{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:46:17Z","timestamp":1789605977515,"version":"build-2803163510"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Rotavirus is the leading cause of dehydrating diarrhea among children in developing countries. The impact of rotaviral diarrhea on nutritional status is not well understood. We aimed to determine the association between rotavirus-positive moderate-to-severe diarrhea and nutrition in children under 5\u2009years of age. We analyzed data from the Global Enteric Multicenter Study on children 0\u201359 months old from South Asia and sub-Saharan Africa. The relationships between explanatory variables and outcome variables were assessed using multiple linear regression; the explanatory variable was the presence of rotavirus in the stool sample, and the outcome variables were <jats:italic>z<\/jats:italic> scores [length\/height-for-age (LAZ\/HAZ), weight-for-age (WAZ), and weight-for-length\/height (WLZ\/WHZ)] at follow-up (\u223c60\u2009days). The prevalence of rotaviral diarrhea was 17.3% (905\/5,219) in South Asia and 19.95% (842\/4,220) in sub-Saharan Africa. Rotavirus was associated with higher LAZ\/HAZ (\u03b2: 0.19; 95% CI: 0.12, 0.26; <jats:italic>P<\/jats:italic> &lt;0.001) and WAZ (\u03b2: 0.15; 95% CI: 0.79, 0.22; <jats:italic>P<\/jats:italic> &lt;0.001) in sub-Saharan Africa and with lower WLZ\/WHZ (\u03b2 coefficient: \u22120.08; 95% CI: \u22120.15, \u22120.009; <jats:italic>P<\/jats:italic> = 0.027) in South Asia. Our study indicates that rotaviral diarrhea is positively associated with nutritional status in sub-Saharan Africa and is negatively associated with nutritional status in South Asia. An expedited implementation policy of ongoing preventive and control strategies, including vaccination against rotavirus, is necessary to reduce the burden of rotaviral diarrhea, which may further help to reduce the potential nutritional ramifications.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0406","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T22:04:22Z","timestamp":1708466662000},"page":"749-758","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Rotaviral Diarrhea on Child Growth in Sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study"],"prefix":"10.4269","volume":"110","author":[{"given":"Rukaeya Amin","family":"Sobi","sequence":"first","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al-Afroza","family":"Sultana","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soroar Hossain","family":"Khan","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Ahshanul","family":"Haque","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharika","family":"Nuzhat","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"},{"name":"James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Nasif","family":"Hossain","sequence":"additional","affiliation":[{"name":"Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradip K.","family":"Bardhan","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammod Jobayer","family":"Chisti","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhra","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahmeed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"},{"name":"James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh;"},{"name":"Department of Global Health, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Das","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"},{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu S. G.","family":"Faruque","sequence":"additional","affiliation":[{"name":"Nutrition Research Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Bull World Health Organ","first-page":"197","article-title":"The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000","volume":"81","author":"Kosek","year":"2003"},{"key":"b2","year":"2019"},{"key":"b3","series-title":"Lancet","first-page":"209","article-title":"Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study","volume":"382","author":"Kotloff","year":"2013"},{"key":"b4","year":"2022"},{"key":"b5","series-title":"Lancet Infect Dis","first-page":"1211","article-title":"Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","year":"2018"},{"key":"b6","series-title":"JAMA Pediatr","first-page":"958","article-title":"Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years","volume":"172","author":"Troeger","year":"2018"},{"key":"b7","series-title":"Ann Trop Paediatr","first-page":"39","article-title":"Rotavirus gastro-enteritis in hospitalized children with acute diarrhoea in Zambia","volume":"15","author":"Mpabalwani","year":"1995"},{"key":"b8","series-title":"J Trop Pediatr","first-page":"343","article-title":"Prevalence of rotavirus-induced diarrhea among children