Risk Factors for Death among Children Less than 5 Years Old Hospitalized with Diarrhea in Rural Western Kenya, 2005–2007: A Cohort Study
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Risk factors for death among children less than 5 years old hospitalized with diarrhea in rural Western Kenya, 2005-2007: A cohort study", "type"=>"journal", "authors"=>[{"first_name"=>"Ciara E.", "last_name"=>"O'Reilly", "scopus_author_id"=>"36871335000"}, {"first_name"=>"Peter", "last_name"=>"Jaron", "scopus_author_id"=>"6507321242"}, {"first_name"=>"Benjamin", "last_name"=>"Ochieng", "scopus_author_id"=>"30567600900"}, {"first_name"=>"Amek", "last_name"=>"Nyaguara", "scopus_author_id"=>"55325284700"}, {"first_name"=>"Jacqueline E.", "last_name"=>"Tate", "scopus_author_id"=>"7102851944"}, {"first_name"=>"Michele B.", "last_name"=>"Parsons", "scopus_author_id"=>"25223869600"}, {"first_name"=>"Cheryl A.", "last_name"=>"Bopp", "scopus_author_id"=>"7005629902"}, {"first_name"=>"Kara A.", "last_name"=>"Williams", "scopus_author_id"=>"7404142147"}, {"first_name"=>"Jan", "last_name"=>"Vinjé", "scopus_author_id"=>"6603953885"}, {"first_name"=>"Elizabeth", "last_name"=>"Blanton", "scopus_author_id"=>"6603856934"}, {"first_name"=>"Kathleen A.", "last_name"=>"Wannemuehler", "scopus_author_id"=>"6602252029"}, {"first_name"=>"John", "last_name"=>"Vulule", "scopus_author_id"=>"7004162096"}, {"first_name"=>"Kayla F.", "last_name"=>"Laserson", "scopus_author_id"=>"6601976259"}, {"first_name"=>"Robert F.", "last_name"=>"Breiman", "scopus_author_id"=>"34567511600"}, {"first_name"=>"Daniel R.", "last_name"=>"Feikin", "scopus_author_id"=>"7003816969"}, {"first_name"=>"Marc Alain", "last_name"=>"Widdowson", "scopus_author_id"=>"26429004600"}, {"first_name"=>"Eric", "last_name"=>"Mintz", "scopus_author_id"=>"7006650309"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-84864428364", "pui"=>"365352082", "doi"=>"10.1371/journal.pmed.1001256", "isbn"=>"1549-1676", "sgr"=>"84864428364", "pmid"=>"22802736"}, "id"=>"a9bc618f-ec41-3bc3-a04f-fcbbd5ee6ecd", "abstract"=>"BACKGROUND: Diarrhea is a leading cause of childhood morbidity and mortality in sub-Saharan Africa. Data on risk factors for mortality are limited. We conducted hospital-based surveillance to characterize the etiology of diarrhea and identify risk factors for death among children hospitalized with diarrhea in rural western Kenya.\\n\\nMETHODS AND FINDINGS: We enrolled all children <5 years old, hospitalized with diarrhea (≥3 loose stools in 24 hours) at two district hospitals in Nyanza Province, western Kenya. Clinical and demographic information was collected. Stool specimens were tested for bacterial and viral pathogens. Bivariate and multivariable logistic regression analyses were carried out to identify risk factors for death. From May 23, 2005 to May 22, 2007, 1,146 children <5 years old were enrolled; 107 (9%) children died during hospitalization. Nontyphoidal Salmonella were identified in 10% (118), Campylobacter in 5% (57), and Shigella in 4% (42) of 1,137 stool samples; rotavirus was detected in 19% (196) of 1,021 stool samples. Among stools from children who died, nontyphoidal Salmonella were detected in 22%, Shigella in 11%, rotavirus in 9%, Campylobacter in 5%, and S. Typhi in <1%. In multivariable analysis, infants who died were more likely to have nontyphoidal Salmonella (adjusted odds ratio [aOR] = 6·8; 95% CI 3·1-14·9), and children <5 years to have Shigella (aOR = 5·5; 95% CI 2·2-14·0) identified than children who survived. Children who died were less likely to be infected with rotavirus (OR = 0·4; 95% CI 0·2-0·8). Further risk factors for death included being malnourished (aOR = 4·2; 95% CI 2·1-8·7); having oral thrush on physical exam (aOR = 2·3; 95% CI 1·4-3·8); having previously sought care at a hospital for the illness (aOR = 2·2; 95% CI 1·2-3·8); and being dehydrated as diagnosed at discharge/death (aOR = 2·5; 95% CI 1·5-4·1). A clinical diagnosis of malaria, and malaria parasites seen on blood smear, were not associated with increased risk of death. This study only captured in-hospital childhood deaths, and likely missed a substantial number of additional deaths that occurred at home.\\n\\nCONCLUSION: Nontyphoidal Salmonella and Shigella are associated with mortality among rural Kenyan children with diarrhea who access a hospital. Improved prevention and treatment of diarrheal disease is necessary. Enhanced surveillance and simplified laboratory diagnostics in Africa may assist clinicians in appropriately treating potentially fatal diarrheal illness.", "link"=>"http://www.mendeley.com/research/risk-factors-death-among-children-less-5-years-old-hospitalized-diarrhea-rural-western-kenya-2005200-1", "reader_count"=>115, "reader_count_by_academic_status"=>{"Librarian"=>2, "Researcher"=>17, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>20, "Student > Postgraduate"=>13, "Student > Master"=>41, "Other"=>3, "Student > Bachelor"=>9, "Professor"=>2}, "reader_count_by_user_role"=>{"Librarian"=>2, "Researcher"=>17, "Student > Doctoral Student"=>8, "Student > Ph. D. Student"=>20, "Student > Postgraduate"=>13, "Student > Master"=>41, "Other"=>3, "Student > Bachelor"=>9, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Agricultural and Biological Sciences"=>18, "Business, Management and Accounting"=>2, "Chemistry"=>1, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1, "Engineering"=>2, "Environmental Science"=>2, "Nursing and Health Professions"=>13, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>57, "Physics and Astronomy"=>1, "Psychology"=>2, "Social Sciences"=>6, "Immunology and Microbiology"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>57}, "Social Sciences"=>{"Social Sciences"=>6}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>2}, "Unspecified"=>{"Unspecified"=>4}, "Environmental Science"=>{"Environmental Science"=>2}, "Engineering"=>{"Engineering"=>2}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>18}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>13}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}}, "reader_count_by_country"=>{"United States"=>2, "Malawi"=>1, "Rwanda"=>1, "Italy"=>1, "Kenya"=>3}, "group_count"=>10}

CrossRef

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84864428364"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84864428364?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84864428364&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84864428364&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/84864428364", "dc:identifier"=>"SCOPUS_ID:84864428364", "eid"=>"2-s2.0-84864428364", "dc:title"=>"Risk factors for death among children less than 5 years old hospitalized with diarrhea in rural Western Kenya, 2005-2007: A cohort study", "dc:creator"=>"O'Reilly C.E.", "prism:publicationName"=>"PLoS Medicine", "prism:issn"=>"15491277", "prism:eIssn"=>"15491676", "prism:volume"=>"9", "prism:issueIdentifier"=>"7", "prism:pageRange"=>nil, "prism:coverDate"=>"2012-07-01", "prism:coverDisplayDate"=>"July 2012", "prism:doi"=>"10.1371/journal.pmed.1001256", "citedby-count"=>"63", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"National Center for Emerging and Zoonotic Infectious Diseases", "affiliation-city"=>"Atlanta", "affiliation-country"=>"United States"}], "pubmed-id"=>"22802736", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "article-number"=>"e1001256", "source-id"=>"144840", "openaccess"=>"1", "openaccessFlag"=>true, "freetoread"=>{"value"=>[{"$"=>"all"}, {"$"=>"publisherfree2read"}, {"$"=>"publisherfullgold"}, {"$"=>"repository"}, {"$"=>"repositoryvor"}, {"$"=>"repositoryam"}]}, "freetoreadLabel"=>{"value"=>[{"$"=>"All Open Access"}, {"$"=>"Gold"}, {"$"=>"Bronze"}, {"$"=>"Green"}]}}

Facebook

  • {"url"=>"http%3A%2F%2Fjournals.plos.org%2Fplosmedicine%2Farticle%3Fid%3D10.1371%252Fjournal.pmed.1001256", "share_count"=>0, "like_count"=>0, "comment_count"=>0, "click_count"=>0, "total_count"=>0}

Twitter

Counter

  • {"month"=>"7", "year"=>"2012", "pdf_views"=>"163", "xml_views"=>"26", "html_views"=>"1370"}
  • {"month"=>"8", "year"=>"2012", "pdf_views"=>"96", "xml_views"=>"8", "html_views"=>"1118"}
  • {"month"=>"9", "year"=>"2012", "pdf_views"=>"30", "xml_views"=>"2", "html_views"=>"291"}
  • {"month"=>"10", "year"=>"2012", "pdf_views"=>"49", "xml_views"=>"0", "html_views"=>"340"}
  • {"month"=>"11", "year"=>"2012", "pdf_views"=>"42", "xml_views"=>"1", "html_views"=>"315"}
  • {"month"=>"12", "year"=>"2012", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"242"}
  • {"month"=>"1", "year"=>"2013", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"162"}
  • {"month"=>"2", "year"=>"2013", "pdf_views"=>"21", "xml_views"=>"3", "html_views"=>"147"}
  • {"month"=>"3", "year"=>"2013", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"100"}
  • {"month"=>"4", "year"=>"2013", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"183"}
  • {"month"=>"5", "year"=>"2013", "pdf_views"=>"16", "xml_views"=>"1", "html_views"=>"244"}
  • {"month"=>"6", "year"=>"2013", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"231"}
  • {"month"=>"7", "year"=>"2013", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"182"}
  • {"month"=>"8", "year"=>"2013", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"127"}
  • {"month"=>"9", "year"=>"2013", "pdf_views"=>"37", "xml_views"=>"4", "html_views"=>"199"}
  • {"month"=>"10", "year"=>"2013", "pdf_views"=>"18", "xml_views"=>"2", "html_views"=>"275"}
  • {"month"=>"11", "year"=>"2013", "pdf_views"=>"27", "xml_views"=>"1", "html_views"=>"298"}
  • {"month"=>"12", "year"=>"2013", "pdf_views"=>"15", "xml_views"=>"2", "html_views"=>"283"}
  • {"month"=>"1", "year"=>"2014", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"304"}
  • {"month"=>"2", "year"=>"2014", "pdf_views"=>"23", "xml_views"=>"1", "html_views"=>"306"}
  • {"month"=>"3", "year"=>"2014", "pdf_views"=>"23", "xml_views"=>"3", "html_views"=>"366"}
  • {"month"=>"4", "year"=>"2014", "pdf_views"=>"19", "xml_views"=>"1", "html_views"=>"315"}
  • {"month"=>"5", "year"=>"2014", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"255"}
  • {"month"=>"6", "year"=>"2014", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"250"}
