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- Title
Some Epidemiologic, Clinical, Microbiologic, and Organizational Assumptions That Influenced the Design and Performance of the Global Enteric Multicenter Study (GEMS).
- Authors
Farag, Tamer H.; Nasrin, Dilruba; Wu, Yukun; Muhsen, Khitam; Blackwelder, William C.; Sommerfelt, Halvor; Panchalingam, Sandra; Nataro, James P.; Kotloff, Karen L.; Levine, Myron M.
- Abstract
The overall aim of the Global Enteric Multicenter Study–1 (GEMS-1) is to identify the etiologic agents associated with moderate-to-severe diarrhea (MSD) among children <5 years of age, and thereby the attributable pathogen-specific population-based incidence of MSD, to guide investments in research and public health interventions against diarrheal disease. To accomplish this, 9 core assumptions were vetted through widespread consultation: (1) a limited number of etiologic agents may be responsible for most MSD; (2) a definition of MSD can be crafted that encompasses cases that might otherwise be fatal in the community without treatment; (3) MSD seen at sentinel centers is a proxy for fatal diarrheal disease in the community; (4) matched case/control is the appropriate epidemiologic design; (5) methods across the sites can be standardized and rigorous quality control maintained; (6) a single 60-day postenrollment visit to case and control households creates mini-cohorts, allowing comparisons; (7) broad support for GEMS-1 messages can be achieved by incorporating advice from public health spokespersons; (8) results will facilitate the setting of investment and intervention priorities; and (9) wide acceptance and dissemination of the GEMS-1 results can be achieved.
- Subjects
EPIDEMIOLOGY; INTESTINAL infections; ETIOLOGY of diseases; DIARRHEA in children; PUBLIC health; SENTINEL health events
- Publication
Clinical Infectious Diseases, 2012, Vol 55, Issue suppl_4, pS225
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cis787