Vaccines are one of the most successful interventions to prevent infections, and licensed enteric vaccines against rotavirus, cholera, and typhoid have proven to be safe and effective in preventing diarrhea episodes and deaths. Vaccines against Shigella, enterotoxigenic E. coli (ETEC), norovirus, and invasive nontyphoidal Salmonella are in clinical development. In January 2022, the Infectious Diseases and Vaccine Delivery team at BMGF commissioned START to map the long-term sequelae (other than death) of Campylobacter, Norovirus, and ETEC infections in children under 5. START attended a meeting that included members of the WHO Burden of Enteric Diseases Morbidity Working Group (BoED MWG), conducted a literature review of the publications on the subject published between January 1980 to the present, and developed a database of publications with the relevant outcomes. The objective of this project was to undertake a literature review and meta-analysis of the long-term sequelae (other than death) of Campylobacter, Norovirus, and ETEC infections in children under 5 to inform the full value of enteric vaccines.
The START team screened a total of 3,305 research articles for inclusion criteria, of which 79 were screened for full-text review. After further exclusions, the team identified relevant literature for data extraction. The START team then developed a REDCap survey for the data extraction process, which was shared with the client for their input. Upon completing the data extraction process, the team imported the outcome data from 19 eligible papers into an Excel database. Overall, most of the studies were published between 2010 to the present. Most of the study countries included in the publications were from South-East Asia, with Bangladesh being the most represented country. Seventy-nine percent of the articles studied outcomes associated with Campylobacter. The most studied outcome was overwhelmingly linear growth, and only one publication assessed the impact of these infections on neurodevelopment.
Ultimately, the team developed an Excel database with data on linear growth, ponderal growth, weight gain, and neurodevelopment extracted from the included research articles. Additionally, the team prepared a slide deck synthesizing the published research findings and an Excel database with raw data for the client to utilize as they deem fit.