  • {"month"=>"7", "year"=>"2014", "pdf_views"=>"17", "xml_views"=>"1", "html_views"=>"268"}
  • {"month"=>"8", "year"=>"2014", "pdf_views"=>"32", "xml_views"=>"4", "html_views"=>"269"}
  • {"month"=>"9", "year"=>"2014", "pdf_views"=>"33", "xml_views"=>"0", "html_views"=>"380"}
  • {"month"=>"10", "year"=>"2014", "pdf_views"=>"38", "xml_views"=>"5", "html_views"=>"489"}
  • {"month"=>"11", "year"=>"2014", "pdf_views"=>"36", "xml_views"=>"2", "html_views"=>"490"}
  • {"month"=>"12", "year"=>"2014", "pdf_views"=>"26", "xml_views"=>"2", "html_views"=>"257"}
  • {"month"=>"1", "year"=>"2015", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"166"}
  • {"month"=>"2", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"245"}
  • {"month"=>"3", "year"=>"2015", "pdf_views"=>"31", "xml_views"=>"0", "html_views"=>"301"}
  • {"month"=>"4", "year"=>"2015", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"163"}
  • {"month"=>"5", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"304"}
  • {"month"=>"6", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"221"}
  • {"month"=>"7", "year"=>"2015", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"190"}
  • {"month"=>"8", "year"=>"2015", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"200"}
  • {"month"=>"9", "year"=>"2015", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"178"}
  • {"month"=>"10", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"272"}
  • {"month"=>"11", "year"=>"2015", "pdf_views"=>"24", "xml_views"=>"2", "html_views"=>"241"}
  • {"month"=>"12", "year"=>"2015", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"165"}
  • {"month"=>"1", "year"=>"2016", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"216"}
  • {"month"=>"2", "year"=>"2016", "pdf_views"=>"24", "xml_views"=>"0", "html_views"=>"209"}
  • {"month"=>"3", "year"=>"2016", "pdf_views"=>"15", "xml_views"=>"0", "html_views"=>"185"}
  • {"month"=>"4", "year"=>"2016", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"167"}
  • {"month"=>"5", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"125"}
  • {"month"=>"6", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"121"}
  • {"month"=>"7", "year"=>"2016", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"99"}
  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"91"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"126"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"144"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"168"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"137"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"32", "xml_views"=>"1", "html_views"=>"221"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"42", "xml_views"=>"0", "html_views"=>"361"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"48", "xml_views"=>"1", "html_views"=>"418"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"307"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"284"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"30", "xml_views"=>"2", "html_views"=>"227"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"192"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"18", "xml_views"=>"1", "html_views"=>"276"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"31", "xml_views"=>"0", "html_views"=>"215"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"21", "xml_views"=>"2", "html_views"=>"249"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"40", "xml_views"=>"1", "html_views"=>"251"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"155"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"35", "xml_views"=>"1", "html_views"=>"171"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"26", "xml_views"=>"2", "html_views"=>"180"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"35", "xml_views"=>"0", "html_views"=>"126"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"45", "xml_views"=>"0", "html_views"=>"130"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"17", "xml_views"=>"2", "html_views"=>"116"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"30", "xml_views"=>"4", "html_views"=>"69"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"11", "xml_views"=>"4", "html_views"=>"43"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"73"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"19", "xml_views"=>"2", "html_views"=>"71"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"25", "xml_views"=>"2", "html_views"=>"70"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"107"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"48"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"32", "xml_views"=>"0", "html_views"=>"83"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"79"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"30", "xml_views"=>"2", "html_views"=>"86"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"54"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"87"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"84"}
  • {"month"=>"7", "year"=>"2019", "pdf_views"=>"37", "xml_views"=>"0", "html_views"=>"39"}
  • {"month"=>"8", "year"=>"2019", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"34"}
