Khalil IA, et al. - Researchers looked for a causal association between Cryptosporidium and childhood growth and if so, they intended to quantify the related additional burden. They found that the previously reported burden of Cryptosporidium was an underestimation of the true burden. Children suffering from diarrhoea from Cryptosporidium infection were shown to have decreased growth, particularly weight gain, and increased risk of subsequent infectious disease episodes. Compared with previous reports, 2·5 times higher burden of Cryptosporidium was reported in this study after properly accounting for some of the long-term outcomes. These data call for the interventions aimed at preventing and effectively treating infection in children younger than 5 years.

Methods

• In the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2016, the morbidity and mortality related to more than 300 causes of death and disability, including diarrhoea caused by Cryptosporidium infection, was quantified.
• The estimates on the burden of Cryptosporidium in GBD 2016 were supplemented with findings from a systematic review of published and unpublished cohort studies.
• Further, these data were supplemented with findings of a meta-analysis of the impact of childhood diarrhoea caused by Cryptosporidium infection on physical growth.

Results

• Data revealed acute Cryptosporidium infection caused more than 48,000 deaths (95% uncertainty interval [UI] 24,600–81,900) and more than 4·2 million disability-adjusted life-years lost (95% UI 2·2 million–7·2 million) and was recognized as the fifth leading diarrhoeal aetiology in children younger than 5 years, in 2016.
• Researchers identified seven data sources from the scientific literature and six individual-level data sources reporting the link between Cryptosporidium and childhood growth.
• In relation to each episode of diarrhoea caused by Cryptosporidium infection, the following were observed: a decrease in height-for-age Z score (0·049, 95% CI 0·014–0·080), weight-for-age Z score (0·095, 0·055–0·134), and weight-for-height Z score (0·126, 0·057–0·194).
• They estimated that an additional 7·85 million disability-adjusted life-years resulted from diarrhoea from Cryptosporidium infection (95% UI 5·42 million–10·11 million) after they accounted for its effect on growth faltering—153% more than that estimated from acute effects alone.