{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:49:39Z","timestamp":1789620579367,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["38874"],"award-info":[{"award-number":["38874"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"name":"VIDA","award":["OPP1111236"],"award-info":[{"award-number":["OPP1111236"]}]},{"name":"VIDA","award":["OPP1116751"],"award-info":[{"award-number":["OPP1116751"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Studies conducted before rotavirus vaccine introduction found that moderate-to-severe diarrhea (MSD) in children aged &amp;lt;5 years was associated with stunting at follow-up. It is unknown whether the reduction in rotavirus-associated MSD following vaccine introduction decreased the risk of stunting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Global Enteric Multicenter Study (GEMS) and the Vaccine Impact on Diarrhea in Africa (VIDA) study, two comparable matched case-control studies, were conducted during 2007\u20132011 and 2015\u20132018, respectively. We analyzed data from 3 African sites where rotavirus vaccine was introduced after GEMS and before starting VIDA. Children with acute MSD (&amp;lt;7 days onset) were enrolled from a health center and children without MSD (diarrhea-free for \u22657 days) were enrolled at home within 14 days of the index MSD case. The odds of being stunted at a follow-up visit 2\u20133 months after enrollment for an episode of MSD was compared between GEMS and VIDA using mixed-effects logistic regression models controlling for age, sex, study site, and socioeconomic status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We analyzed data from 8808 children from GEMS and 10 579 from VIDA. Among those who were not stunted at enrollment in GEMS, 8.6% with MSD and 6.4% without MSD became stunted during the follow-up period. In VIDA, 8.0% with MSD and 5.5% children without MSD developed stunting. An episode of MSD was associated with higher odds of being stunted at follow-up compared with children without MSD in both studies (adjusted odds ratio [aOR], 1.31; 95% confidence interval [CI]: 1.04\u20131.64 in GEMS and aOR, 1.30; 95% CI: 1.04\u20131.61 in VIDA). However, the magnitude of association was not significantly different between GEMS and VIDA (P = .965).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The association of MSD with subsequent stunting among children aged &amp;lt;5 years in sub-Saharan Africa did not change after rotavirus vaccine introduction. Focused strategies are needed for prevention of specific diarrheal pathogens that cause childhood stunting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac948","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T13:58:50Z","timestamp":1681912730000},"page":"S49-S57","source":"Crossref","is-referenced-by-count":6,"title":["Stunting Following Moderate-to-Severe Diarrhea Among Children Aged &amp;lt;5 Years in Africa Before and After Rotavirus Vaccine Introduction: A Comparison of the Global Enteric Multicenter Study and the Vaccine Impact on Diarrhea in Africa (VIDA) Study"],"prefix":"10.1093","volume":"76","author":[{"given":"Dilruba","family":"Nasrin","sequence":"first","affiliation":[{"name":"Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba O","family":"Sow","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Omore","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Jahangir","family":"Hossain","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanogo","family":"Doh","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins du Mali , Bamako , Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed M A","family":"Zaman","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joquina Chiquita M","family":"Jones","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine , Banjul , The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex O","family":"Awuor","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Center for Global Health Research , Kisumu , Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene N","family":"Kasumba","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , 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