  • {"month"=>"9", "year"=>"2019", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"49"}
  • {"month"=>"10", "year"=>"2019", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"69"}
  • {"month"=>"11", "year"=>"2019", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"45"}
  • {"month"=>"12", "year"=>"2019", "pdf_views"=>"21", "xml_views"=>"4", "html_views"=>"38"}
  • {"month"=>"1", "year"=>"2020", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"46"}
  • {"month"=>"2", "year"=>"2020", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"54"}
  • {"month"=>"3", "year"=>"2020", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"52"}
  • {"month"=>"4", "year"=>"2020", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"18"}
  • {"month"=>"5", "year"=>"2020", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"59"}
  • {"month"=>"6", "year"=>"2020", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"21"}
  • {"month"=>"7", "year"=>"2020", "pdf_views"=>"11", "xml_views"=>"1", "html_views"=>"23"}
  • {"month"=>"8", "year"=>"2020", "pdf_views"=>"23", "xml_views"=>"1", "html_views"=>"18"}
  • {"month"=>"9", "year"=>"2020", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"27"}
  • {"month"=>"10", "year"=>"2020", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"59"}
  • {"month"=>"11", "year"=>"2020", "pdf_views"=>"17", "xml_views"=>"1", "html_views"=>"27"}
  • {"month"=>"12", "year"=>"2020", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"30"}
  • {"month"=>"1", "year"=>"2021", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"22"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/319839", "https://ndownloader.figshare.com/files/319889"], "description"=>"<div><h3>Background</h3><p>Diarrhea is a leading cause of childhood morbidity and mortality in sub-Saharan Africa. Data on risk factors for mortality are limited. We conducted hospital-based surveillance to characterize the etiology of diarrhea and identify risk factors for death among children hospitalized with diarrhea in rural western Kenya.</p> <h3>Methods and Findings</h3><p>We enrolled all children <5 years old, hospitalized with diarrhea (≥3 loose stools in 24 hours) at two district hospitals in Nyanza Province, western Kenya. Clinical and demographic information was collected. Stool specimens were tested for bacterial and viral pathogens. Bivariate and multivariable logistic regression analyses were carried out to identify risk factors for death. From May 23, 2005 to May 22, 2007, 1,146 children <5 years old were enrolled; 107 (9%) children died during hospitalization. Nontyphoidal <em>Salmonella</em> were identified in 10% (118), <em>Campylobacter</em> in 5% (57), and <em>Shigella</em> in 4% (42) of 1,137 stool samples; rotavirus was detected in 19% (196) of 1,021 stool samples. Among stools from children who died, nontyphoidal <em>Salmonella</em> were detected in 22%, <em>Shigella</em> in 11%, rotavirus in 9%, <em>Campylobacter</em> in 5%, and <em>S</em>. Typhi in <1%. In multivariable analysis, infants who died were more likely to have nontyphoidal <em>Salmonella</em> (adjusted odds ratio [aOR] = 6·8; 95% CI 3·1–14·9), and children <5 years to have <em>Shigella</em> (aOR = 5·5; 95% CI 2·2–14·0) identified than children who survived. Children who died were less likely to be infected with rotavirus (OR = 0·4; 95% CI 0·2–0·8). Further risk factors for death included being malnourished (aOR = 4·2; 95% CI 2·1–8·7); having oral thrush on physical exam (aOR = 2·3; 95% CI 1·4–3·8); having previously sought care at a hospital for the illness (aOR = 2·2; 95% CI 1·2–3·8); and being dehydrated as diagnosed at discharge/death (aOR = 2·5; 95% CI 1·5–4·1). A clinical diagnosis of malaria, and malaria parasites seen on blood smear, were not associated with increased risk of death. This study only captured in-hospital childhood deaths, and likely missed a substantial number of additional deaths that occurred at home.</p> <h3>Conclusion</h3><p>Nontyphoidal <em>Salmonella</em> and <em>Shigella</em> are associated with mortality among rural Kenyan children with diarrhea who access a hospital. Improved prevention and treatment of diarrheal disease is necessary. Enhanced surveillance and simplified laboratory diagnostics in Africa may assist clinicians in appropriately treating potentially fatal diarrheal illness.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["factors", "children", "years", "hospitalized", "diarrhea", "cohort"], "article_id"=>123117, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001256.s001", "https://dx.doi.org/10.1371/journal.pmed.1001256.s002"], "stats"=>{"downloads"=>13, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Risk_Factors_for_Death_among_Children_Less_than_5_Years_Old_Hospitalized_with_Diarrhea_in_Rural_Western_Kenya_2005_2007_A_Cohort_Study/123117", "title"=>"Risk Factors for Death among Children Less than 5 Years Old Hospitalized with Diarrhea in Rural Western Kenya, 2005–2007: A Cohort Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-07-03 00:51:57"}
