Nutrition and Clinical Services Division, icddr,b, Dhaka, 1212, Bangladesh.
James P. Grant School of Public Health, BRAC University, Dhaka, 1212, Bangladesh.
Sci Rep. 2021 Jun 17;11(1):12738. doi: 10.1038/s41598-021-92132-z.
Both Campylobacter- and Shigella-induced invasive enteritis are common in under-5 Bangladeshi children. Our study aimed to determine the factors associated with Campylobacter and Shigella enteritis among under-5 children, the post-infection worsening growth, and the household cost of invasive enteritis. Data of children having Shigella (591/803) and Campylobacter (246/1148) isolated from the fecal specimen in Bangladesh were extracted from the Global Enteric Multicenter Study (GEMS) for the period December 2007 to March 2011. In multiple logistic regression analysis, fever was observed more frequently among shigellosis cases [adjusted OR 2.21; (95% CI 1.58, 3.09)]. Breastfeeding [aOR 0.55; (95% CI 0.37, 0.81)] was found to be protective against Shigella. The generalized estimating equations multivariable model identified a negative association between Shigella and weight-for-height z score [aOR - 0.11; (95% CI - 0.21, - 0.001)]; a positive association between symptomatic Campylobacter and weight-for-age z score [aOR 0.22; (95% CI 0.06, 0.37)] and weight-for-height z score [aOR 0.22; (95% CI 0.08, 0.37)]. Total costs incurred by households were more in shigellosis children than Campylobacter-induced enteritis ($4.27 vs. $3.49). Households with low-level maternal education tended to incur less cost in case of their shigellosis children. Our findings underscore the need for preventive strategies targeting Shigella infection, which could potentially reduce the disease burden, associated household costs, and child growth faltering.
在 5 岁以下的孟加拉国儿童中,弯曲杆菌和志贺氏菌引起的侵袭性肠炎很常见。我们的研究旨在确定弯曲杆菌和志贺氏菌肠炎与 5 岁以下儿童的相关因素、感染后生长恶化以及侵袭性肠炎的家庭费用。2007 年 12 月至 2011 年 3 月期间,从孟加拉国粪便样本中分离出的志贺氏菌(591/803)和弯曲杆菌(246/1148)的数据从全球肠道多中心研究(GEMS)中提取出来。在多变量逻辑回归分析中,发热在志贺氏菌病病例中更为常见[调整后的 OR 2.21;(95%可信区间 1.58,3.09)]。母乳喂养[aOR 0.55;(95%可信区间 0.37,0.81)]被发现对志贺氏菌有保护作用。广义估计方程多变量模型确定了志贺氏菌与身高体重 z 分数之间的负相关[aOR -0.11;(95%可信区间 -0.21,-0.001)];症状性弯曲杆菌与年龄体重 z 分数[aOR 0.22;(95%可信区间 0.06,0.37)]和身高体重 z 分数[aOR 0.22;(95%可信区间 0.06,0.37)]呈正相关。家庭支出的总费用在志贺氏菌病儿童中高于弯曲杆菌引起的肠炎($4.27 与$3.49)。母亲受教育程度较低的家庭,其志贺氏菌病儿童的费用往往较低。我们的研究结果强调了针对志贺氏菌感染的预防策略的必要性,这可能会降低疾病负担、相关家庭费用和儿童生长发育迟缓。