Peer-reviewed article
Enteropathogen-specific pathways linking moderate-to-severe diarrhea to linear growth faltering in sub-Saharan African children: a decomposition analysis of the GEMS study.
Ashaolu JO, Ji DD, Adesuyi TA, Ajakaiye IA, Omoyajowo EA et al. ·
Summary
Written by AI, not yet AICS's view ·Key points
Limitations
Abstract
Background Associations exist between moderate-to-severe diarrhea (MSD) and growth faltering in children; however, the underlying mechanisms are not well-understood. We evaluated the extent to which seven enteropathogens explain the association between MSD and linear growth faltering in children from sub-Saharan Africa. Methods We conducted a pathway decomposition analysis using data from 20,695 children from the Global Enteric Multicenter Study (GEMS), with 8,382 MSD cases and 12,313 controls. Seven pathogens were assessed as possible explanatory variables for the MSD-growth association. Results Two pathogens significantly explained the MSD-growth association: ETEC (27.0%, p<0.001) and Cryptosporidium (42.8%, p<0.001). Shigella (71.7%, p=0.063) and Adenovirus (80.5%, p=0.067) showed potential but imprecise effects. Rotavirus did not explain linear growth (28.2%, p=0.243) but strongly explained weight-related outcomes (WAZ: 119.1%; WHZ: 79.7%). Conclusion The MSD-growth association was explained by ETEC and Cryptosporidium. Rotavirus explained weight-related outcomes but not linear growth. Growth benefits associated with rotavirus vaccination may operate through prevention of acute wasting rather than stunting.