under 5 years in Ilorin, Nigeria","volume":"54","author":"Odimayo","year":"2008"},{"key":"b9","series-title":"PLoS One","first-page":"e0273862","article-title":"Factors associated with dehydrating rotavirus diarrhea in children under five in Bangladesh: an urban-rural comparison","volume":"17","author":"Yeasmin","year":"2022"},{"key":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e0007211","article-title":"The seasonality of diarrheal pathogens: a retrospective study of seven sites over three years","volume":"13","author":"Chao","year":"2019"},{"key":"b11","series-title":"Am J Clin Nutr","first-page":"1070","article-title":"The effect of malnutrition on the risk of diarrheal and respiratory mortality in children <2 y of age in Cebu, Philippines","volume":"65","author":"Yoon","year":"1997"},{"key":"b12","series-title":"J Immunol","first-page":"2818","article-title":"Dendritic cell anergy results from endotoxemia in severe malnutrition","volume":"183","author":"Hughes","year":"2009"},{"key":"b13","series-title":"PLoS One","first-page":"e105017","article-title":"The immune system in children with malnutrition \u2013 a systematic review","volume":"9","author":"Rytter","year":"2014"},{"key":"b14","series-title":"mSphere","first-page":"e00046-e17","article-title":"Protein malnutrition modifies innate immunity and gene expression by intestinal epithelial cells and human rotavirus infection in neonatal gnotobiotic pigs","volume":"2","author":"Vlasova","year":"2017"},{"key":"b15","series-title":"Clin Vaccine Immunol","first-page":"e00172-e17","article-title":"Protein malnutrition alters tryptophan and angiotensin-converting enzyme 2 homeostasis and adaptive immune responses in human rotavirus-infected gnotobiotic pigs with human infant fecal microbiota transplant","volume":"24","author":"Fischer","year":"2017"},{"key":"b16","series-title":"Infect Immun","first-page":"3542","article-title":"Protein malnutrition impairs intestinal epithelial cell turnover, a potential mechanism of increased cryptosporidiosis in a murine model","volume":"84","author":"Liu","year":"2016"},{"key":"b17","series-title":"J Immunol","first-page":"77","article-title":"Protein energy malnutrition impairs homeostatic proliferation of memory CD8 T cells","volume":"188","author":"Iyer","year":"2012"},{"key":"b18","series-title":"Int J Infect Dis","first-page":"e646","article-title":"Burden of rotavirus and other enteropathogens among children with diarrhea in Burkina Faso","volume":"15","author":"Nitiema","year":"2011"},{"key":"b19","series-title":"BMC Infect Dis","first-page":"18","article-title":"Rotavirus A infection in children under five years old with a double health problem: undernutrition and diarrhoea \u2013 a cross-sectional study in four provinces of Mozambique","volume":"21","author":"Chissaque","year":"2021"},{"key":"b20","series-title":"PLoS One","first-page":"e0240258","article-title":"Nutritional status, environmental enteric dysfunction, and prevalence of rotavirus diarrhoea among children in Zambia","volume":"15","author":"Koyuncu","year":"2020"},{"key":"b21","series-title":"BMC Pediatr","first-page":"69","article-title":"Prevalence and factors associated with rotavirus infection among children admitted with acute diarrhea in Uganda","volume":"10","author":"Nakawesi","year":"2010"},{"key":"b22","series-title":"J Clin Microbiol","first-page":"2568","article-title":"Malnutrition is associated with protection from rotavirus diarrhea: evidence from a longitudinal birth cohort study in Bangladesh","volume":"54","author":"Verkerke","year":"2016"},{"key":"b23","series-title":"PLoS One","first-page":"e0179418","article-title":"Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh","volume":"12","author":"Das","year":"2017"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"S232","article-title":"The Global Enteric Multicenter Study (GEMS) of diarrheal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case\/control study","volume":"55","author":"Kotloff","year":"2012"},{"key":"b25","series-title":"Clin Infect Dis","first-page":"S232","article-title":"The Global Enteric Multicenter Study (GEMS) of diarrheal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case\/control study","volume":"55","author":"Kotloff","year":"2012"},{"key":"b26","series-title":"Clin Infect Dis","first-page":"S294","article-title":"Diagnostic microbiologic methods in the GEMS-1 case\/control study","volume":"55","author":"Panchalingam","year":"2012"},{"key":"b27","series-title":"Clin Infect Dis","first-page":"1199","article-title":"Manual of Clinical Microbiology, 8th edition. Edited by Patrick R. Murray, Ellen Jo Baron, James H. Jorgensen, Michael A. Pfaller, and Robert H. Yolken Washington, D.C.: American Society for Microbiology Press, 2003. 