidium, Giardia, enteric adenoviruses, and enterotoxigenic Escherichia coli. PD signals growth shortfalls and increased diarrhea burdens; children with PD merit extended support, and the illness warrants further study to elucidate its prevention, treatment, and impact.

Original languageEnglish (US)
Pages (from-to)1643-1651
Number of pages9
JournalJournal of Infectious Diseases
Volume181
Issue number5
DOIs
StatePublished - 2000

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Brazil
Diarrhea
Cohort Studies
Prospective Studies
Enterotoxigenic Escherichia coli
Giardia
Cryptosporidium
Nutritional Status
Adenoviridae
Epidemiology
Breast
Weights and Measures
Growth

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

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Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls : A prospective cohort study among children in northeastern Brazil. / Lima, A. A M; Moore, S. R.; Barboza, M. S.; Soares, A. M.; Schleupner, M. A.; Newman, R. D.; Sears, Cynthia Louise; Nataro, J. P.; Fedorko, D. P.; Wuhib, T.; Schorling, J. B.; Guerrant, R. L.

In: Journal of Infectious Diseases, Vol. 181, No. 5, 2000, p. 1643-1651.

Research output: Contribution to journalArticle

Lima, AAM, Moore, SR, Barboza, MS, Soares, AM, Schleupner, MA, Newman, RD, Sears, CL, Nataro, JP, Fedorko, DP, Wuhib, T, Schorling, JB & Guerrant, RL 2000, 'Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls: A prospective cohort study among children in northeastern Brazil', Journal of Infectious Diseases, vol. 181, no. 5, pp. 1643-1651. https://doi.org/10.1086/315423
Lima, A. A M ; Moore, S. R. ; Barboza, M. S. ; Soares, A. M. ; Schleupner, M. A. ; Newman, R. D. ; Sears, Cynthia Louise ; Nataro, J. P. ; Fedorko, D. P. ; Wuhib, T. ; Schorling, J. B. ; Guerrant, R. L. / Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls : A prospective cohort study among children in northeastern Brazil. In: Journal of Infectious Diseases. 2000 ; Vol. 181, No. 5. pp. 1643-1651.
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