Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1–24 Months in Low-Resource Settings
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Data Collection
2.3. Assessment of Nutritional Status
2.4. Laboratory Testing
2.5. Statistical Analysis
2.6. Ethics Statement
3. Results
3.1. General Characteristics
3.2. Incidence Rate of Asymptomatic Shigella Infection
3.3. Association between Asymptomatic Shigella Infection and Childhood Malnutrition
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics, n (%) | Bangladesh | Brazil | India | Nepal | Peru | Pakistan | South Africa | Tanzania | Overall |
---|---|---|---|---|---|---|---|---|---|
Male sex | 108 (51.4) | 89 (53.9) | 105 (46.3) | 122 (53.7) | 105 (54.1) | 120 (48.8) | 120 (50.6) | 105 (50.2) | 874 (51.0) |
Birth weight (kg) † | 2.8 ± 0.4 | 3.4 ± 0.5 | 2.9 ± 0.4 | 3 ± 0.4 | 3.1 ± 0.4 | 2.7 ± 0.4 | 3.2 ± 0.5 | 3.2 ± 0.5 | 3.0 ± 0.5 |
Days of exclusive breastfeeding † | 143.2 ± 42.7 | 93.7 ± 57.8 | 105.4 ± 42.9 | 92.5 ± 54.5 | 89.5 ± 61.3 | 19.9 ± 22.7 | 38.6 ± 26.3 | 62.2 ± 35 | 78.6 ± 57.7 |
Weight for age z-score at enrolment † | −1.3 ± 0.9 | −0.2 ± 1 | −1.3 ± 1 | −0.9 ± 1 | −0.6 ± 0.9 | −1.4 ± 1 | −0.4 ± 1 | −0.1 ± 0.9 | −0.8 ± 1.1 |
Length for age z-score at enrolment † | −0.96 ± 1 | −0.8 ± 1.1 | −1 ± 1.1 | −0.7 ± 1 | −0.9 ± 1 | −1.3 ± 1.1 | −0.7 ± 1 | −1 ± 1.1 | −0.9 ± 1.1 |
Length for age z-score at 24 months † | −2.0 ± 0.9 | 0 ± 1.1 | −1.9 ± 1 | −1.3 ± 0.9 | −1.9 ± 0.9 | N/A | −1.7 ± 1.1 | −2.7 ± 1 | −1.7 ± 1.2 |
Maternal age (years) † | 25.0 ± 5.0 | 25.4 ± 5.6 | 23.9 ± 4.2 | 26.6 ± 3.7 | 24.8 ± 6.3 | 28.1 ± 5.9 | 27 ± 7.2 | 29.1 ± 6.5 | 26.3 ± 5.9 |
Maternal weight (kg) † | 49.7 ± 8.5 | 62 ± 11.5 | 50.3 ± 9.3 | 56.2 ± 8.3 | 56.3 ± 9.6 | 50.7 ± 9.6 | 68 ± 15.3 | 55.7 ± 8.8 | 55.9 ± 12 |
Maternal height (cm) † | 149.0 ± 5.0 | 155.1 ± 6.7 | 151.1 ± 5.2 | 149.7 ± 5.3 | 150.2 ± 5.5 | 153.4 ± 5.7 | 158.7 ± 6.6 | 155.9 ± 5.9 | 152.9 ± 6.6 |
Maternal educational level < 6 y | 133 (63.3) | 22 (13.3) | 80 (35.2) | 59 (26) | 44 (22.7) | 202 (82.1) | 5 (2.1) | 75 (35.9) | 620 (36.2) |
Mother has less than 3 alive children | 160 (76.2) | 113 (68.5) | 157 (69.8) | 199 (87.7) | 111 (57.2) | 105 (42.7) | 141 (59.5) | 58 (27.8) | 1044 (61) |
Routine treatment of drinking water | 130 (61.9) | 10 (6.1) | 7 (3.1) | 98 (43.2) | 32 (16.5) | 0 (0) | 12 (5.1) | 12 (5.7) | 301 (17.6) |
