Karen L. Kotloff, James P. Nataro, William C. Blackwelder, Dilruba Nasrin et al.
Background Diarrhoeal diseases cause illness and death among children younger than 5 years in low-income countries. We designed the Global Enteric Multicenter Study (GEMS) to identify the aetiology and population-based burden of paediatric diarrhoeal disease in sub-Saharan Africa and south Asia. Met...
Sofie Livio, Nancy Strockbine, Sandra Panchalingam, Sharon M. Tennant et al.
BACKGROUND: Shigella, a major diarrheal disease pathogen worldwide, is the target of vaccine development. The Global Enteric Multicenter Study (GEMS) investigated burden and etiology of moderate-to-severe diarrheal disease in children aged <60 months and matched controls without diarrhea during 3 ye...
Karen L. Kotloff, William C. Blackwelder, Dilruba Nasrin, James P. Nataro et al.
BACKGROUND: Diarrhea is a leading cause of illness and death among children aged <5 years in developing countries. This paper describes the clinical and epidemiological methods used to conduct the Global Enteric Multicenter Study (GEMS), a 3-year, prospective, age-stratified, case/control study to e...
Florian Marks, Vera von Kalckreuth, Peter Aaby, Yaw Adu‐Sarkodie et al.
BACKGROUND: Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence estimates of typhoid fever and invasive non-...
Samba O. Sow, Khitam Muhsen, Dilruba Nasrin, William C. Blackwelder et al.
BACKGROUND: The importance of Cryptosporidium as a pediatric enteropathogen in developing countries is recognized. METHODS: Data from the Global Enteric Multicenter Study (GEMS), a 3-year, 7-site, case-control study of moderate-to-severe diarrhea (MSD) and GEMS-1A (1-year study of MSD and less-sever...
Marta‐Louise Ackers, Nancy D. Puhr, Robert V. Tauxe, Eric D. Mintz
CONTEXT: Multidrug-resistant Salmonella serotype Typhi infections have been reported worldwide, but data on the incidence of resistant strains in the United States are lacking. OBJECTIVES: To determine the incidence of antimicrobial-resistant Salmonella Typhi infections and to identify risk factors ...
Anna Bowen, Huilai Ma, Jianming Ou, Ward Billhimer et al.
Intensive handwashing promotion can reduce diarrheal and respiratory disease incidence. To determine whether less intensive, more scalable interventions can improve health, we evaluated a school-based handwashing program. We randomized 87 Chinese schools to usual practices: standard intervention (ha...
Myron M. Levine, Dilruba Nasrin, Sozinho Acácio, Quique Bassat et al.
BACKGROUND: The Global Enteric Multicenter Study (GEMS) was a 3-year case-control study that measured the burden, aetiology, and consequences of moderate-to-severe diarrhoea (MSD) in children aged 0-59 months. GEMS-1A, a 12-month follow-on study, comprised two parallel case-control studies, one asse...
Kelly K. Baker, Ciara E. O’Reilly, Myron M. Levine, Karen L. Kotloff et al.
BACKGROUND: Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal ...
Ellen B. Steinberg, Richard D. Bishop, Penina Haber, Amanda F. Dempsey et al.
To clarify indications for typhoid vaccination, we reviewed laboratory-confirmed cases of typhoid fever reported to the United States Centers for Disease Control and Prevention between 1994 and 1999. To estimate the risk of adverse events associated with typhoid vaccination, we reviewed reports to t...
Aliya Naheed, Pavani K. Ram, W. Abdullah Brooks, M. Anowar Hossain et al.
BACKGROUND: We conducted blood culture surveillance to estimate the incidence of typhoid and paratyphoid fever among urban slum residents in Dhaka, Bangladesh. METHODS: Between January 7, 2003 and January 6, 2004, participants were visited weekly to detect febrile illnesses. Blood cultures were obta...
Sean M. Moore, Andrew S. Azman, Benjamin F. Zaitchik, Eric D. Mintz et al.
The El Niño Southern Oscillation (ENSO) and other climate patterns can have profound impacts on the occurrence of infectious diseases ranging from dengue to cholera. In Africa, El Niño conditions are associated with increased rainfall in East Africa and decreased rainfall in southern Africa, West Af...
Dilruba Nasrin, William C. Blackwelder, Halvor Sommerfelt, Yukun Wu et al.
BACKGROUND: The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment. METHODS: The Global Enteric Mul...
Roberto Vidal, Khitam Muhsen, Sharon M. Tennant, Ann‐Mari Svennerholm et al.
BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) encoding heat-stable enterotoxin (ST) alone or with heat-labile enterotoxin (LT) cause moderate-to-severe diarrhea (MSD) in developing country children. The Global Enteric Multicenter Study (GEMS) identified ETEC encoding ST among the top four ente...
Vera von Kalckreuth, Frank Konings, Peter Aaby, Yaw Adu‐Sarkodie et al.
BACKGROUND: New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive meas...