  • {"files"=>["https://ndownloader.figshare.com/files/613645"], "description"=>"a<p>Before initiating analysis data exploration (not shown) was carried out to compare the entire cohort of all enrolled children to the subset of children with available information from Health and Demographic Surveillance System data and no differences were noted.</p>b<p>For the multivariable logistic regression model, <i>n</i> = 84 for children who died and <i>n</i> = 781 for children who survived due to missing data.</p>", "links"=>[], "tags"=>[], "article_id"=>284104, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_the_data_collected_for_each_of_the_subsets_and_the_associated_denominators_/284104", "title"=>"List of the data collected for each of the subsets, and the associated denominators.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:08:24"}
  • {"files"=>["https://ndownloader.figshare.com/files/614019"], "description"=>"a<p>Unadjusted odds ratio from bivariate analysis.</p>b<p>Fisher exact test, and exact 95% CIs reported.</p>c<p>Where available included conjunctivitis, neonatal sepsis, meningitis, respiratory tract infection, pulmonary tuberculosis, sickle-cell disease.</p>d<p>Dehydration on physical exam defined as sunken eyes, loss of skin turgor (slow skin pinch return [≤2 s] or very slow return [>2 s]) or sunken fontenelle.</p>e<p>Fast breathing defined as ≥60 breaths per minute for children 0–<2 mo old, ≥50 breaths per minute for children 2–11 mo, and ≥40 breaths per minute for children 12–59 mo.</p>f<p>Lethargic and comatose were combined as being in a state of coma was rarely reported (<i>n</i> = 2 for children who died, <i>n</i> = 3 for children who survived).</p>g<p>Kruskal-Wallis test.</p>h<p>Cut-off based on the overall median parasite density (19,149 µl), high parasite density was defined as ≥20,000 parasites per µl.</p>i<p>Severe anemia defined as a hemoglobin concentration <5 g/dl.</p>j<p>Diagnoses considered to indicate HIV/AIDS were a diagnosis of immune suppression syndrome, or if a child was documented as being on antiretroviral therapy on their medical records. Classified separately due to non-routine data collection.</p>", "links"=>[], "tags"=>["children", "hospitalized", "diarrhea", "kenya", "85", "788"], "article_id"=>284465, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t004", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_information_for_children_lt_5_y_old_hospitalized_with_diarrhea_in_rural_western_Kenya_HDSS_subset_85_children_who_died_788_children_who_survived_/284465", "title"=>"Clinical information for children <5 y old hospitalized with diarrhea in rural western Kenya (HDSS subset: 85 children who died, 788 children who survived).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:14:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/613752"], "description"=>"a<p>Denominators for rotavirus are <i>n</i> = 98 for patients who died, and <i>n</i> = 923 for patients who survived. Denominators for culturing are <i>n</i> = 107 for patients who died, and <i>n</i> = 1,030 for patients who survived. 9 enrolled children did not have a culture work up but had viral testing carried out on stool.</p>b<p>Unadjusted odds ratio from bivariate analysis (odds of death among those with the enteric pathogen versus those without the pathogen within specific age groups).</p>c<p><i>p</i>-Value for the interaction term.</p>", "links"=>[], "tags"=>["enteric", "pathogens", "enrolled", "children", "hospitalized", "diarrhea", "had", "stool", "specimen", "cultured", "tested", "viral", "died", "survived", "kenya"], "article_id"=>284170, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t003", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Select_enteric_pathogens_identified_by_age_group_among_enrolled_children_n_107_and_survived_n_1_039_western_Kenya_2005_2007_/284170", "title"=>"Select enteric pathogens identified by age group among enrolled children <5 y old hospitalized with diarrhea and had a stool specimen cultured and/or tested for viral pathogens, by children who died (<i>n</i> = 107) and survived (<i>n</i> = 1,039), western Kenya 2005–2007.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:09:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/613932"], "description"=>"<p>The denominators for the data included in this analysis were <i>n</i> = 84 children who died and <i>n</i> = 781 children who survived, i.e. children for whom additional HDSS inpatient data were available.</p>a<p>Twelve variables were included in the final model with results shown for the six main effects, and the interaction between nontyphoidal <i>Salmonella</i> and age. The five additional non-significant variables were gender, duration of diarrhea, a diagnosis of HIV/AIDS, seeking care at a traditional healer previous to hospital visit, and referred for care.</p>b<p>aOR, whereby all odds ratios control for other factors in the model.</p>c<p>Confidence interval.</p>d<p><i>p</i>-Value for the interaction term of nontyphoidal <i>Salmonella</i> and age.</p>", "links"=>[], "tags"=>["independently", "children", "hospitalized", "diarrhea", "multivariable", "logistic", "regression", "kenya"], "article_id"=>284375, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t005", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Factors_independently_associated_with_an_increased_or_decreased_risk_of_death_among_children_lt_5_y_old_hospitalized_with_diarrhea_in_a_multivariable_logistic_regression_analysis_western_Kenya_2005_8211_2007_/284375", "title"=>"Factors independently associated with an increased or decreased risk of death among children <5 y old hospitalized with diarrhea in a multivariable logistic regression analysis, western Kenya 2005–2007.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:12:55"}