Improved drinking water source | 210 (100) | 165 (100) | 227 (100) | 227 (100) | 184 (94.9) | 246 (100) | 196 (82.7) | 89 (42.6) | 1544 (90.0) |
Improved floor | 204 (97.1) | 165 (100) | 222 (97.8) | 109 (48) | 69 (35.6) | 81 (32.9) | 231 (97.5) | 13 (6.2) | 1094 (63.8) |
Improved latrine | 210 (100) | 165 (100) | 121 (53.3) | 227 (100) | 66 (34) | 197 (80.1) | 232 (97.9) | 19 (9.1) | 1237 (72.1) |
Monthly income < $150 | 69 (32.9) | 161 (97.6) | 19 (8.4) | 106 (46.7) | 58 (29.9) | 115 (46.8) | 179 (75.5) | 0 (0) | 707 (41.2) |
Incidence Rate per 100 Child-Months (95% CI) | Adjusted Incidence Rate Ratio (95% CI) * | p Value | |
---|---|---|---|
Shigella | |||
Overall | 10.78 (10.42, 11.16) | ||
Bangladesh | 13.06 (12.02, 14.18) | Reference | |
Brazil | 4.89 (4.15, 5.78) | 0.49 (0.39, 0.60) | <0.001 |
India | 12.41 (11.45, 13.46) | 0.91 (0.81, 1.02) | 0.136 |
Nepal | 5.75 (5.12, 6.45) | 0.49 (0.42, 0.57) | <0.001 |
Peru | 13.63 (12.56, 14.79) | 1.04 (0.92, 1.16) | 0.549 |
South Africa | 7.01 (6.28, 7.82) | 0.64 (0.55, 0.76) | <0.001 |
Tanzania | 17.80 (16.57, 19.11) | 1.07 (0.91, 1.25) | 0.379 |
Unadjusted OR (95% CI) | p Value | Adjusted OR (95% CI) | p Value | |
---|---|---|---|---|
Stunting [LAZ<-2] | ||||
Overall | 1.54 (1.45, 1.62) | <0.001 | 1.60 (1.50, 1.70) | <0.001 |
Bangladesh | 1.97 (1.73, 2.24) | <0.001 | 2.09 (1.81, 2.41) | <0.001 |
Brazil | 1.36 (0.69, 2.64) | 0.368 | 1.33 (0.64, 2.79) | 0.447 |
India | 1.40 (1.23, 1.58) | <0.001 | 1.41 (1.24, 1.61) | <0.001 |
Nepal | 1.54 (1.24, 1.91) | <0.001 | 1.62 (1.26, 2.08) | <0.001 |
Peru | 1.44 (1.26, 1.65) | <0.001 | 1.50 (1.29, 1.73) | <0.001 |
South Africa | 1.32 (1.11, 1.57) | 0.002 | 1.35 (1.12, 1.63) | 0.002 |
Tanzania | 1.58 (1.40, 1.79) | <0.001 | 1.65 (1.44, 1.89) | <0.001 |
Wasting [WLZ<-2] | ||||
Overall | 1.26 (1.10, 1.44) | 0.001 | 1.26 (1.09, 1.46) | 0.002 |
Bangladesh | 1.49 (1.15, 1.93) | 0.003 | 1.50 (1.15, 1.95) | 0.003 |
Brazil | 0.54 (0.16, 1.83) | 0.325 | 0.57 (0.14, 2.35) | 0.433 |
India | 1.15 (0.95, 1.40) | 0.146 | 1.15 (0.95, 1.40) | 0.143 |
Nepal | 1.22 (0.69, 2.20) | 0.487 | 1.24 (0.67, 2.29) | 0.488 |
Peru | 0.47 (0.19, 1.12) | 0.088 | 0.45 (0.17, 1.19) | 0.109 |
South Africa | 1.53 (0.88, 2.66) | 0.133 | 1.53 (0.88, 2.64) | 0.129 |
Tanzania | 2.06 (1.13, 3.77) | 0.019 | 2.06 (1.12, 3.77) | 0.020 |
Underweight [WAZ<-2] | ||||
Overall | 1.42 (1.33, 1.51) | <0.001 | 1.45 (1.35, 1.56) | <0.001 |
Bangladesh | 1.81 (1.58, 2.07) | <0.001 | 1.90 (1.64, 2.20) | <0.001 |
