ArticlePloS one2016
Etiologies, Risk Factors and Impact of Severe Diarrhea in the Under-Fives in Moramanga and Antananarivo, Madagascar.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 5 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Prevalence and determinants of Campylobacter infection in under-five children of East Africa: systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Prevalence of Shigella species and antimicrobial resistance patterns in Africa: systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Pooled it
- Enteric pathogens associated with gastroenteritis among children under 5 years in sub-Saharan Africa: a systematic review and meta-analysis.Epidemiology and infection · 2020Pooled it
- Exposure to Animal Feces and Human Health: A Systematic Review and Proposed Research Priorities.Environmental science & technology · 2017Pooled it
- Identifying risk factors for vomiting during diarrhea: A secondary analysis of a randomized trial of zinc supplementation.Journal of pediatric gastroenterology and nutrition · 2025Trial
- Diarrhea and its associated factors among children aged under five years in Madagascar, 2024: a multilevel logistic regression analysis.BMC public health · 2024Article
- Addressing Fecal Contamination in Rural Kenyan Households: The Roles of Environmental Interventions and Animal Ownership.Environmental science & technology · 2024Article
- Factors Associated with Carriage of Enteropathogenic and Non-Enteropathogenic Viruses: A Reanalysis of Matched Case-Control Data from the AFRIBIOTA Site in Antananarivo, Madagascar.Pathogens (Basel, Switzerland) · 2023Article
- Comparing transmission potential networks based on social network surveys, close contacts and environmental overlap in rural Madagascar.Journal of the Royal Society, Interface · 2022Article
- Development of a diarrhoea severity scoring scale in a passive health facility-based surveillance system.PloS one · 2022Article
- Global epidemiology of campylobacteriosis and the impact of COVID-19.Frontiers in cellular and infection microbiology · 2022Review
- Determinants of diarrheal diseases among under five children in Jimma Geneti District, Oromia region, Ethiopia, 2020: a case-control study.BMC pediatrics · 2021Article
- Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic.Maternal and child health journal · 2021Article
- A Systematic Review ofEvidence-based complementary and alternative medicine : eCAM · 2020Review
- Identifying the etiology and pathophysiology underlying stunting and environmental enteropathy: study protocol of the AFRIBIOTA project.BMC pediatrics · 2018Article
- Hypoglycemia and failure of respiratory compensation are risk factors for mortality in diarrheic calves in Hokkaido, northern Japan.The Journal of veterinary medical science · 2018Article
- Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA).PloS one · 2017Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiarrheal disease remains a leading cause of death in children in low-income countries. We investigated the etiology, risk factors and effects on nutritional status of severe diarrhea in children from two districts in Madagascar.
methodsWe performed a matched case-control study in 2011 to 2014, on children under the age of five years from Moramanga and Antananarivo. The cases were children hospitalized for severe diarrhea and the controls were children without diarrhea selected at random from the community. Stool samples were collected from both groups. Anthropometric measurements were made during follow-up visits about one and two months after enrolment.
resultsWe enrolled 199 cases and 199 controls. Rotavirus infection was the most frequently detected cause of diarrhea. It was strongly associated with severe diarrhea (OR: 58.3; 95% CI: 7.7-439.9), accounting for 42.4% (95% CI: 37.6-43.1) of severe diarrhea cases. At the household level, possession of cattle (OR = 0.3; 95% CI: 0.1-0.6) and living in a house with electricity (OR = 0.4; 95% CI: 0.2-0.8) were protective factors. The presence of garbage around the house was a risk factor for severe diarrhea (OR = 3.2; 95% CI: 1.9-5.4). We found no significant association between severe diarrhea and the nutritional status of the children at follow-up visits, but evident wasting at enrolment was associated with a higher risk of severe diarrhea (OR = 9; 95% CI: 4.5-17.9).
conclusionsSevere childhood diarrhea is mostly caused by rotavirus infection. An anti-rotavirus vaccine has already been introduced in Madagascar and should be promoted more widely. However, post-licensing surveillance is required. Interventions to improve the nutritional status of children, preventive measures focused on household and personal hygiene and nutritional rehabilitation during severe diarrheal disease should be reinforced.
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