  • {"files"=>["https://ndownloader.figshare.com/files/614122"], "description"=>"a<p>Unmatched, unadjusted odds ratio.</p>b<p>Unmatched aOR, whereby, odds ratios control for age and the significant variables from the model shown in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001256#pmed-1001256-t005\" target=\"_blank\">Table 5</a>.</p>c<p>Matched odds ratio on univariate analysis.</p>d<p>aOR, whereby, matched odds ratios control the significant variables from the model shown in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001256#pmed-1001256-t005\" target=\"_blank\">Table 5</a>.</p>e<p>Represents bfpA− EPEC.</p>f<p>Represents bfpA+ EPEC.</p><p>mOR, matched odds ratio.</p>", "links"=>[], "tags"=>["conditional", "logistic", "regression", "pathogen-specific", "factors", "children", "died", "hospitalization", "diarrhea", "compared", "survived", "kenya"], "article_id"=>284549, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t006", "stats"=>{"downloads"=>3, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Matched_conditional_logistic_regression_analysis_of_pathogen_specific_risk_factors_for_death_among_children_n_107_compared_with_children_n_107_western_Kenya_2005_2007_/284549", "title"=>"Matched conditional logistic regression analysis of pathogen-specific risk factors for death among children <5 y old who died during hospitalization with diarrhea (<i>n</i> = 107), compared with children <5 y old with diarrhea who survived hospitalization (<i>n</i> = 107), western Kenya 2005–2007.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:15:49"}
  • {"files"=>["https://ndownloader.figshare.com/files/613845"], "description"=>"a<p>Unadjusted odds ratio from bivariate analysis.</p>b<p>Kruskal-Wallis test.</p>c<p>Based on caretakers assessment on admission.</p>d<p>Fisher exact test, and exact 95% CIs reported.</p>e<p>Denominators for rotavirus are <i>n</i> = 98 for patients who died, and <i>n</i> = 923 for patients who survived. Denominators for culturing are <i>n</i> = 107 for patients who died, and <i>n</i> = 1,030 for patients who survived. 9 enrolled children did not have a culture work up but had viral testing carried out on stool.</p>f<p>Wald CI for binomial proportion.</p>g<p>Wilson CI for binomial proportion.</p>h<p>Not estimated due to insufficient data.</p><p>IQR, interquartile range.</p>", "links"=>[], "tags"=>["enteric", "pathogens", "pathogen-specific", "cfrs", "children", "hospitalized", "died", "survived", "kenya"], "article_id"=>284278, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.t002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_and_clinical_characteristics_enteric_pathogens_identified_and_pathogen_specific_CFRs_for_1_146_children_n_107_and_survived_n_1_039_western_Kenya_2005_2007_/284278", "title"=>"Demographic and clinical characteristics, enteric pathogens identified, and pathogen-specific CFRs for 1,146 children <5 y old hospitalized with diarrhea, by children who died (<i>n</i> = 107) and survived (<i>n</i> = 1,039), western Kenya 2005–2007.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-07-03 01:11:18"}
  • {"files"=>["https://ndownloader.figshare.com/files/613501"], "description"=>"<p>Inset, age distribution by 1-mo periods, for children aged <1 to 12 mo old (<i>n</i> = 778).</p>", "links"=>[], "tags"=>["age-specific", "cfr", "children", "hospitalized", "kenya"], "article_id"=>283940, "categories"=>["Medicine"], "users"=>["Ciara E. O'Reilly", "Peter Jaron", "Benjamin Ochieng", "Amek Nyaguara", "Jacqueline E. Tate", "Michele B. Parsons", "Cheryl A. Bopp", "Kara A. Williams", "Jan Vinje", "Elizabeth Blanton", "Kathleen A. Wannemuehler", "John Vulule", "Kayla F. Laserson", "Robert F. Breiman", "Daniel R. Feikin", "Marc-Alain Widdowson", "Eric Mintz"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001256.g001", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Age_distribution_bars_and_age_specific_CFR_line_of_1_146_children_hospitalized_with_diarrhea_western_Kenya_2005_8211_2007_/283940", "title"=>"Age distribution (bars) and age-specific CFR (line) of 1,146 children hospitalized with diarrhea, western Kenya 2005–2007.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-07-03 01:05:40"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"48", "full-text"=>"53", "pdf"=>"32", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"7"}
  • {"unique-ip"=>"56", "full-text"=>"54", "pdf"=>"53", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2012", "month"=>"8"}
