Estimates of Protection Against Severe Attributable Diarrhea Episodes Due to 1 or More Prior Infections From the Same Pathogen in the MAL-ED Cohort
| Pathogen . | No. of Previous Infections . | N . | N (%) With Subsequent Severe Diarrhea . | Unadjusteda HR (95% CI) . | Adjustedb HR (95% CI) . | Calibratedc HR (95% CI) . |
|---|---|---|---|---|---|---|
| Rotavirus | 0 | 1715 | 121 (7.1) | 1. | 1. | 1. |
| 1+ | 839 | 29 (3.5) | 0.37 (0.24–0.58) | 0.37 (0.24–0.58) | 0.31 (0.20–0.48) | |
| Astrovirus | 0 | 1715 | 35 (2.0) | 1. | 1. | 1. |
| 1+ | 1048 | 11 (1.0) | 0.40 (0.19–0.85) | 0.39 (0.18–0.84) | 0.34 (0.16–0.74) | |
| Norovirus GII | 0 | 1715 | 15 (0.9) | 1. | 1. | 1. |
| 1+ | 1310 | 24 (1.8) | 0.70 (0.31–1.55) | 0.76 (0.34–1.70) | 0.73 (0.32–1.65) | |
| Sapovirus | 0 | 1715 | 27 (1.6) | 1. | 1. | 1. |
| 1+ | 1350 | 34 (2.5) | 1.12 (0.64–1.97) | 1.11 (0.62–1.96) | 0.97 (0.55–1.72) | |
| Adenovirus 40/41 | 0 | 1715 | 29 (1.7) | 1. | 1. | 1. |
| 1+ | 1161 | 26 (2.2) | 0.91 (0.54–1.51) | 0.89 (0.51–1.54) | 0.74 (0.42–1.29) | |
| Shigella | 0 | 1715 | 62 (3.6) | 1. | 1. | 1. |
| 1+ | 1141 | 24 (2.1) | 0.78 (0.45–1.34) | 0.73 (0.43–1.25) | 0.57 (0.33–0.97) | |
| ST-ETEC | 0 | 1715 | 28 (1.6) | 1. | 1. | 1. |
| 1+ | 1244 | 33 (2.7) | 1.01 (0.53–1.89) | 0.97 (0.52–1.83) | 0.82 (0.43–1.56) | |
| tEPEC | 0 | 1715 | 8 (0.5) | — | — | — |
| 1+ | 1251 | 0 | — | — | — | |
| Campylobacter jejuni/Campylobacter coli | 0 | 1715 | 3 (0.2) | 1. | 1. | 1. |
| 1+ | 1191 | 7 (0.6) | 1.82 (0.49–6.70) | 1.71 (0.46–6.33) | 1.81 (0.49–6.70) | |
| Cryptosporidium | 0 | 1715 | 13 (0.8) | 1. | 1. | 1. |
| 1+ | 950 | 1 (0.1) | 0.21 (0.02–2.15) | 0.20 (0.02–2.11) | 0.16 (0.02–1.72) |
| Pathogen . | No. of Previous Infections . | N . | N (%) With Subsequent Severe Diarrhea . | Unadjusteda HR (95% CI) . | Adjustedb HR (95% CI) . | Calibratedc HR (95% CI) . |
|---|---|---|---|---|---|---|
| Rotavirus | 0 | 1715 | 121 (7.1) | 1. | 1. | 1. |
| 1+ | 839 | 29 (3.5) | 0.37 (0.24–0.58) | 0.37 (0.24–0.58) | 0.31 (0.20–0.48) | |
| Astrovirus | 0 | 1715 | 35 (2.0) | 1. | 1. | 1. |
| 1+ | 1048 | 11 (1.0) | 0.40 (0.19–0.85) | 0.39 (0.18–0.84) | 0.34 (0.16–0.74) | |
| Norovirus GII | 0 | 1715 | 15 (0.9) | 1. | 1. | 1. |
| 1+ | 1310 | 24 (1.8) | 0.70 (0.31–1.55) | 0.76 (0.34–1.70) | 0.73 (0.32–1.65) | |
| Sapovirus | 0 | 1715 | 27 (1.6) | 1. | 1. | 1. |
| 1+ | 1350 | 34 (2.5) | 1.12 (0.64–1.97) | 1.11 (0.62–1.96) | 0.97 (0.55–1.72) | |
| Adenovirus 40/41 | 0 | 1715 | 29 (1.7) | 1. | 1. | 1. |
| 1+ | 1161 | 26 (2.2) | 0.91 (0.54–1.51) | 0.89 (0.51–1.54) | 0.74 (0.42–1.29) | |
