The proposed ICIDR program comprises a multidisciplinary and coordinated set of epidemiological, clinical, and laboratory research activities in enteric parasitic disease, and will specifically focus on giardiasis and cryptosporidiosis. A major integrating theme will be to determine relationships between manifestation of infection in the host, and characteristics of the host and of the parasite. We will explore how the clinical expression of infection relates to the environmental, nutritional, and immunological status of the infected child and to genetic and/or antigenic variability of the parasite. The proposed ICIDR will be organized as 4 Research Projects and 4 Core Components and will be a collaborative program among investigators from U.S. institutions (Columbia University, Cornell University) and institutions in Israel and adjacent areas (Hebrew University, Ben Gurion University, Ramallah Hospital). Project A will prospectively follow the natural history of G. lamblia and Cryptosporidium infections in a cohort of newborn children for three years in a Bedouin village in the Negev, and will determine the interactions of growth and nutrition of these children with symptomatic and asymptomatic infections with these parasites. Because the cohort study will not provide a sufficient number of cases to explore in depth associations between symptomatic infec- tions with nutrition and malnutrition chronic diarrhea and immunologic status. Project B will do so in case control studies of diarrhea associated with these two Parasites in different population settings; hosPitalized children in Jerusalem and in the West bank and ambulatory children ar a West bank primary health center and in 3 kibbutzim. Project C will Probe the distribution of strain diversity of G. lamblia and Cryptosporidium using the immunologic response isoenzyme comParisons antigenic analysis, and DNA sequence analysis (Pulsed field gel-electroPhoresis) on isolates to be obtained in Projects A and B. Project D aims to investigate the mechanism regulating strain variability in G. lamblia and to determine whether antigenic diversity results from changes in the DNA sequence itself, or from variable gene expression (or both). The 4 Core components include: A) ICIDR administration at Columbia University; B) a coordination Core in Israel; C) an immunology Core laboratory and; D) a Core biostatistics resource. The program will, therefore, integrate basic molecular genetic and immunologic analysis with what is expressed in different population and clinical settings.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program Projects (P01)
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Columbia University (N.Y.)
Schools of Medicine
New York
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Levy, Amalia; Fraser, Drora; Rosen, Shirley D et al. (2005) Anemia as a risk factor for infectious diseases in infants and toddlers: results from a prospective study. Eur J Epidemiol 20:277-84
Fraser, D; Shahar, D; Shai, I et al. (2000) Negev nutritional studies: nutritional deficiencies in young and elderly populations. Public Health Rev 28:31-46
Fraser, D; Bilenko, N; Deckelbaum, R J et al. (2000) Giardia lamblia carriage in Israeli Bedouin infants: risk factors and consequences. Clin Infect Dis 30:419-24
Bilenko, N; Fraser, D; Naggan, L (1999) Maternal knowledge and environmental factors associated with risk of diarrhea in Israeli Bedouin children. Eur J Epidemiol 15:907-12
Yavzori, M; Porath, N; Ochana, O et al. (1998) Detection of enterotoxigenic Escherichia coli in stool specimens by polymerase chain reaction. Diagn Microbiol Infect Dis 31:503-9
Porat, N; Levy, A; Fraser, D et al. (1998) Prevalence of intestinal infections caused by diarrheagenic Escherichia coli in Bedouin infants and young children in Southern Israel. Pediatr Infect Dis J 17:482-8
Fraser, D; Dagan, R; Naggan, L et al. (1997) Natural history of Giardia lamblia and Cryptosporidium infections in a cohort of Israeli Bedouin infants: a study of a population in transition. Am J Trop Med Hyg 57:544-9
Dagan, R; Fraser, D; El-On, J et al. (1995) Evaluation of an enzyme immunoassay for the detection of Cryptosporidium spp. in stool specimens from infants and young children in field studies. Am J Trop Med Hyg 52:134-8
el-On, J; Dagan, R; Fraser, D et al. (1994) Detection of Cryptosporidium and Giardia intestinalis in Bedouin children from southern Israel. Int J Parasitol 24:409-11
Fraser, D (1994) Epidemiology of Giardia lamblia and Cryptosporidium infections in childhood. Isr J Med Sci 30:356-61

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