Diarrhea in children less than two years of age with known HIV status in Kisumu, Kenya.
Open accessAbstract
OBJECTIVE: To compare the frequency and etiology of diarrhea in children aged less than 2 years with known HIV status. METHODS: This was a nested cohort study, whereby children were followed during monthly routine and unscheduled visits. The HIV status of children was determined with PCR. A stool culture was obtained from children with diarrhea. A subset of stool samples was examined for parasites and tested for rotavirus. RESULTS: Between 1997 and 2001, 682 children (51.0% male) contributed observation periods with a mean of 47 weeks. Overall there were 198 episodes of diarrhea per 100 child-years of observation (CYO); diarrhea was more common among HIV-positive children than among HIV-negative children (321 vs. 183 episodes/100 CYO, respectively, p<0.01) and was not statistically different for HIV-negative children born to HIV-positive compared with HIV-negative mothers (182 vs. 187 episodes/100 CYO, respectively, p=0.36). For 66.5% of the acute episodes a stool culture was obtained; 27.8% of stool cultures yielded a bacterial pathogen. A positive stool culture was less likely among HIV-positive children compared to children of HIV-negative mothers (20.5% vs. 34.3%, p=0.01). Susceptibility of Salmonella and Shigella to commonly used antibiotics was low. Rotavirus was detected in 13.9% of 202 examined stool samples, and a stool parasite in 3.8% of 394 samples. Diarrhea was associated with 37.8% of child deaths. CONCLUSIONS: Diarrhea was more common among HIV-infected children, but was not associated with specific bacterial pathogens. Measures that reduce diarrhea will benefit all children, but may benefit HIV-infected children in particular.
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Although diarrhea was more common among HIV-infected children, bacterial pathogens such as Campylobacter and Shigella were not frequent, suggesting that other pathogens or causes may be important in this population.
“Although diarrhea was more common among HIV-infected children, bacterial pathogens such as Campylobacter and Shigella were not frequent, suggesting that other pathogens (e.g. viruses, parasites, diarrheagenic E. coli) or other causes (e.g. malabsorption, metabolic enteritis) may be important in this population 42.”
From Antibiotic treatment of acute gastroenteritis in children (2018) · cites this paper as [42]
Section 3.2 reports more diarrhea in HIV-infected children but fewer Campylobacter and Shigella isolates than in HIV-negative children. The Discussion (section 3.5) notes that viral and parasitic pathogens and diarrheagenic E. coli were not routinely tested, and considers other possible causes. It does not specifically identify malabsorption or metabolic enteritis as explanations. (LLM, conf=0.86)
Experimental — accuracy not yet measuredHIV-positive infants were significantly more likely to experience persistent diarrhea than HIV-negative infants (p<0.01).
“In addition, HIV-positive infants were significantly more likely to experience persistent diarrhea than HIV-negative infants ( p<0.01).”
From Antibiotic treatment of acute gastroenteritis in children (2018) · cites this paper as [42]
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Antibiotic treatment of acute gastroenteritis in children
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- Authors
- van Eijk, A. M., Brooks, J. T., Adcock, P. M., Garrett, V., Eberhard, M., Rosen, D. H., Ayisi, J. G., Ochieng, J. B., Kumar, L., Gentsch, J. R., Nahlen, B. L., Mintz, E. D., & Slutsker, L.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Kenya Medical Research Institute (KE)
- Venue
- International Journal of Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 14
- Issue
- 3
- Pages
- e220-e225
- ISSN
- 1201-9712 (ISSN-L)
- OpenAlex
- W2149647471
- Cited by
- 51
- References
- 21
- Citations by year
- 2026: 2 · 2024: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 9 · 2013: 2 · 2012: 5
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- United States Agency for International Development
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- childhood diarrhea, HIV infection, infants and young children, etiology of diarrhea, pathogenic bacteria, rotavirus, stool parasites, antibiotic susceptibility, Salmonella, Shigella, child mortality, maternal HIV status, Kisumu
- MeSH terms
- Child, Preschool, Diarrhea, Dysentery, Bacillary, Feces, Female, Gram-Negative Bacteria, Humans, Infant, Kenya, Male, Rotavirus Infections, Rotavirus, HIV-1, HIV Infections, Gram-Negative Bacterial Infections, AIDS-Related Opportunistic Infections
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