| Shigella | 0 | 1715 | 62 (3.6) | 1. | 1. | 1. |
| 1+ | 1141 | 24 (2.1) | 0.78 (0.45–1.34) | 0.73 (0.43–1.25) | 0.57 (0.33–0.97) | |
| ST-ETEC | 0 | 1715 | 28 (1.6) | 1. | 1. | 1. |
| 1+ | 1244 | 33 (2.7) | 1.01 (0.53–1.89) | 0.97 (0.52–1.83) | 0.82 (0.43–1.56) | |
| tEPEC | 0 | 1715 | 8 (0.5) | — | — | — |
| 1+ | 1251 | 0 | — | — | — | |
| Campylobacter jejuni/Campylobacter coli | 0 | 1715 | 3 (0.2) | 1. | 1. | 1. |
| 1+ | 1191 | 7 (0.6) | 1.82 (0.49–6.70) | 1.71 (0.46–6.33) | 1.81 (0.49–6.70) | |
| Cryptosporidium | 0 | 1715 | 13 (0.8) | 1. | 1. | 1. |
| 1+ | 950 | 1 (0.1) | 0.21 (0.02–2.15) | 0.20 (0.02–2.11) | 0.16 (0.02–1.72) |
Abbreviations: CI, confidence interval; HR, hazard ratio; ST-ETEC, heat-stable enterotoxigenic E coli; tEPEC, typical enteropathogenic E coli.
aEstimates adjusted for site.
bEstimates adjusted for site, socioeconomic status, sex, enrollment weight-for-age z-score, maternal education, maternal height, crowding, and exclusive breastfeeding in first 6 months.
cEstimates adjusted for the same variables above and calibrated based on negative control estimates for the associations between 1 or more previous infections and attributable diarrhea of any severity.
Estimates of Protection Against Severe Attributable Diarrhea Episodes Due to 1 or More Prior Infections From the Same Pathogen in the MAL-ED Cohort
| Pathogen . | No. of Previous Infections . | N . | N (%) With Subsequent Severe Diarrhea . | Unadjusteda HR (95% CI) . | Adjustedb HR (95% CI) . | Calibratedc HR (95% CI) . |
|---|---|---|---|---|---|---|
| Rotavirus | 0 | 1715 | 121 (7.1) | 1. | 1. | 1. |
| 1+ | 839 | 29 (3.5) | 0.37 (0.24–0.58) | 0.37 (0.24–0.58) | 0.31 (0.20–0.48) | |
| Astrovirus | 0 | 1715 | 35 (2.0) | 1. | 1. | 1. |
| 1+ | 1048 | 11 (1.0) | 0.40 (0.19–0.85) | 0.39 (0.18–0.84) | 0.34 (0.16–0.74) | |
| Norovirus GII | 0 | 1715 | 15 (0.9) | 1. | 1. | 1. |
| 1+ | 1310 | 24 (1.8) | 0.70 (0.31–1.55) | 0.76 (0.34–1.70) | 0.73 (0.32–1.65) | |
| Sapovirus | 0 | 1715 | 27 (1.6) | 1. | 1. | 1. |
| 1+ | 1350 | 34 (2.5) | 1.12 (0.64–1.97) | 1.11 (0.62–1.96) | 0.97 (0.55–1.72) | |
| Adenovirus 40/41 | 0 | 1715 | 29 (1.7) | 1. | 1. | 1. |
| 1+ | 1161 | 26 (2.2) | 0.91 (0.54–1.51) | 0.89 (0.51–1.54) | 0.74 (0.42–1.29) | |
| Shigella | 0 | 1715 | 62 (3.6) | 1. | 1. | 1. |
| 1+ | 1141 | 24 (2.1) | 0.78 (0.45–1.34) | 0.73 (0.43–1.25) | 0.57 (0.33–0.97) | |
| ST-ETEC | 0 | 1715 | 28 (1.6) | 1. | 1. | 1. |
| 1+ | 1244 | 33 (2.7) | 1.01 (0.53–1.89) | 0.97 (0.52–1.83) | 0.82 (0.43–1.56) | |
