Hidden killer: chronic gut bacteria stunts growth in poor countries
A major study reveals that nearly half of infants in developing regions suffer prolonged Campylobacter infections lasting months—not days—causing measurable stunting. The finding challenges assumptions that this foodborne pathogen causes only brief illness and signals a public health crisis demanding new intervention strategies in resource-limited settings.
Originaltitel: The epidemiology and impact of persistent Campylobacter infections on childhood growth among children 0–24 months of age in resource-limited settings
<p>Background</p><p>Campylobacter is the leading cause of bacterial gastroenteritis worldwide. It is generally associated with an acute gastrointestinal infection causing a self-limiting diarrheal episode. However, there is evidence that persistent/recurrent carriage of Campylobacter also occurs. In hyperendemic settings the epidemiology and consequences of persistent Campylobacter enteric infections is poorly studied.</p><p>Methods</p><p>Risk factors for and growth consequences of persistent Campylobacter infections detected by polymerase chain reaction (qPCR) were evaluated with data from the MAL-ED birth cohort study in children 0–24 months of age between November 2009 and February 2012. A persistent Campylobacter infection was defined as three or more consecutive Campylobacter positive monthly stools.</p><p>Findings</p><p>Across all study sites, 45.5% (781/1715) of children experienced at least one persistent Campylobacter episode. The average cumulative duration of days in which children with persistent Campylobacter were positive for Campylobacter spp. was 150 days (inter-quartile range: 28–236 days). Children who experienced a persistent Campylobacter episode had an attained 24-month length-for-age (LAZ) score that was 0.23 (95% (CI): −0.31, −0.15) less than children without a persistent Campylobacter episode. Among children who had at least one episode of Campylobacter over a 3-month or 9-month window, persistent episodes were not significantly associated with poorer 3-month weight gain (−28.7 g, 95% CI: −63.4 g, 6.0 g) but were associated with poorer 9-month linear growth (−0.134 cm 95% CI: −0.246, −0.022) compared to children with an episode that resolved within 31 days.</p><p>Interpretation</p><p>Persistent/recurrent Campylobacter infection is common among children and has a measurable negative impact on linear growth in early childhood.</p>