Brazil | 0.52 (0.07, 3.93) | 0.529 | 0.56 (0.11, 2.85) | 0.485 |
India | 1.31 (1.16, 1.48) | <0.001 | 1.31 (1.16, 1.48) | <0.001 |
Nepal | 1.63 (1.28, 2.08) | <0.001 | 1.71 (1.27, 2.30) | <0.001 |
Peru | 1.06 (0.84, 1.33) | 0.649 | 1.06 (0.82, 1.38) | 0.646 |
South Africa | 1.36 (1.06, 1.76) | 0.016 | 1.38 (1.05, 1.80) | 0.019 |
Tanzania | 1.38 (1.17, 1.63) | <0.001 | 1.40 (1.18, 1.68) | <0.001 |
Composite index of anthropometric failure [LAZ<-2 or WLZ<-2 or WAZ<-2] | ||||
Overall | 1.49 (1.41, 1.58) | <0.001 | 1.55 (1.46, 1.65) | <0.001 |
Bangladesh | 1.95 (1.71, 2.22) | <0.001 | 2.02 (1.77, 2.33) | <0.001 |
Brazil | 1.05 (0.58, 1.87) | 0.881 | 1.02 (0.58, 1.83) | 0.924 |
India | 1.31 (1.16, 1.48) | <0.001 | 1.32 (1.16, 1.50) | <0.001 |
Nepal | 1.54 (1.25, 1.89) | <0.001 | 1.61 (1.27, 2.04) | <0.001 |
Peru | 1.39 (1.22, 1.59) | <0.001 | 1.45 (1.25, 1.67) | <0.001 |
South Africa | 1.33 (1.12, 1.58) | 0.001 | 1.36 (1.13, 1.63) | 0.001 |
Tanzania | 1.54 (1.36, 1.75) | <0.001 | 1.60 (1.40, 1.84) | <0.001 |
Stunting and underweight only [LAZ<-2 and WAZ<-2] | ||||
Overall | 1.42 (1.30, 1.56) | <0.001 | 1.42 (1.29, 1.56) | <0.001 |
Bangladesh | 1.73 (1.45, 2.07) | <0.001 | 1.79 (1.47, 2.17) | <0.001 |
Brazil | - | - | - | - |
India | 1.29 (1.08, 1.54) | 0.005 | 1.27 (1.06, 1.52) | 0.011 |
Nepal | 1.54 (1.09, 2.16) | 0.013 | 1.59 (1.08, 2.34) | 0.019 |
Peru | 1.26 (0.94, 1.68) | 0.117 | 1.28 (0.94, 1.75) | 0.117 |
South Africa | 1.23 (0.87, 1.73) | 0.238 | 1.24 (0.86, 1.77) | 0.246 |
Tanzania | 1.37 (1.15, 1.65) | 0.001 | 1.40 (1.15, 1.69) | 0.001 |
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Nasrin, S.; Haque, M.A.; Palit, P.; Das, R.; Mahfuz, M.; Faruque, A.S.G.; Ahmed, T. Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1–24 Months in Low-Resource Settings. Life 2022, 12, 607. https://doi.org/10.3390/life12050607
Nasrin S, Haque MA, Palit P, Das R, Mahfuz M, Faruque ASG, Ahmed T. Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1–24 Months in Low-Resource Settings. Life. 2022; 12(5):607. https://doi.org/10.3390/life12050607
Chicago/Turabian StyleNasrin, Sabiha, Md. Ahshanul Haque, Parag Palit, Rina Das, Mustafa Mahfuz, Abu S. G. Faruque, and Tahmeed Ahmed. 2022. "Incidence of Asymptomatic Shigella Infection and Association with the Composite Index of Anthropometric Failure among Children Aged 1–24 Months in Low-Resource Settings" Life 12, no. 5: 607. https://doi.org/10.3390/life12050607