  • {"unique-ip"=>"34", "full-text"=>"31", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2012", "month"=>"9"}
  • {"unique-ip"=>"53", "full-text"=>"57", "pdf"=>"29", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"10"}
  • {"unique-ip"=>"40", "full-text"=>"26", "pdf"=>"28", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"12"}
  • {"unique-ip"=>"48", "full-text"=>"48", "pdf"=>"19", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"1"}
  • {"unique-ip"=>"54", "full-text"=>"54", "pdf"=>"30", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"2"}
  • {"unique-ip"=>"46", "full-text"=>"56", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"3"}
  • {"unique-ip"=>"47", "full-text"=>"59", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"4"}
  • {"unique-ip"=>"43", "full-text"=>"51", "pdf"=>"27", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2012", "month"=>"11"}
  • {"unique-ip"=>"48", "full-text"=>"54", "pdf"=>"21", "abstract"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"5"}
  • {"unique-ip"=>"38", "full-text"=>"35", "pdf"=>"19", "abstract"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"6"}
  • {"unique-ip"=>"23", "full-text"=>"22", "pdf"=>"10", "abstract"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2013", "month"=>"7"}
  • {"unique-ip"=>"25", "full-text"=>"22", "pdf"=>"11", "abstract"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"8"}
  • {"unique-ip"=>"26", "full-text"=>"29", "pdf"=>"20", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"9"}
  • {"unique-ip"=>"35", "full-text"=>"38", "pdf"=>"18", "abstract"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"6", "year"=>"2013", "month"=>"10"}
  • {"unique-ip"=>"23", "full-text"=>"18", "pdf"=>"14", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2013", "month"=>"11"}
  • {"unique-ip"=>"19", "full-text"=>"24", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2013", "month"=>"12"}
  • {"unique-ip"=>"17", "full-text"=>"17", "pdf"=>"15", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"1"}
  • {"unique-ip"=>"24", "full-text"=>"22", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"2"}
  • {"unique-ip"=>"33", "full-text"=>"36", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2014", "month"=>"3"}
  • {"unique-ip"=>"20", "full-text"=>"18", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"5"}
  • {"unique-ip"=>"15", "full-text"=>"14", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"6"}
  • {"unique-ip"=>"23", "full-text"=>"20", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"4"}
  • {"unique-ip"=>"21", "full-text"=>"22", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"11", "full-text"=>"9", "pdf"=>"8", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"29", "full-text"=>"26", "pdf"=>"18", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"25", "full-text"=>"38", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"8", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"19", "full-text"=>"18", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"27", "full-text"=>"30", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"23", "full-text"=>"26", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"29", "full-text"=>"35", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"38", "full-text"=>"41", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"33", "full-text"=>"36", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"38", "full-text"=>"39", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"39", "full-text"=>"41", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"33", "full-text"=>"36", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"32", "full-text"=>"28", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"56", "full-text"=>"61", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"67", "full-text"=>"86", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"71", "full-text"=>"100", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"52", "full-text"=>"61", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"63", "full-text"=>"70", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"66", "full-text"=>"67", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"50", "full-text"=>"60", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"40", "full-text"=>"47", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"47", "full-text"=>"57", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"34", "full-text"=>"42", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"44", "full-text"=>"49", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"48", "full-text"=>"52", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"63", "full-text"=>"65", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"54", "full-text"=>"57", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"108", "full-text"=>"131", "pdf"=>"20", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"69", "full-text"=>"75", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"61", "full-text"=>"67", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"38", "full-text"=>"48", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"55", "full-text"=>