International Centre for Diarrhoeal Disease Research, Bangladesh

About: International Centre for Diarrhoeal Disease Research, Bangladesh is a facility organization based out in Dhaka, Bangladesh. It is known for research contribution in the topics: Population & Vibrio cholerae. The organization has 3103 authors who have published 5238 publications receiving 226880 citations. The organization is also known as: SEATO Cholera Research Laboratory & Bangladesh International Centre for Diarrhoeal Disease Research.

Eliminating visceral leishmaniasis in South Asia: the road ahead.

Abstract: Suman Rijal and colleagues highlight lessons from a regional collaboration to eliminate visceral leishmaniasis and identify priorities for the post-elimination plan

Malnutrition and Helminth Infection Affect Performance of an Interferon γ–Release Assay

Abstract: Tuberculosis (TB) is a leading global cause of morbidity and mortality in children. Timely diagnosis and treatment of TB infection and disease are especially important for pediatric populations. Once infected with Mycobacterium tuberculosis, immunocompetent adults have a 5% to 10% lifetime risk of progressing to have TB disease. Children have an increased risk: within 2 years of infection, nearly half of infants and up to 15% of older children will develop TB disease.1 Those who do not develop TB disease in childhood will serve as reservoirs during adulthood. Identification and treatment of latent TB infection (LTBI) is a proposed key strategy for global TB control.2 However, the lack of a gold-standard test to detect LTBI makes accurate diagnosis difficult. The tuberculin skin test (TST), the most widely used method of diagnosing LTBI, is fraught with limitations including poor specificity because of cross-reactivity with nontuberculous mycobacteria and the bacille Calmette-Guerin (BCG) vaccine and poor sensitivity among people who may be anergic as a result of malnutrition, HIV/AIDS, or immunosuppressive states.3 The BCG vaccine's limited performance is magnified in populations who are at the highest risk (young children and immunocompromised hosts) of progressing from infection to TB disease.4 Interferon γ (IFN-γ)–release assays (IGRAs), such as the QuantiFERON-TB Gold In-Tube assay (QFT-IT), have been developed as possible replacements for the TST. The QFT-IT has the potential to be more specific than the TST by using antigens encoded within region-of-difference 1 (early secreted antigenic target, 6 kDa [ESAT-6] and culture filtrate protein, 10 kDa [CFP-10]) and region-of-difference 11 (TB7.7) of the M tuberculosis genome, antigens that are not included in the BCG vaccine and most nontuberculous mycobacteria, respectively.5 However, IGRAs quantify cell-mediated immune responses; therefore, the sensitivity may be limited in immunocompromised populations. When using TB disease as an indicator for LTBI, IGRAs have been successful at diagnosing LTBI in adults3; a meta-analysis by Pai et al6 revealed a pooled sensitivity of 70% and specificity of 99% from studies that used the QFT-IT. Although the replacement of the TST by IGRAs may not be imminent in resource-limited settings, IGRAs are increasingly being recommended in resource-rich countries for the diagnosis of LTBI in adults. It should be noted that recommendations for the use of IGRAs in children have been limited by a lack of evidence among high-risk pediatric subpopulations. Recently, more pediatric IGRA studies have emerged7; however, validation studies among children with immune dysfunction have been few and focused on children immunosuppressed from treatment for rheumatologic conditions, malignancies, and organ transplantation.8,9 Malnutrition and helminth infection are other immunomodulating states that may lead to anergic TST responses,10,11 but their effect on IGRA performance has not been well characterized. One study of hospitalized children from rural India suspected to have TB disease showed no association between malnutrition and QFT-IT result.12 To our knowledge, no studies have assessed the effect of helminth infection on IGRA performance. Because many nations are adopting guidelines to use IGRAs, additional investigation of the performance of these tests among a variety of pediatric hosts is imperative. We sought to compare the QFT-IT with the TST in detecting LTBI among a cohort of children with a high burden of malnutrition and helminth infection from a TB-endemic area and assess whether malnutrition, helminth infections, BCG-vaccine status, or previous TB contact influenced QFT-IT results.

Natural History of Cryptosporidiosis in a Longitudinal Study of Slum-Dwelling Bangladeshi Children: Association with Severe Malnutrition.

Abstract: BACKGROUND: Cryptosporidiosis is a common cause of infectious diarrhea in young children worldwide and is a significant contributor to under-five mortality. Current treatment options are limited in young children. In this study we describe the natural history of Cryptosporidium spp. infection in a birth cohort of children in Bangladesh and evaluate for association with malnutrition. METHODOLOGY/PRINCIPAL FINDINGS: This is a longitudinal birth cohort study of 392 slum-dwelling Bangladeshi children followed over the first two years of life from 2008 to 2014. Children were monitored for diarrheal disease and stool was tested for intestinal protozoa. Anthropometric measurements were taken at 3-month intervals. A subset of Cryptosporidium positive stools were genotyped for species and revealed that C. hominis was isolated from over 90% of samples. In the first two years of life 77% of children experienced at least one infection with Cryptosporidium spp. Non-diarrheal infection (67%) was more common than diarrheal infection (6.3%) although 27% of children had both types of infection. Extreme poverty was associated with higher rates of infection (chi-square 49.7% vs 33.3% p = 0.006). Malnutrition was common in this cohort 56% of children had stunted growth by age two. Children with Cryptosporidium spp. infection had a greater than 2-fold increased risk of severe stunting at age two compared to uninfected children (odds ratio 2.69 95% CI 1.17 6.15 p = 0.019) independent of sex income maternal body-mass index maternal education and weight for age adjusted z (WAZ) score at birth. CONCLUSIONS/SIGNIFICANCE: Cryptosporidium infection is common (77%) in this cohort of slum-dwelling Bangladeshi children and both non-diarrheal and diarrheal infections are significantly associated with a childs growth at 2 years of age.