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

This article, published in The Lancet, reports on results of the Global Enteric Multicenter Study (GEMS), which was designed to identify the aetiology and population-based burden of pediatric diarrheal disease in sub-Saharan Africa and south Asia. GEMS was a three-year, prospective, age-stratified, matched case-control study of moderate-to-severe diarrhea in children aged 0 to 59 months at four sites in Africa and three in Asia. The study enrolled 9,439 children with moderate-to-severe diarrhea and 13,129 control children without diarrhea. By analysing adjusted population attributable fractions, the authors found that most attributable cases of moderate-to-severe diarrhea were due to four pathogens: rotavirus, Cryptosporidium, enterotoxigenic Escherichia coli producing heat-stable toxin (ST-ETEC; with or without co-expression of heat-labile enterotoxin), and Shigella.

Author(s): Kotloff KL, Nataro JP, Blackwelder WC, et al.

Published: 2013

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    Citation: Kotloff KL, Nataro JP, Blackwelder WC, et al. 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. The Lancet. 2013;382(9888):209-222.