Author(s):
Khalil, Ibrahim A. ; Troeger, Christopher ; Rao, Puja C. ; Blacker, Brigette F. ; Brown, Alexandria ; Brewer, Thomas G. ; Colombara, Danny V. ; Hostos, Eugenio L. de ; Engmann, Cyril ; Guerrant, Richard L. ; Haque, Rashidul ; Houpt, Eric R. ; Kang, Gagandeep ; Korpe, Poonum S. ; Kotloff, Karen L. ; Lima, Aldo A. M. ; Petri Jr., William A. ; Platts-Mills, James A. ; Shoultz, David A. ; Forouzanfar, Mohammed H. ; Hay, Simon I. ; Reiner Jr, Robert C. ; Mokdad, Ali H.
Date: 2018
Origin: Oasisbr
Subject(s): Morbidade; Morbidity; Cryptosporidium
Description
Background The protozoan Cryptosporidium is a leading cause of diarrhoea morbidity and mortality in children younger than 5 years. However , the true global burden of C ryptosporidium infection in children younger than 5 years might have been underestimated in previous quantifications because it only took account of the acute eects of diarrhoea. W e aimed to demonstrate whether there is a causal relation between C ryptosporidium and childhood growth and, if so, to quantify the associated additional burden. Methods The Global Burden of Diseases, Injuries, and Risk F actors study (GBD) 2016 was a systematic and scientific eort to quantify the morbidity and mortality associated with more than 300 causes of death and disability , including diarrhoea caused by C ryptosporidium infection. W e supplemented estimates on the burden of C ryptosporidium in GBD 2016 with findings from a systematic review of published and unpublished cohort studies and a meta-analysis of the eect of childhood diarrhoea caused by C ryptosporidium infection on physical growth Findings In 2016, Cryptosporidium infection was the fifth leading diarrhoeal aetiology in children younger than 5 years, and acute infection caused more than 48 000 deaths (95% uncertainty interval [UI] 24 600–81 900) and more than 4·2 million disability-adjusted life-years lost (95% UI 2·2 million–7·2 million). W e identified seven data sources from the scientific literature and six individual-level data sources describing the relation between C ryptosporidium and childhood growth. Each episode of diarrhoea caused by C ryptosporidium infection was associated with a decrease in height-for -age Z score (0·049, 95% CI 0·014–0·080), weight-for-age Z score (0·095, 0·055–0·134), and weight-for -height Z score (0·126, 0·057–0·194). W e estimated that diarrhoea from C ryptosporidium infection caused an additional 7·85 million disability-adjusted life-years (95% UI 5·42 million–10·11 million) after we accounted for its eect on growth faltering—153% more than that estimated from acute eects alone. Interpretation Our findings show that the substantial short-term burden of diarrhoea from Cryptosporidium infection on childhood growth and wellbeing is an underestimate of the true burden. Interventions designed to prevent and eectively treat infection in children younger than 5 years will have enormous public health and social development impacts.
