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dc.contributor.authorOperario, DJ
dc.contributor.authorPlatts-Mills, JA
dc.contributor.authorNadan, S
dc.contributor.authorPage, N
dc.contributor.authorSeheri, M
dc.contributor.authorMphahlele, J
dc.contributor.authorPraharaj, I
dc.contributor.authorKang, G
dc.contributor.authorAraujo, IT
dc.contributor.authorLeite, JPG
dc.contributor.authorCowley, D
dc.contributor.authorThomas, S
dc.contributor.authorKirkwood, CD
dc.contributor.authorDennis, F
dc.contributor.authorArmah, G
dc.contributor.authorMwenda, JM
dc.contributor.authorWijesinghe, PR
dc.contributor.authorRey, G
dc.contributor.authorGrabovac, V
dc.contributor.authorBerejena, C
dc.contributor.authorSimwaka, CJ
dc.contributor.authorUwimana, J
dc.contributor.authorSherchand, JB
dc.contributor.authorThu, HM
dc.contributor.authorGalagoda, G
dc.contributor.authorBonkoungou, IJO
dc.contributor.authorJagne, S
dc.contributor.authorTsolenyanu, E
dc.contributor.authorDiop, A
dc.contributor.authorEnweronu-Laryea, C
dc.contributor.authorBorbor, S-A
dc.contributor.authorLiu, J
dc.contributor.authorMcMurry, T
dc.contributor.authorLopman, B
dc.contributor.authorParashar, U
dc.contributor.authorGentsch, J
dc.contributor.authorSteele, AD
dc.contributor.authorCohen, A
dc.contributor.authorSerhan, F
dc.contributor.authorHoupt, ER
dc.date.accessioned2020-12-17T03:34:09Z
dc.date.available2020-12-17T03:34:09Z
dc.date.issued2017-07-15
dc.identifierpii: 3882676
dc.identifier.citationOperario, D. J., Platts-Mills, J. A., Nadan, S., Page, N., Seheri, M., Mphahlele, J., Praharaj, I., Kang, G., Araujo, I. T., Leite, J. P. G., Cowley, D., Thomas, S., Kirkwood, C. D., Dennis, F., Armah, G., Mwenda, J. M., Wijesinghe, P. R., Rey, G., Grabovac, V. ,... Houpt, E. R. (2017). Etiology of Severe Acute Watery Diarrhea in Children in the Global Rotavirus Surveillance Network Using Quantitative Polymerase Chain Reaction. JOURNAL OF INFECTIOUS DISEASES, 216 (2), pp.220-227. https://doi.org/10.1093/infdis/jix294.
dc.identifier.issn0022-1899
dc.identifier.urihttp://hdl.handle.net/11343/254938
dc.description.abstractBackground: The etiology of acute watery diarrhea remains poorly characterized, particularly after rotavirus vaccine introduction. Methods: We performed quantitative polymerase chain reaction for multiple enteropathogens on 878 acute watery diarrheal stools sampled from 14643 episodes captured by surveillance of children <5 years of age during 2013-2014 from 16 countries. We used previously developed models of the association between pathogen quantity and diarrhea to calculate pathogen-specific weighted attributable fractions (AFs). Results: Rotavirus remained the leading etiology (overall weighted AF, 40.3% [95% confidence interval {CI}, 37.6%-44.3%]), though the AF was substantially lower in the Americas (AF, 12.2 [95% CI, 8.9-15.6]), based on samples from a country with universal rotavirus vaccination. Norovirus GII (AF, 6.2 [95% CI, 2.8-9.2]), Cryptosporidium (AF, 5.8 [95% CI, 4.0-7.6]), Shigella (AF, 4.7 [95% CI, 2.8-6.9]), heat-stable enterotoxin-producing Escherichia coli (ST-ETEC) (AF, 4.2 [95% CI, 2.0-6.1]), and adenovirus 40/41 (AF, 4.2 [95% CI, 2.9-5.5]) were also important. In the Africa Region, the rotavirus AF declined from 54.8% (95% CI, 48.3%-61.5%) in rotavirus vaccine age-ineligible children to 20.0% (95% CI, 12.4%-30.4%) in age-eligible children. Conclusions: Rotavirus remained the leading etiology of acute watery diarrhea despite a clear impact of rotavirus vaccine introduction. Norovirus GII, Cryptosporidium, Shigella, ST-ETEC, and adenovirus 40/41 were also important. Prospective surveillance can help identify priorities for further reducing the burden of diarrhea.
dc.languageEnglish
dc.publisherOXFORD UNIV PRESS INC
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleEtiology of Severe Acute Watery Diarrhea in Children in the Global Rotavirus Surveillance Network Using Quantitative Polymerase Chain Reaction
dc.typeJournal Article
dc.identifier.doi10.1093/infdis/jix294
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.source.titleJournal of Infectious Diseases
melbourne.source.volume216
melbourne.source.issue2
melbourne.source.pages220-227
dc.rights.licenseCC BY
melbourne.elementsid1229792
melbourne.contributor.authorKirkwood, Carl
melbourne.contributor.authorCowley, Daniel
dc.identifier.eissn1537-6613
melbourne.accessrightsOpen Access


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