American Journal of Epidemiology Vol. 154, No. 2 : 166-173
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Pathogenicity and Convalescent Excretion of Campylobacter in Rural Egyptian Children
1 Epidemiology Branch, National Institute of Child Health and Human Development, Bethesda, MD.
2 US Naval Medical Research Unit-3, Cairo, Egypt.
3 International Vaccine Institute, Seoul, South Korea.
Campylobacter infection in developing countries has not received much public health attention because of the observation that infections are not associated with disease beyond the first 6 months of life. A cohort of 397 Egyptian children aged less than 3 years, who were observed twice weekly during 1995–1998, experienced an incidence of 0.6 episodes of Campylobacter diarrhea per child-year. A total of 13% of the Campylobacter diarrheal episodes were characterized by severe dehydration. Age-specific incidence rates (episodes per year) were 0.9 in infants aged less than 6 months, 1.5 in those 6–12 months, and 0.4 and 0.2 in the second and third years of life, respectively. Convalescent excretion of Campylobacter after a diarrheal episode might be enhancing transmission and contributing to this high incidence. Observed risk factors for Campylobacter diarrhea were poor hygienic conditions and the presence of animals in the house. Regardless of the child's age, a first infection by Campylobacter was associated with diarrhea (odds ratio = 2.45; 95% confidence interval: 1.61, 3.71); however, subsequent infections were associated with diarrhea only in children aged less than 6 months. This observation that natural infection did not confer protection during the first 6 months of life poses a challenge to vaccine development.
Campylobacter; cohort studies; convalescence; diarrhea
Abbreviations: CI, confidence interval; OR, odds ratio; RR, relative rate
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