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首页> 外文期刊>Clinical infectious diseases >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
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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

机译：发展中国家婴幼儿腹泻病的全球肠道多中心研究（GEMS）：病例/对照研究的流行病学和临床方法

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Background. Diarrhea is a leading cause of illness and death among children aged <5 years in developing countries. This paper describes the clinical and epidemiological methods used to conduct the Global Enteric Multicenter Study (GEMS), a 3-year, prospective, age-stratified, case/control study to estimate the population-based burden, microbiologic etiology, and adverse clinical consequences of acute moderate-to-severe diarrhea (MSD) among a censused population of children aged 0-59 months seeking care at health centers in sub-Saharan Africa and South Asia.Methods. GEMS was conducted at 7 field sites, each serving a population whose demography and healthcare utilization practices for childhood diarrhea were documented. We aimed to enroll 220 MSD cases per year from selected health centers serving each site in each of 3 age strata (0-11, 12-23, and 24-59 months), along with 1-3 matched community controls. Cases and controls supplied clinical, epidemiologic, and anthropometric data at enrollment and again approximately 60 days later, and provided enrollment stool specimens for identification and characterization of potential diarrheal pathogens. Verbal autopsy was performed if a child died. Analytic strategies will calculate the fraction of MSD attributable to each pathogen and the incidence, financial costs, nutritional consequences, and case fatality overall and by pathogen.Conclusions. When completed, GEMS will provide estimates of the incidence, etiology, and outcomes of MSD among infants and young children in sub-Saharan Africa and South Asia. This information can guide development and implementation of public health interventions to diminish morbidity and mortality from diarrheal diseases.
机译：背景。在发展中国家，腹泻是导致5岁以下儿童患病和死亡的主要原因。本文介绍了用于进行全球肠道多中心研究（GEMS）的临床和流行病学方法，这项为期3年，前瞻性，年龄分层的病例/对照研究旨在评估人群的负担，微生物病因和不良的临床后果在撒哈拉以南非洲和南亚健康中心寻求医疗服务的0-59个月受普查儿童中，急性中重度腹泻（MSD）的发生率。 GEMS在7个现场进行，每个现场服务于记录了儿童腹泻的人口统计学和医疗保健实践的人群。我们的目标是每年从3个年龄层（0-11、12-23和24-59个月）的每个站点的选定医疗中心招募220名MSD病例，以及1-3个匹配的社区对照。病例和对照在入组时以及大约60天后再次提供临床，流行病学和人体测量学数据，并提供了入院粪便标本以鉴定和表征潜在的腹泻病原体。如果有儿童死亡，则进行口头尸检。分析策略将计算可归因于每种病原体的MSD比例以及发病率，财务成本，营养后果以及整个病原体的病死率。完成后，GEMS将提供撒哈拉以南非洲和南亚婴幼儿MSD的发病率，病因和结果的估计值。这些信息可以指导公共卫生干预措施的开发和实施，以减少腹泻病的发病率和死亡率。

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