The Burden of Cryptosporidium Diarrheal Disease among Children < 24 Months of Age in Moderate/High Mortality Regions of Sub-Saharan Africa and South Asia, Utilizing Data from the Global Enteric Multicenter Study (GEMS)

Factors associated with nontyphoidal Salmonella (NTS) infection have not been well characterized to date. We aimed to compare the associated factors among children under age 5 years with NTS infection in sub-Saharan Africa and South Asia. Data from children having moderate-to-severe diarrhea (MSD) and asymptomatic children with NTS isolated from fecal specimens were extracted from the Global Enteric Multicenter Study (GEMS), conducted from December 2007 to March 2011. Compared with NTS-negative children, NTS-associated MSD cases in South Asia were associated with the presence of goat in the house (adjusted odds ratio [aOR]: 2.15; 95% confidence interval [CI]: 1.25–3.70) and handwashing after handling an animal (aOR: 2.26; 95% CI: 1.36–3.74). In sub-Saharan Africa, children with NTS associated MSD had a greater association with stunting (1.21 95% CI: 1.01–1.45), longer duration of diarrhea (aOR: 1.25 95% CI: 1.19–1.31); presence of cow in house (aOR: 1.54 95% CI: 1.09–2.16), handwashing after handling animal (aOR: 2.41 95% CI: 1.74–3.33). Drinking tube well water (aOR: 0.54 95% CI: 0.32–0.91), availability of toilet facility (aOR: 0.58 95% CI: 0.53–0.65), and handwashing before eating (aOR: 0.76 95% CI: 0.57–1.00) and after defecation (aOR: 0.80 95% CI: 0.69, 0.94) were found to be protective. The differentials between children of both regions having fecal NTS are distinct and underscore the need for policymaking for preventive and control strategies targeting stunted children.

Download Full-text

1660. Protective Effect of Living with Animals on Diarrheal Illness Among Children Younger Than Five in Sub-Saharan Africa and South Asia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1524 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S608-S608

Author(s):

Meghan T Murray ◽

Natalie Neu ◽

Elaine Larson

Keyword(s):

Risk Factors ◽

Protective Effect ◽

South Asia ◽

Exclusive Breastfeeding ◽

Diarrheal Disease ◽

Companion Animals ◽

Living Environment ◽

Sub Saharan Africa ◽

Diarrheal Illness ◽

Sub Saharan

Abstract Background Diarrheal disease is one of the top three causes of death in children <5 years old, with the majority occurring in sub-Saharan Africa and South Asia. Animals are known reservoirs of diarrheal pathogens. While previous studies have investigated companion animals and livestock as contributors to human diarrheal disease, few have investigated this association in sub-Saharan Africa and/or South Asia among children younger than 5 years old. The aim of this study was to determine the relationship between animals living in or near the home and diarrheal disease in this population. Methods We conducted a secondary analysis of the Global Enteric Multicenter Study (GEMS), a case–control study that described the epidemiology of and evaluated the risk factors for diarrheal illness in children <5 years old living in sub-Saharan Africa and South Asia. Children with moderate-to-severe diarrhea (MSD) were matched to community controls without diarrhea. Associations between the predictor of animals present in a child’s living environment and the outcomes of diarrhea and diarrheal pathogens were assessed using multivariable conditional logistic regression with alpha = 0.05. Known risk factors for MSD were assessed for confounding. Results From December 1, 2007 to March 3, 2011, there were 9,439 cases with MSD and 13,128 controls enrolled in GEMS. 87% of children had at least 1 animal present at their home. When controlling for exclusive breastfeeding, access to an improved water source, access to a private improved sanitation facility, and the number of children <5 living in the home, children were less likely to have MSD if there was at least one animal present at their home (aOR 0.66, CI95 0.59 – 0.74). Children living with an animal were also 15% less likely to be colonized or infected with a viral diarrheal pathogen (aOR 0.85, CI95 0.72–0.99), when controlling for exclusive breastfeeding. There were no significant differences in the presence of bacterial or protozoal pathogens in the stool of children with and without animals present at their home. Conclusion In contrast to prior research, having an animal present at the home does not appear to increase the risk of childhood diarrhea. Furthermore, the presence of animals may have a protective effect against viral diarrheal disease in young children. Additional research is needed to gain greater understanding of this relationship. Disclosures All authors: No reported disclosures.

Download Full-text

Campylobacter Abundance in Breastfed Infants and Identification of a New Species in the Global Enterics Multicenter Study

mSphere ◽

10.1128/msphere.00735-19 ◽

2020 ◽

Vol 5 (1) ◽

Cited By ~ 3

Author(s):

Xiaoming Bian ◽

Jolene M. Garber ◽

Kerry K. Cooper ◽

Steven Huynh ◽

Jennifer Jones ◽

...

