{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:28:44Z","timestamp":1789036124091,"version":"build-2803163510"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T00:00:00Z","timestamp":1482537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cryptosporidium is a leading cause of moderate to severe childhood diarrhea in resource-poor settings. Understanding the natural history of cryptosporidiosis and the correlates of protection are essential to develop effective and sustainable approaches to disease control and prevention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children (N = 497) were recruited at birth in semiurban slums in Vellore, India, and followed for 3 years with twice-weekly home visits. Stool samples were collected every 2 weeks and during diarrheal episodes were tested for Cryptosporidium species by polymerase chain reaction (PCR). Serum samples obtained every 6 months were evaluated for seroconversion, defined as a 4-fold increase in immunoglobulin G directed against Cryptosporidium gp15 and\/or Cp23 antigens between consecutive sera.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 410 children completing follow-up, 397 (97%) acquired cryptosporidiosis by 3 years of age. PCR identified 1053 episodes of cryptosporidiosis, with an overall incidence of 0.86 infections per child-year by stool and serology. The median age for the first infection was 9 (interquartile range, 4\u201317) months, indicating early exposure. Although infections were mainly asymptomatic (693 [66%]), Cryptosporidium was identified in 9.4% of diarrheal episodes. The proportion of reinfected children was high (81%) and there was clustering of asymptomatic and symptomatic infections (P &amp;lt; .0001 for both). Protection against infection increased with the order of infection but was only 69% after 4 infections. Cryptosporidium hominis (73.3%) was the predominant Cryptosporidium species, and there was no species-specific protection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a high burden of endemic cryptosporidiosis in southern India. Clustering of infection is suggestive of host susceptibility. Multiple reinfections conferred some protection against subsequent infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciw730","type":"journal-article","created":{"date-parts":[[2016,11,1]],"date-time":"2016-11-01T12:05:18Z","timestamp":1478001918000},"page":"347-354","source":"Crossref","is-referenced-by-count":35,"title":["Natural History of Cryptosporidiosis in a Birth Cohort in Southern India"],"prefix":"10.1093","volume":"64","author":[{"given":"Deepthi","family":"Kattula","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithya","family":"Jeyavelu","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok D","family":"Prabhakaran","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanna S","family":"Premkumar","sequence":"first","affiliation":[{"name":"Department Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasanthakumar","family":"Velusamy","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Venugopal","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi C","family":"Geetha","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin P","family":"Lazarus","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Princey","family":"Das","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthick","family":"Nithyanandhan","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, 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