Karen L Kotloff
Biographic Data
| ID | 6330253 |
|---|---|
| NAME | Karen L Kotloff |
| GIVEN NAMES | Karen L |
| FAMILY NAME | Kotloff |
| SIGNATURE | KOTLOFF K L |
| AFFILIATIONS | University of Maryland, Baltimore |
| ORCID | 0000-0003-1808-6431 |
| VERIFIED | Yes |
| TOTAL WORKS | 15 |
| TOTAL CITATIONS | 0 |
| AUTHOR COUNT | 15 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 0 |
Temporal patterns and risk factors of diarrheal comorbidity among children aged < 5 years in rural western Kenya
Sub-Saharan Africa bears the highest burden of diarrhea, often complicated by comorbidities that delay diagnosis, hinder treatment, and worsen outcomes. As the epidemiology of diarrheal disease evolves, understanding comorbidity patterns is critical for effective public health responses. We examined the temporal patterns and risk factors of diarrheal comorbidity in Kenyan children aged Shigella surveillance study (2022–2024). The outcome was como…
Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the…
INTRODUCTION: One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with…
Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal d…
Achieving the Sustainable Development Goal of reducing child mortality to Shigella /EIEC (14.0%), ST-ETEC (12.4%), rotavirus (26.4%), and adenovirus (non-40/41: 19.0%; 40/41: 5.0%). These pathogens were frequently identified as co-infections. Diarrheal disease accounted for a substantial share of child deaths across CHAMPS sites. Reducing mortality will require preventing diarrhea and addressing key contributors such as malnutrition and HIV
Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia
Introduction Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition’s role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network. Methods We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and…
Identifying delays in healthcare seeking and provision
Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the “Three Delays-in-Healthcare”, and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical r…
Comparison of causes of stillbirth and child deaths as determined by verbal autopsy and minimally invasive tissue sampling
In resource-limited settings where vital registration and medical death certificates are unavailable or incomplete, verbal autopsy (VA) is often used to attribute causes of death (CoD) and prioritize resource allocation and interventions. We aimed to determine the CoD concordance between InterVA and CHAMPS’s method. The causes of death (CoDs) of children
Characteristics and outcomes of children 2–23 months of age with prolonged diarrhoea
Background: Approximately 12% of all diarrhoeal episodes last for 7-13 days. As such, they are termed prolonged diarrhoea, and are associated with over two-thirds of all diarrhoeal deaths. Due to a lack of robust data, we aimed to evaluate a comparative background characteristics of young children with acute and prolonged diarrhoea, and their outcomes at day 90 follow-up. Methods: We performed a secondary analysis of data from the Antibiotics for…
Causes of death identified in neonates enrolled through Child Health and Mortality Prevention Surveillance (CHAMPS), December 2016 –December 2021
Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24–72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathoge…
Derivation and external validation of a clinical prognostic model identifying children at risk of death following presentation for diarrheal care
Diarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation. We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) to build clinical prognostic mod…
Associations between Household-Level Exposures and All-Cause Diarrhea and Pathogen-Specific Enteric Infections in Children Enrolled in Five Sentinel Surveillance Studies
Diarrheal disease remains a major cause of childhood mortality and morbidity causing poor health and economic outcomes. In low-resource settings, young children are exposed to numerous risk factors for enteric pathogen transmission within their dwellings, though the relative importance of different transmission pathways varies by pathogen species. The objective of this analysis was to model associations between five household-level risk factors-w…
Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990-2016 and assesses how the burden of diarrhoea has changed in people of all ages. METHODS: We modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types…
Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide. METHODS: We estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platfor…
The effect of costs on Kenyan households’ demand for medical care
In an environment of constrained resources, policymakers must identify solutions for financing and delivering health services that are efficient and sustainable. However, such solutions require that policymakers understand the complex interaction between household utilization patterns, factors influencing household medical decisions, and provider performance. This study examined whether and under what conditions out-of-pocket, transportation, and…
Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, Pakistan
BACKGROUND: Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care-seeking behavior and other predictors of diarrhea-related mortality in children in selected low-income peri-urban communities of Karachi, Pakistan. METHODS: A mixed methods study (qualitative and quantitative) using matched case-control design…
Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, Gems)
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Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, Gems)
Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, Pakistan
BACKGROUND: Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care-seeking behavior and other predictors of diarrhea-related mortality in children in selected low-income peri-urban communities of Karachi, Pakistan. METHODS: A mixed methods study (qualitative and quantitative) using matched case-control design…
Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide. METHODS: We estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platfor…
The effect of costs on Kenyan households’ demand for medical care
