ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Etiology, Presentation, and Risk Factors for Diarrheal Syndromes in 3 Sub-Saharan African Countries After the Introduction of Rotavirus Vaccines From the Vaccine Impact on Diarrhea in Africa (VIDA) Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed.
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- Characteristics and outcomes of children 2-23 months of age with prolonged diarrhoea: A secondary analysis of data from the 'Antibiotics for Children with Diarrhea' trial.Journal of global health · 2024Trial
- Vulnerability to climate-driven pathogen-specific diarrheal diseases: secondary analysis from the Global Enteric Multicenter Study and Vaccine Impact on Diarrhea in Africa follow-up.Nature communications · 2026Article
- The consequences ofEClinicalMedicine · 2026Article
- Performance of fecal inflammatory biomarkers to identify watery shigellosis: Findings from the Enterics for Global Health (EFGH) Shigella surveillance study.PLoS neglected tropical diseases · 2026Article
- Burden of diarrheal diseases among children under five in East Africa, 2000-2023: insights from the global burden of disease 2023 study.BMC infectious diseases · 2026Article
- Deployment of a machine learning-based predictive system for childhood diarrhea in Sub-Saharan Africa.Scientific reports · 2026Article
- Prevalence and risk factors of diarrhea among young children in Kenya's drylands: A longitudinal study.PLOS global public health · 2026Article
- Natural history parameters for enteric pathogens to inform modeling studies of diarrhea among children in low-resource settings: results from the MAL-ED longitudinal birth cohort.BMC infectious diseases · 2025Article
- National trends in burden of enteric infections in China: Shifts from 1990 to 2021.Infectious medicine · 2025Article
- Whole-genome analysis of rotavirus G1P[8] and other Wa-like strains in Mozambican children: evidence of genetic variations of pre-vaccine G1P[8] strains from Manhiça, Mozambique.Microbial genomics · 2025Article
- Development and Evaluation of a Nanoparticle-Based Immunoassay for Rotavirus Detection: A Suitable Alternative to ELISA and PCR in Low-Income Setting.Methods and protocols · 2025Article
- Versatile Imidazole Scaffold with Potent Activity against Multiple Apicomplexan Parasites.ACS infectious diseases · 2025Article
- Cohort Profile: Basse Health and Demographic Surveillance System, the Gambia.International journal of epidemiology · 2025Article
- Multicountry surveillance study of acute febrile disease of unknown cause in sub-Saharan Africa.BMJ public health · 2025Article
- Microphysiological gut-on-chip enables extendedFrontiers in cellular and infection microbiology · 2025Article
- Genomic analysis of DS-1-like human rotavirus A strains uncovers genetic relatedness of NSP4 gene with animal strains in Manhiça District, Southern Mozambique.Scientific reports · 2024Article
- Etiologies of Bloody Diarrhea in Children Presenting With Acute Gastroenteritis to US Emergency Departments.Open forum infectious diseases · 2024Article
- Impact of rotavirus vaccination in Malawi from 2012 to 2022 compared to model predictions.NPJ vaccines · 2024Article
- A Pumpless and Tubeless Microfluidic Device Enables Extended In Vitro Development ofOpen forum infectious diseases · 2024Article
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20 authors.
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Abstract
backgroundDiarrheal disease is heterogeneous, including watery diarrhea (WD) and dysentery, some cases of which become persistent diarrhea (PD). Changes in risk over time necessitate updated knowledge of these syndromes in sub-Saharan Africa.
methodsThe Vaccine Impact on Diarrhea in Africa (VIDA) study was an age-stratified, case-control study of moderate-to-severe diarrhea among children <5 years old in The Gambia, Mali, and Kenya (2015-2018). We analyzed cases with follow-up of about 60 days after enrollment to detect PD (lasting ≥14 days), examined the features of WD and dysentery, and examined determinants for progression to and sequelae from PD. Data were compared with those from the Global Enteric Multicenter Study (GEMS) to detect temporal changes. Etiology was assessed from stool samples using pathogen attributable fractions (AFs), and predictors were assessed using χ2 tests or multivariate regression, where appropriate.
resultsAmong 4606 children with moderate-to-severe diarrhea, 3895 (84.6%) had WD and 711 (15.4%) had dysentery. PD was more frequent among infants (11.3%) than in children 12-23 months (9.9%) or 24-59 months (7.3%), P = .001 and higher in Kenya (15.5%) than in The Gambia (9.3%) or Mali (4.3%), P < .001; the frequencies were similar among children with WD (9.7%) and those with dysentery (9.4%). Compared to children not treated with antibiotics, those who received antibiotics had a lower frequency of PD overall (7.4% vs 10.1%, P = .01), and particularly among those with WD (6.3% vs 10.0%; P = .01) but not among children with dysentery (8.5% vs 11.0%; P = .27). For those with watery PD, Cryptosporidium and norovirus had the highest AFs among infants (0.16 and 0.12, respectively), while Shigella had the highest AF (0.25) in older children. The odds of PD decreased significantly over time in Mali and Kenya while increasing significantly in The Gambia.
conclusionsThe burden of PD endures in sub-Saharan Africa, with nearly 10% of episodes of WD and dysentery becoming persistent.
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