Species of cryptosporidia causing subclinical infection associated with growth faltering in rural and Urban Bangladesh: A birth cohort study

Kevin L. Steiner, Shahnawaz Ahmed, Carol A. Gilchrist, Cecelia Burkey, Heather Cook, Jennie Z. Ma, Poonum S. Korpe, Emtiaz Ahmed, Masud Alam, Mamun Kabir, Fahmida Tofail, Tahmeed Ahmed, Rashidul Haque, William A. Petri, Abu S.G. Faruque

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Abstract

Background Cryptosporidiosis is a major cause of childhood diarrhea in low- and middle-income countries and has been linked to impairment of child growth. This study investigated the burden of cryptosporidiosis and its impact on child growth in both a rural and an urban site in Bangladesh. Methods Pregnant women in the second trimester were identified at 2 sites in Bangladesh, 1 urban and 1 rural. Their offspring were enrolled at birth into the study (urban, n = 250; rural, n = 258). For 2 years, the children were actively monitored for diarrhea and anthropometric measurements were obtained every 3 months. Stool samples were collected monthly and during diarrheal episodes with Cryptosporidium infection and causative species determined by quantitative polymerase chain reaction assays. Results Cryptosporidium infections were common at both sites and mostly subclinical. In the urban site, 161 (64%) children were infected and 65 (26%) had ≥2 infections. In the rural site, 114 (44%) were infected and 24 (9%) had multiple infections. Adjusted for potential confounders, cryptosporidiosis was associated with a significantly greater drop in the length-for-age z score (LAZ) at 24 months from LAZ at enrollment ("-LAZ), an effect greatest in the children with multiple episodes of cryptosporidiosis. The most common species in Mirpur was Cryptosporidium hominis, whereas Cryptosporidium meleagridis predominated in Mirzapur. Conclusions Cryptosporidiosis is common in early childhood and associated with early growth faltering in Bangladeshi children. Predominant Cryptosporidium species differed between the 2 sites, suggesting different exposures or modes of transmission but similar consequences for child growth. Clinical Trials Registration NCT02764918.

Original languageEnglish (US)
Pages (from-to)1347-1355
Number of pages9
JournalClinical Infectious Diseases
Volume67
Issue number9
DOIs
StatePublished - Oct 15 2018

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Keywords

  • Bangladesh
  • birth cohort
  • cryptosporidiosis
  • growth faltering
  • species

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Steiner, K. L., Ahmed, S., Gilchrist, C. A., Burkey, C., Cook, H., Ma, J. Z., Korpe, P. S., Ahmed, E., Alam, M., Kabir, M., Tofail, F., Ahmed, T., Haque, R., Petri, W. A., & Faruque, A. S. G. (2018). Species of cryptosporidia causing subclinical infection associated with growth faltering in rural and Urban Bangladesh: A birth cohort study. Clinical Infectious Diseases, 67(9), 1347-1355. https://doi.org/10.1093/cid/ciy310