title: Risk factors for cryptosporidiosis among children in a semi urban slum in southern India: a nested case-control study.
abstract: The risk factors for acquisition of cryptosporidial infection in resource-poor settings are poorly understood. A nested case-control study was conducted to assess factors associated with childhood cryptosporidiosis (detected by stool polymerase chain reaction) in an endemic, Indian slum community using data from two community-based studies with 580 children followed prospectively until their second birthday. Factors were assessed for overall cryptosporidiosis (N = 406), and for multiple (N = 208), asymptomatic (N = 243), and symptomatic (N = 163) infections, respectively. Presence of older siblings (odds ratio [OR] = 1.88, P = 0.002) and stunting at 6 months of age (OR = 1.74, P = 0.019) were important risk factors for childhood cryptosporidiosis. Always boiling drinking water before consumption, the use of a toilet by all members of the family, and maternal age ≥ 23 years were protective. These results provide insights into acquisition of childhood cryptosporidiosis in settings with poor environmental sanitation, contaminated public water supply systems, and close human-animal contact. Disease control strategies will require a multifaceted approach.
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sarkar
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Deepthi
authors.initials: D
authors.lastname: Kattula
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Francis
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Sitara S R
authors.initials: SS
authors.lastname: Ajjampur
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Ashok D
authors.initials: AD
authors.lastname: Prabakaran
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Nithya
authors.initials: N
authors.lastname: Jayavelu
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Muliyil
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Vinohar
authors.initials: V
authors.lastname: Balraj
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Elena N
authors.initials: EN
authors.lastname: Naumova
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Honorine D
authors.initials: HD
authors.lastname: Ward
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India; Community Health Department, Christian Medical College, Vellore, India; Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts gkang@cmcvellore.ac.in.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D016022:Case-Control Studies; D002648:Child; D003457:Cryptosporidiosis / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D011203:Poverty; D014505:Urban Population