Rihlat Said-Mohamed1, Aryeh D Stein1,2, John M Pettifor1, Shane A Norris1,2. 1. SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa. 2. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Abstract
Background: Cardiometabolic disease is associated with chronic low-grade inflammation. While low birthweight, childhood stunting and rapid weight gain predict higher adult high-sensitivity C-reactive protein (hs-CRP) concentrations, associations between childhood infections and adulthood CRP are inconsistent.Aim: To assess the associations between sanitation, diarrhoea and a combined score of both from birth to age 2 years and hs-CRP at age 18 years, independently of early life nutrition and adult adiposity.Subjects and methods: This study collected data on sanitation and diarrhoea episodes from birth to 2 years on 756 participants of the Birth-to-Twenty Plus cohort, a birth cohort initiated in South Africa in 1990, and calculated a combined score of both variables. Anthropometry was measured at 2 years and 18 years and hs-CRP at 18 years. Results: Of the participants, 29.5% had no access to indoor flush sanitation and 38.2% experienced ≥1 diarrhoea episode between birth and 2 years. Not having access to indoor flush sanitation and experiencing ≥1 diarrhoea episodes were associated with 1.50 mg/L and 1.52 mg/L higher hs-CRP, respectively. Prevalence of both burdens in infancy was associated with a 2.18 mg/L higher hs-CRP. Conclusion: In this population, poor sanitation and diarrhoea in early life predict elevated CRP in young adulthood, independently of early life nutrition and adiposity.
Background: Cardiometabolic disease is associated with chronic low-grade inflammation. While low birthweight, childhood stunting and rapid weight gain predict higher adult high-sensitivity C-reactive protein (hs-CRP) concentrations, associations between childhood infections and adulthood CRP are inconsistent.Aim: To assess the associations between sanitation, diarrhoea and a combined score of both from birth to age 2 years and hs-CRP at age 18 years, independently of early life nutrition and adult adiposity.Subjects and methods: This study collected data on sanitation and diarrhoea episodes from birth to 2 years on 756 participants of the Birth-to-Twenty Plus cohort, a birth cohort initiated in South Africa in 1990, and calculated a combined score of both variables. Anthropometry was measured at 2 years and 18 years and hs-CRP at 18 years. Results: Of the participants, 29.5% had no access to indoor flush sanitation and 38.2% experienced ≥1 diarrhoea episode between birth and 2 years. Not having access to indoor flush sanitation and experiencing ≥1 diarrhoea episodes were associated with 1.50 mg/L and 1.52 mg/L higher hs-CRP, respectively. Prevalence of both burdens in infancy was associated with a 2.18 mg/L higher hs-CRP. Conclusion: In this population, poor sanitation and diarrhoea in early life predict elevated CRP in young adulthood, independently of early life nutrition and adiposity.
Authors: Karoun H Bagamian; Chloe Puett; John D Anderson; Farzana Muhib; Clint Pecenka; Jere Behrman; Robert F Breiman; Ijeoma Edoka; Susan Horton; Gagandeep Kang; Karen L Kotloff; Claudio F Lanata; James A Platts-Mills; Firdausi Qadri; Elizabeth T Rogawski McQuade; Christopher Sudfeld; Pascale Vonaesch; Thomas F Wierzba; Suzanne Scheele Journal: Vaccine X Date: 2022-09-21