Keyword(s):

New Species ◽

South Asia ◽

Multicenter Study ◽

The United States ◽

Sub Saharan Africa ◽

Content Type ◽

Breastfed Infants ◽

Sub Saharan ◽

A New Species ◽

Bacterial Diarrhea

ABSTRACT Campylobacter jejuni is a leading cause of bacterial diarrhea worldwide and is associated with high rates of mortality and growth stunting in children inhabiting low- to middle-resource countries. To better understand the impact of breastfeeding on Campylobacter infection in infants in sub-Saharan Africa and South Asia, we examined fecal microbial compositions, bacterial isolates, and their carbohydrate metabolic pathways in Campylobacter-positive infants <1 year of age from the Global Enterics Multicenter Study. Exclusively breastfed infants with diarrhea exhibited high Campylobacter abundances, and this negatively correlated with bacterial carbohydrate metabolism. Although C. jejuni and Campylobacter coli are prevalent among these infants, the second most abundant Campylobacter species was a new species, which we named “Candidatus Campylobacter infans.” Asymptomatic Campylobacter carriers also possess significantly different proportions of specific gut microbes compared to diarrheal cases. These findings provide insight into Campylobacter infections in infants in sub-Saharan Africa and South Asia and help inform strategies aimed at eliminating campylobacteriosis in these areas. IMPORTANCE Campylobacter is the primary cause of bacterial diarrhea in the United States and can lead to the development of the postinfectious autoimmune neuropathy known as Guillain-Barré syndrome. Also, drug-resistant campylobacters are becoming a serious concern both locally and abroad. In low- and middle-income countries (LMICs), infection with Campylobacter is linked to high rates of morbidity, growth stunting, and mortality in children, and breastfeeding is important for infant nutrition, development, and protection against infectious diseases. In this study, we examined the relationship between breastfeeding and Campylobacter infection and demonstrate the increased selection for C. jejuni and C. coli strains unable to metabolize fucose. We also identify a new Campylobacter species coinfecting these infants with a high prevalence in five of the seven countries in sub-Saharan Africa and South Asia examined. These findings indicate that more detailed studies are needed in LMICs to understand the Campylobacter infection process in order to devise a strategy for eliminating this pathogenic microbe.

Download Full-text

Chronic Poverty in Sub-Saharan Africa and South Asia: A Select Annotated Bibliography with Special Reference to Remote Rural Areas

SSRN Electronic Journal ◽

10.2139/ssrn.1754547 ◽

2001 ◽

Cited By ~ 1

Author(s):

Sam Hickey ◽

Karen Moore

Keyword(s):

Special Reference ◽

South Asia ◽

Rural Areas ◽

Annotated Bibliography ◽

Sub Saharan Africa ◽

Chronic Poverty ◽

Sub Saharan

Download Full-text

Catch-Up Index, Relative and Absolute Convergence, South Asia and Sub-Saharan Africa

SSRN Electronic Journal ◽

10.2139/ssrn.2909325 ◽

2017 ◽

Cited By ~ 1

Author(s):

Chander Kant

Keyword(s):

South Asia ◽

Absolute Convergence ◽

Sub Saharan Africa ◽

Catch Up ◽

Sub Saharan

Download Full-text

Human Development Paradigm for South Asia

10.1093/oso/9780199474684.003.0028 ◽

2018 ◽

Keyword(s):

South Asia ◽

Human Development ◽

Sub Saharan Africa ◽

Health And Nutrition ◽

The People ◽

Sub Saharan ◽

Development Paradigm

In the chapter, Haq gives a snapshot of the human progress of South Asia, comparing it with other regions. He was worried about the region beginning to lag behind all other regions, including Sub-Saharan Africa. He highlights the role of the two largest economies in the region, India and Pakistan, in financing the major investment in education, health and nutrition for the people. Haq advocates some fiscal and monetary reforms are suggested to invest in human development.

Download Full-text

Mapping of affordability levels for photovoltaic-based electricity generation in the solar belt of sub-Saharan Africa, East Asia and South Asia

Scientific Reports ◽

10.1038/s41598-021-82638-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sándor Szabó ◽

Irene Pinedo Pascua ◽

Daniel Puig ◽

Magda Moner-Girona ◽

Mario Negre ◽

...

Keyword(s):

East Asia ◽

South Asia ◽

Electricity Generation ◽

Sub Saharan Africa ◽

Solar Photovoltaic ◽

Term Operation ◽

Sub Saharan ◽

High Level ◽

Do So

AbstractLack of access to modern forms of energy hampers efforts to reduce poverty. The provision of electricity to off-grid communities is therefore a long-standing developmental goal. Yet, many off-grid electrification projects neglect mid- and long-term operation and maintenance costs. When this is the case, electricity services are unlikely to be affordable to the communities that are the project’s primary target. Here we show that, compared with diesel-powered electricity generation systems, solar photovoltaic systems are more affordable to no less than 36% of the unelectrified populations in East Asia, South Asia, and sub-Saharan Africa. We do so by developing geo-referenced estimates of affordability at a high level of resolution (1 km2). The analysis illustrates the differences in affordability that may be found at the subnational level, which underscores that electrification investments should be informed by subnational data.

Download Full-text