2322 pp. $189.95 (cloth)","volume":"38","author":"Wormser","year":"2004"},{"key":"b28","series-title":"WHO Child Growth Standards: Length\/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-height and Body Mass Index-for-Age: Methods and Development","year":"2006"},{"key":"b29","series-title":"Lancet","first-page":"204","article-title":"WHO child growth standards","volume":"371","author":"De Onis","year":"2008"},{"key":"b30","series-title":"WHO Child Growth Standards: Training Course on Child Growth Assessment","year":"2008"},{"key":"b31","series-title":"PLoS One","first-page":"e0160060","article-title":"Epidemiology, seasonality and factors associated with rotavirus infection among children with moderate-to-severe diarrhea in rural western Kenya, 2008\u20132012: the Global Enteric Multicenter Study (GEMS)","volume":"11","author":"Omore","year":"2016"},{"key":"b32","series-title":"J Infect Dis","first-page":"305","article-title":"Rotavirus infection and disease in a multisite birth cohort: results from the MAL-ED Study","volume":"216","author":"Mohan","year":"2017"},{"key":"b33","series-title":"J Virol","first-page":"10213","article-title":"Pathogenesis of intestinal and systemic rotavirus infection","volume":"78","author":"Ramig","year":"2004"},{"key":"b34","series-title":"Acta Paediatr","first-page":"627","article-title":"Nutritional status and diarrhoeal pathogen in hospitalized children in Bangladesh","volume":"87","author":"Dewan","year":"1998"},{"key":"b35","series-title":"Trop Med Int Health","first-page":"840","article-title":"Incidence and risk factors of paediatric rotavirus diarrhoea in northern Ghana","volume":"8","author":"Binka","year":"2003"},{"key":"b36","series-title":"Pediatr Infect Dis J","first-page":"S50","article-title":"Rotavirus overview","volume":"28","author":"Bernstein","year":"2009"},{"key":"b37","series-title":"Nat Rev Gastroenterol Hepatol","first-page":"446","article-title":"Secretory diarrhoea: mechanisms and emerging therapies","volume":"12","author":"Thiagarajah","year":"2015"},{"key":"b38","series-title":"Clin Infect Dis","first-page":"S23","article-title":"Management of diarrhea in young children in sub-Saharan Africa: adherence to World Health Organization recommendations during the global enteric multisite study (2007\u20132011) and the Vaccine Impact of Diarrhea in Africa (VIDA) study (2015\u20132018)","volume":"76","author":"Deichsel","year":"2023"},{"key":"b39","series-title":"J Trop Med Hyg","first-page":"83","article-title":"Nutritional status, body size and severity of diarrhoea associated with rotavirus or enterotoxigenic Escherichia coli.","volume":"87","author":"Black","year":"1984"},{"key":"b40","series-title":"Pediatr Infect Dis J","first-page":"1123","article-title":"A case-control study to determine risk factors for hospitalization for rotavirus gastroenteritis in U.S. children","volume":"25","author":"Dennehy","year":"2006"},{"key":"b41","series-title":"Early Hum Dev","first-page":"S83","article-title":"Gastroenteritis, diarrhoea and breast feeding","volume":"49","author":"Golding","year":"1997"},{"key":"b42","series-title":"J Pediatr","first-page":"297","article-title":"Human milk oligosaccharides are associated with protection against diarrhea in breast-fed infants","volume":"145","author":"Morrow","year":"2004"},{"key":"b43","series-title":"J Pediatr","first-page":"696","article-title":"Differences in morbidity between breast-fed and formula-fed infants","volume":"126","author":"Dewey","year":"1995"},{"key":"b44","series-title":"JAMA","first-page":"413","article-title":"Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus","volume":"285","author":"Kramer","year":"2001"},{"key":"b45","series-title":"Acta Paediatr Scand Suppl","first-page":"131","article-title":"The protective effect of human milk against diarrhea: a review of studies from Bangladesh","volume":"351","author":"Glass","year":"1989"},{"key":"b46","series-title":"Vaccine","first-page":"7507","article-title":"Rotavirus incidence and genotype distribution before and after national rotavirus vaccine introduction in Belgium","volume":"28","author":"Zeller","year":"2010"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/4\/article-p749.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/4\/article-p749.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/4\/article-p749.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T13:11:03Z","timestamp":1712149863000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/4\/article-p749.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,3]]},"references-count":46,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0406","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,3]]}}}