Cumulative Febrile, Respiratory, and Gastrointestinal Illness Among Infants in Rural Guatemala and Association With Neurodevelopmental and Growth Outcomes.
| Title: | Cumulative Febrile, Respiratory, and Gastrointestinal Illness Among Infants in Rural Guatemala and Association With Neurodevelopmental and Growth Outcomes. |
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| Authors: | Olson D; From the Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.; Center for Global Health, Colorado School of Public Health, Aurora, CO.; Children's Hospital Colorado, Aurora, CO.; Department of Epidemiology, Colorado School of Public Health, Aurora, CO.; Lamb MM; Center for Global Health, Colorado School of Public Health, Aurora, CO.; Department of Epidemiology, Colorado School of Public Health, Aurora, CO.; Connery AK; Children's Hospital Colorado, Aurora, CO.; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO.; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.; Colbert AM; Children's Hospital Colorado, Aurora, CO.; Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO.; Calvimontes DM; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Bauer D; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Paniagua-Avila MA; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Martínez MA; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Arroyave P; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Hernandez S; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; Colborn KL; Department of Surgery, University of Colorado School of Medicine, Aurora, CO.; Roell Y; Center for Global Health, Colorado School of Public Health, Aurora, CO.; Waggoner JJ; Department of Medicine, Emory University School of Medicine, Atlanta, GA.; Natrajan MS; Department of Medicine, Emory University School of Medicine, Atlanta, GA.; Anderson EJ; Department of Medicine, Emory University School of Medicine, Atlanta, GA.; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.; Bolaños GA; Center for Human Development, Fundacion para la Salud Integral de los Guatemaltecos, Retalhuleu, Guatemala.; El Sahly HM; Department of Molecular Virology and Microbiology.; Munoz FM; Department of Pediatrics, Baylor College of Medicine, Houston, TX.; Asturias EJ; From the Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.; Center for Global Health, Colorado School of Public Health, Aurora, CO.; Children's Hospital Colorado, Aurora, CO.; Department of Epidemiology, Colorado School of Public Health, Aurora, CO. |
| Source: | The Pediatric infectious disease journal [Pediatr Infect Dis J] 2023 Sep 01; Vol. 42 (9), pp. 739-744. Date of Electronic Publication: 2023 Jun 21. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Baltimore, Md. : Williams & Wilkins, c1987- |
| MeSH Terms: | Microcephaly*; Guatemala/epidemiology ; Diarrhea/epidemiology ; Growth Disorders/epidemiology ; Humans ; Infant ; Aged, 80 and over ; Cough ; Vomiting |
| Abstract: | Background: Infectious disease exposures in early life are increasingly recognized as a risk factor for poor subsequent growth and neurodevelopment. We aimed to evaluate the association between cumulative illness with neurodevelopment and growth outcomes in a birth cohort of Guatemalan infants.; Methods: From June 2017 to July 2018, infants 0-3 months of age living in a resource-limited region of rural southwest Guatemala were enrolled and underwent weekly at-home surveillance for caregiver-reported cough, fever, and vomiting/diarrhea. They also underwent anthropometric assessments and neurodevelopmental testing with the Mullen Scales of Early Learning (MSEL) at enrollment, 6 months, and 1 year.; Results: Of 499 enrolled infants, 430 (86.2%) completed all study procedures and were included in the analysis. At 12-15 months of age, 140 (32.6%) infants had stunting (length-for-age Z [LAZ] score < -2 SD) and 72 (16.7%) had microcephaly (occipital-frontal circumference [OFC] < -2 SD). In multivariable analysis, greater cumulative instances of reported cough illness (beta = -0.08/illness-week, P = 0.06) and febrile illness (beta = -0.36/illness-week, P < 0.001) were marginally or significantly associated with lower MSEL Early Learning Composite (ELC) Score at 12-15 months, respectively; there was no association with any illness (cough, fever, and/or vomiting/diarrhea; P = 0.27) or with cumulative instances of diarrheal/vomiting illness alone ( P = 0.66). No association was shown between cumulative instances of illness and stunting or microcephaly at 12-15 months.; Conclusions: These findings highlight the negative cumulative consequences of frequent febrile and respiratory illness on neurodevelopment during infancy. Future studies should explore pathogen-specific illnesses, host response associated with these syndromic illnesses, and their association with neurodevelopment.; (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.) |
| Competing Interests: | The authors have no conflicts of interest to disclose. |
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| Grant Information: | 75N93021C00012 United States AI NIAID NIH HHS; HHSN272201300015I United States AI NIAID NIH HHS; K23 AI143967 United States AI NIAID NIH HHS; UL1 TR001082 United States TR NCATS NIH HHS |
| Entry Date(s): | Date Created: 20230621 Date Completed: 20230816 Latest Revision: 20250614 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10527407 |
| DOI: | 10.1097/INF.0000000000004006 |
| PMID: | 37343218 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't