Some Epidemiologic, Clinical, Microbiologic, and Organizational Assumptions That Influenced the Design and Performance of the Global Enteric Multicenter Study (GEMS)
Open Access
- 15 December 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 55 (suppl_4), S225-S231
- https://doi.org/10.1093/cid/cis787
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.Keywords
This publication has 12 references indexed in Scilit:
- Enteric infections and the vaccines to counter them: Future directionsVaccine, 2006
- War and peace at mucosal surfacesNature Reviews Immunology, 2004
- Bacterial Invasion: The Paradigms of Enteroinvasive PathogensScience, 2004
- Case-control studies: research in reverseThe Lancet, 2002
- Cryptosporidium parvum Induces Host Cell Actin Accumulation at the Host-Parasite InterfaceInfection and Immunity, 2000
- Oral Rehydration Therapy in Acute Diarrhoea in ChildhoodJournal of Pediatric Gastroenterology and Nutrition, 1984
- Advances in Therapy of Diarrheal Dehydration: Oral RehydrationAdvances in Pediatrics, 1984
- An Ultrastructural Study of EnteropathogenicEscherichia ColiInfection in Human InfantsUltrastructural Pathology, 1983
- Pathogenesis of Shigella dysenteriae 1 (Shiga) DysenteryThe Journal of Infectious Diseases, 1973