| tEPEC | 0 | 1715 | 8 (0.5) | — | — | — |
| 1+ | 1251 | 0 | — | — | — | |
| Campylobacter jejuni/Campylobacter coli | 0 | 1715 | 3 (0.2) | 1. | 1. | 1. |
| 1+ | 1191 | 7 (0.6) | 1.82 (0.49–6.70) | 1.71 (0.46–6.33) | 1.81 (0.49–6.70) | |
| Cryptosporidium | 0 | 1715 | 13 (0.8) | 1. | 1. | 1. |
| 1+ | 950 | 1 (0.1) | 0.21 (0.02–2.15) | 0.20 (0.02–2.11) | 0.16 (0.02–1.72) |
| Pathogen . | No. of Previous Infections . | N . | N (%) With Subsequent Severe Diarrhea . | Unadjusteda HR (95% CI) . | Adjustedb HR (95% CI) . | Calibratedc HR (95% CI) . |
|---|---|---|---|---|---|---|
| Rotavirus | 0 | 1715 | 121 (7.1) | 1. | 1. | 1. |
| 1+ | 839 | 29 (3.5) | 0.37 (0.24–0.58) | 0.37 (0.24–0.58) | 0.31 (0.20–0.48) | |
| Astrovirus | 0 | 1715 | 35 (2.0) | 1. | 1. | 1. |
| 1+ | 1048 | 11 (1.0) | 0.40 (0.19–0.85) | 0.39 (0.18–0.84) | 0.34 (0.16–0.74) | |
| Norovirus GII | 0 | 1715 | 15 (0.9) | 1. | 1. | 1. |
| 1+ | 1310 | 24 (1.8) | 0.70 (0.31–1.55) | 0.76 (0.34–1.70) | 0.73 (0.32–1.65) | |
| Sapovirus | 0 | 1715 | 27 (1.6) | 1. | 1. | 1. |
| 1+ | 1350 | 34 (2.5) | 1.12 (0.64–1.97) | 1.11 (0.62–1.96) | 0.97 (0.55–1.72) | |
| Adenovirus 40/41 | 0 | 1715 | 29 (1.7) | 1. | 1. | 1. |
| 1+ | 1161 | 26 (2.2) | 0.91 (0.54–1.51) | 0.89 (0.51–1.54) | 0.74 (0.42–1.29) | |
| Shigella | 0 | 1715 | 62 (3.6) | 1. | 1. | 1. |
| 1+ | 1141 | 24 (2.1) | 0.78 (0.45–1.34) | 0.73 (0.43–1.25) | 0.57 (0.33–0.97) | |
| ST-ETEC | 0 | 1715 | 28 (1.6) | 1. | 1. | 1. |
| 1+ | 1244 | 33 (2.7) | 1.01 (0.53–1.89) | 0.97 (0.52–1.83) | 0.82 (0.43–1.56) | |
| tEPEC | 0 | 1715 | 8 (0.5) | — | — | — |
| 1+ | 1251 | 0 | — | — | — | |
| Campylobacter jejuni/Campylobacter coli | 0 | 1715 | 3 (0.2) | 1. | 1. | 1. |
| 1+ | 1191 | 7 (0.6) | 1.82 (0.49–6.70) | 1.71 (0.46–6.33) | 1.81 (0.49–6.70) | |
| Cryptosporidium | 0 | 1715 | 13 (0.8) | 1. | 1. | 1. |
| 1+ | 950 | 1 (0.1) | 0.21 (0.02–2.15) | 0.20 (0.02–2.11) | 0.16 (0.02–1.72) |
Abbreviations: CI, confidence interval; HR, hazard ratio; ST-ETEC, heat-stable enterotoxigenic E coli; tEPEC, typical enteropathogenic E coli.
aEstimates adjusted for site.
bEstimates adjusted for site, socioeconomic status, sex, enrollment weight-for-age z-score, maternal education, maternal height, crowding, and exclusive breastfeeding in first 6 months.
cEstimates adjusted for the same variables above and calibrated based on negative control estimates for the associations between 1 or more previous infections and attributable diarrhea of any severity.
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