"61", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"65", "full-text"=>"72", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"56", "full-text"=>"59", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"50", "full-text"=>"53", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"54", "full-text"=>"71", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"61", "full-text"=>"63", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"91", "full-text"=>"98", "pdf"=>"20", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"2", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"109", "full-text"=>"128", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"114", "full-text"=>"120", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"1", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"53", "full-text"=>"54", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"71", "full-text"=>"79", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"96", "full-text"=>"108", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"34", "full-text"=>"41", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"82", "full-text"=>"110", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"75", "full-text"=>"96", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"76", "full-text"=>"108", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"43", "full-text"=>"54", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"51", "full-text"=>"56", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"52", "full-text"=>"55", "pdf"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"47", "full-text"=>"54", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"62", "full-text"=>"73", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"37", "full-text"=>"45", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"47", "full-text"=>"54", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"59", "full-text"=>"65", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"71", "full-text"=>"82", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"59", "full-text"=>"63", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"36", "full-text"=>"36", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"37", "full-text"=>"35", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"46", "full-text"=>"49", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"46", "full-text"=>"45", "pdf"=>"15", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}
  • {"unique-ip"=>"44", "full-text"=>"46", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2020", "month"=>"2"}
  • {"unique-ip"=>"49", "full-text"=>"66", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"3"}
  • {"unique-ip"=>"48", "full-text"=>"70", "pdf"=>"11", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"4"}
  • {"unique-ip"=>"30", "full-text"=>"33", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"5"}
  • {"unique-ip"=>"26", "full-text"=>"26", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"2", "cited-by"=>"1", "year"=>"2020", "month"=>"6"}
  • {"unique-ip"=>"19", "full-text"=>"20", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"7"}
  • {"unique-ip"=>"17", "full-text"=>"15", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2020", "month"=>"8"}
  • {"unique-ip"=>"24", "full-text"=>"31", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2020", "month"=>"9"}
  • {"unique-ip"=>"38", "full-text"=>"40", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2020", "month"=>"10"}
  • {"unique-ip"=>"29", "full-text"=>"40", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"11"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2020", "month"=>"12"}

Relative Metric

{"start_date"=>"2012-01-01T00:00:00Z", "end_date"=>"2012-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences", "average_usage"=>[322, 550, 671, 773, 864, 955, 1048, 1135, 1223, 1308, 1387, 1465, 1534, 1602, 1673, 1744, 1813, 1885, 1955, 2026, 2093, 2160, 2228, 2290, 2349]}, {"subject_area"=>"/Biology and life sciences/Organisms", "average_usage"=>[331, 557, 677, 777, 868, 960, 1050, 1136, 1223, 1307, 1390, 1466, 1536, 1603, 1673, 1741, 1814, 1889, 1954, 2028, 2096, 2164, 2233, 2305, 2362]}, {"subject_area"=>"/Medicine and health sciences/Gastroenterology and hepatology", "average_usage"=>[300, 551, 690, 799, 882, 973, 1070, 1148, 1253, 1340, 1421, 1524, 1599, 1666, 1752, 1833, 1893, 1990, 2051, 2110, 2181, 2243, 2303, 2369, 2434]}, {"subject_area"=>"/Medicine and health sciences/Pathology and laboratory medicine", "average_usage"=>[321, 553, 683, 785, 880, 973, 1072, 1162, 1249, 1336, 1425, 1504, 1574, 1642, 1711, 1785, 1852, 1923, 1987, 2050, 2129, 2192, 2259, 2325, 2393]}, {"subject_area"=>"/Medicine and health sciences/Pediatrics", "average_usage"=>[300, 544, 655, 754, 851, 952, 1048, 1105, 1224, 1296, 1390, 1469, 1524, 1594, 1666, 1742, 1805, 1852, 1936, 2002, 2069, 2153, 2222, 2309, 2373]}, {"subject_area"=>"/People and places", "average_usage"=>[330, 562, 680, 783, 875, 964, 1062, 1152, 1240, 1327, 1406, 1483, 1561, 1632, 1701, 1770, 1849, 1922, 1993, 2059, 2131, 2197, 2271, 2335, 2403]}]}
Loading … Spinner
There are currently no alerts