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Background  Although diarrheal illnesses are recognized as both a cause and effect of undernutrition, evidence for the effect of specific enteropathogens on early childhood growth remains limited. We estimated the effects of undernutrition as a risk factor for campylobacteriosis, as well as associations between symptomatic and asymptomatic  Campylobacter  infections and growth.    Methodology/Principal Findings  Using data from a prospective cohort of 442 children aged 0–72 months, the effect of nutritional status on the incidence of  Campylobacter  infection was estimated using uni- and multivariate Poisson models. Multivariate regression models were developed to evaluate the effect of  Campylobacter  infection on weight gain and linear growth. Overall, 8.3% of diarrheal episodes were associated with  Campylobacter  (crude incidence rate = 0.37 episodes/year) and 4.9% of quarterly asymptomatic samples were  Campylobacter  positive. In univariate models, the incidence of  Campylobacter  infection was marginally higher in stunted than non-stunted children (IRR 1.270, 95% CI (0.960, 1.681)(p = 0.095). When recent diarrheal burdens were included in the analysis, there was no difference in risk between stunted and unstunted children. Asymptomatic and symptomatic  Campylobacter  infections were associated with reduced weight gain over a three-month period (65.5 g (95% CI: −128.0, −3.0)(p = 0.040) and 43.9 g (95% CI:−87.6, −1.0)(p = 0.049) less weight gain, respectively). Symptomatic  Campylobacter  infections were only marginally associated with reduced linear growth over a nine month period (−0.059 cm per episode, 95% CI: −0.118, 0.001)(p = 0.054), however relatively severe episodes were associated with reduced linear growth (−0.169 cm/episode, 95% CI −0.310, −0.028)(p = 0.019).    Conclusions/Significance  Our findings suggest that  Campylobacter  is not as benign as commonly assumed, and that there is evidence to support expanding the indications for antibiotic therapy in campylobacteriosis in children.

Symptomatic and Asymptomatic Campylobacter Infections Associated with Reduced Growth in Peruvian Children