In an environment of constrained resources, policymakers must identify solutions for financing and delivering health services that are efficient and sustainable. However, such solutions require that policymakers understand the complex interaction between household utilization patterns, factors influencing household medical decisions, and provider performance. This study examined whether and under what conditions out-of-pocket, transportation, and…
Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 provides an up-to-date analysis of the burden of diarrhoea in 195 countries. This study assesses cases, deaths, and aetiologies in 1990-2016 and assesses how the burden of diarrhoea has changed in people of all ages. METHODS: We modelled diarrhoea mortality with a Bayesian hierarchical modelling platform that evaluates a wide range of covariates and model types…
Associations between Household-Level Exposures and All-Cause Diarrhea and Pathogen-Specific Enteric Infections in Children Enrolled in Five Sentinel Surveillance Studies
Diarrheal disease remains a major cause of childhood mortality and morbidity causing poor health and economic outcomes. In low-resource settings, young children are exposed to numerous risk factors for enteric pathogen transmission within their dwellings, though the relative importance of different transmission pathways varies by pathogen species. The objective of this analysis was to model associations between five household-level risk factors-w…
Causes of death identified in neonates enrolled through Child Health and Mortality Prevention Surveillance (CHAMPS), December 2016 –December 2021
Each year, 2.4 million children die within their first month of life. Child Health and Mortality Prevention Surveillance (CHAMPS) established in 7 countries aims to generate accurate data on why such deaths occur and inform prevention strategies. Neonatal deaths that occurred between December 2016 and December 2021 were investigated with MITS within 24–72 hours of death. Testing included blood, cerebrospinal fluid and lung cultures, multi-pathoge…
Derivation and external validation of a clinical prognostic model identifying children at risk of death following presentation for diarrheal care
Diarrhea continues to be a leading cause of death for children under-five. Amongst children treated for acute diarrhea, mortality risk remains elevated during and after acute medical management. Identification of those at highest risk would enable better targeting of interventions, but available prognostic tools lack validation. We used clinical and demographic data from the Global Enteric Multicenter Study (GEMS) to build clinical prognostic mod…
Contribution of malnutrition to infant and child deaths in Sub-Saharan Africa and South Asia
Introduction Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition’s role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network. Methods We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and…
Identifying delays in healthcare seeking and provision
Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the “Three Delays-in-Healthcare”, and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical r…
Comparison of causes of stillbirth and child deaths as determined by verbal autopsy and minimally invasive tissue sampling
In resource-limited settings where vital registration and medical death certificates are unavailable or incomplete, verbal autopsy (VA) is often used to attribute causes of death (CoD) and prioritize resource allocation and interventions. We aimed to determine the CoD concordance between InterVA and CHAMPS’s method. The causes of death (CoDs) of children
Characteristics and outcomes of children 2–23 months of age with prolonged diarrhoea
Background: Approximately 12% of all diarrhoeal episodes last for 7-13 days. As such, they are termed prolonged diarrhoea, and are associated with over two-thirds of all diarrhoeal deaths. Due to a lack of robust data, we aimed to evaluate a comparative background characteristics of young children with acute and prolonged diarrhoea, and their outcomes at day 90 follow-up. Methods: We performed a secondary analysis of data from the Antibiotics for…
Is rotavirus aetiology in young children with acute diarrhoea associated with sociodemographic and clinical factors, including rotavirus vaccination status? A secondary cross-sectional analysis of the…
INTRODUCTION: One of the leading causes of global child mortality continues to be diarrhoea where rotavirus contributed to about 24% of deaths among all diarrhoeal deaths, mostly in low-income and middle-income countries. Rotavirus vaccination programmes have contributed to the reduction of mortality from 24% to 19% in rotavirus infections among hospitalised children, but the burden of rotaviral diarrhoea remains high, especially in settings with…
Use of minimally invasive tissue sampling to determine the contribution of diarrheal diseases to under-five mortality and associated co-morbidities and co-infections in children with fatal diarrheal d…
Achieving the Sustainable Development Goal of reducing child mortality to Shigella /EIEC (14.0%), ST-ETEC (12.4%), rotavirus (26.4%), and adenovirus (non-40/41: 19.0%; 40/41: 5.0%). These pathogens were frequently identified as co-infections. Diarrheal disease accounted for a substantial share of child deaths across CHAMPS sites. Reducing mortality will require preventing diarrhea and addressing key contributors such as malnutrition and HIV
Temporal patterns and risk factors of diarrheal comorbidity among children aged < 5 years in rural western Kenya
Sub-Saharan Africa bears the highest burden of diarrhea, often complicated by comorbidities that delay diagnosis, hinder treatment, and worsen outcomes. As the epidemiology of diarrheal disease evolves, understanding comorbidity patterns is critical for effective public health responses. We examined the temporal patterns and risk factors of diarrheal comorbidity in Kenyan children aged Shigella surveillance study (2022–2024). The outcome was como…
Medicine (14 works) · Child Nutrition and Water Access (12 works) · Environmental health (10 works) · Viral gastroenteritis research and epidemiology (10 works) · Diarrhea (9 works) · Internal Medicine (9 works) · Pediatrics (8 works) · Population (7 works) · Global Maternal and Child Health (6 works) · Cause of death (5 works)