{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T23:26:25Z","timestamp":1781306785055,"version":"3.54.1"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,10,5]]},"abstract":"<jats:p>We report the clinical findings, epidemiology, and risk factors for moderate-to-severe diarrhea (MSD) associated with <jats:italic>Aeromonas<\/jats:italic> species in children 0\u201359 months of age, from the Global Enteric Multicenter Study, conducted at three sites in south Asia and four sites in sub-Saharan Africa. Children with MSD were enrolled along with controls matched for age, gender, and neighborhood. Pooled, age-stratified conditional logistic regression models were applied to evaluate the association of <jats:italic>Aeromonas<\/jats:italic> infection controlling for coinfecting pathogens and sociodemographic variables. A pooled, age-stratified, multivariate logistic regression analysis was done to identify risk factors associated with <jats:italic>Aeromonas<\/jats:italic> positivity in MSD cases. A total of 12,110 cases and 17,291 matched controls were enrolled over a period of 48 months. <jats:italic>Aeromonas<\/jats:italic> was identified as a significant pathogen in 736 cases of MSD in Pakistan and Bangladesh (22.2%). <jats:italic>Aeromonas<\/jats:italic> remained a significant pathogen even after adjustment for the presence of other pathogens and sociodemographic factors. Odds ratio (OR) for <jats:italic>Aeromonas<\/jats:italic> were higher in the presence of <jats:italic>Shigella<\/jats:italic> (matched OR: 6.2, 95% confidence interval [CI]: 1.9\u201320.2). Cases of <jats:italic>Aeromonas<\/jats:italic> were likely to present with dysentery, particularly in the 0\u201311 months (OR: 1.4, 95% CI 1.0\u20132.0) and 12\u201323 months (OR: 1.8, 95% CI: 1.3\u20132.5) age group. The odds of <jats:italic>Aeromonas<\/jats:italic> increased with increasing degree of stunting, being highest for severe stunting (OR: 10.1, 95% CI: 3.6\u201328.9). <jats:italic>Aeromonas<\/jats:italic> is a significant pathogen for MSD in Pakistan and Bangladesh. Presence of dysentery and co-occurrence with other pathogens, notably <jats:italic>Shigella<\/jats:italic> spp. are significant features of <jats:italic>Aeromonas<\/jats:italic>-associated diarrhea.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0321","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T00:43:10Z","timestamp":1471308190000},"page":"774-780","source":"Crossref","is-referenced-by-count":38,"title":["Aeromonas-Associated Diarrhea in Children Under 5 Years: The GEMS Experience"],"prefix":"10.4269","volume":"95","author":[{"given":"Farah Naz","family":"Qamar","sequence":"first","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Imran","family":"Nisar","sequence":"additional","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farheen","family":"Quadri","sequence":"additional","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Shakoor","sequence":"additional","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samba O.","family":"Sow","sequence":"additional","affiliation":[{"name":"2Center for Vaccine Development, Ministry of Health, Bamako, Mali."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilruba","family":"Nasrin","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Blackwelder","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukun","family":"Wu","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Farag","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."},{"name":"5Vaccine Development and Surveillance, Bill & Melinda Gates Foundation, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Panchalingham","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipika","family":"Sur","sequence":"additional","affiliation":[{"name":"6Division of Epidemiology, National Institute of Cholera and Enteric Diseases, Kolkata, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahida","family":"Qureshi","sequence":"additional","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu S. G.","family":"Faruque","sequence":"additional","affiliation":[{"name":"7Clinical Sciences Division, International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debasish","family":"Saha","sequence":"additional","affiliation":[{"name":"8Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro L.","family":"Alonso","sequence":"additional","affiliation":[{"name":"9International Health Research, Barcelona Centre for International Health Research (CRESIB), Hospital Cl\u00ednic\u2013Universitat de Barcelona, Barcelona, Spain."},{"name":"10Microbiology, Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhi\u00e7a (CISM), Maputo, Mozambique."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Breiman","sequence":"additional","affiliation":[{"name":"11International Emerging Infections Program, Kenya Medical Research Institute\/Centers for Disease Control and Prevention (KEMRI\/CDC), Nairobi, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[{"name":"9International Health Research, Barcelona Centre for International Health Research (CRESIB), Hospital Cl\u00ednic\u2013Universitat de Barcelona, Barcelona, Spain."},{"name":"12ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Cl\u00ednic\u2013Universitat de Barcelona, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boubou","family":"Tamboura","sequence":"additional","affiliation":[{"name":"1Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan."},{"name":"13Centre National d'Appui \u00e0 la lutte contre la Maladie\/Centre pour le D\u00e9veloppement des Vaccins (CNAM\/CVD-Mali), Bamako, Mali."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thandavarayan","family":"Ramamurthy","sequence":"additional","affiliation":[{"name":"6Division of Epidemiology, National Institute of Cholera and Enteric Diseases, Kolkata, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suman","family":"Kanungo","sequence":"additional","affiliation":[{"name":"6Division of Epidemiology, National Institute of Cholera and Enteric Diseases, Kolkata, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnawaz","family":"Ahmed","sequence":"additional","affiliation":[{"name":"8Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anowar","family":"Hossain","sequence":"additional","affiliation":[{"name":"8Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumon K.","family":"Das","sequence":"additional","affiliation":[{"name":"8Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Antonio","sequence":"additional","affiliation":[{"name":"14Child Survival Theme, Molecular Diagnostics, Medical Research Council (MRC) Unit, Banjul, The Gambia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Jahangir","family":"Hossain","sequence":"additional","affiliation":[{"name":"14Child Survival Theme, Molecular Diagnostics, Medical Research Council (MRC) Unit, Banjul, The Gambia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inacio","family":"Mandomando","sequence":"additional","affiliation":[{"name":"9International Health Research, Barcelona Centre for International Health Research (CRESIB), Hospital Cl\u00ednic\u2013Universitat de Barcelona, Barcelona, Spain."},{"name":"10Microbiology, Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhi\u00e7a (CISM), Maputo, Mozambique."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Tennant","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Kotloff","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron M.","family":"Levine","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University of Maryland, Baltimore School of Medicine, Maryland."},{"name":"4Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita K. M.","family":"Zaidi","sequence":"additional","affiliation":[{"name":"5Vaccine Development and Surveillance, Bill & Melinda Gates Foundation, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"J Infect Dev Ctries","first-page":"81","article-title":"Aeromonas-associated infections in developing countries","volume":"2","author":"Ghenghesh","year":"2008"},{"issue":"(Suppl 144)","key":"ref2","series-title":"Acta Path Microbiol Scand","first-page":"299","article-title":"Aeromonas hydrophila isolated from human feces and its possible pathological significance","volume":"51","author":"Lautrop","year":"1961"},{"key":"ref3","series-title":"J Infect Dis","first-page":"68","article-title":"The microbiology of childhood gastroenteritis: Aeromonas species and other infective agents","volume":"148","author":"Burke","year":"1983"},{"key":"ref4","series-title":"J Clin 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