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Intestinal permeability, mucosal injury, and growth faltering in Gambian infants

P G Lunn1, C A Northrop-Clewes, R M Downes

  • 1Medical Research Council Dunn Nutrition Centre, Cambridge, UK.

Lancet (London, England)
|October 12, 1991
PubMed

Insights

Children in developing countries may not fully recover growth after diarrhea due to persistent intestinal damage. This study links small bowel mucosal abnormalities to impaired growth in Gambian infants, explaining significant growth faltering.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Global Health

Background:

  • Diarrhea is a major cause of childhood illness in developing countries.
  • Catch-up growth potential after illness is debated, with mucosal injury being a key factor.
  • Assessing intestinal integrity is crucial for understanding growth faltering.

Purpose of the Study:

  • To investigate the relationship between intestinal disease and growth performance in young children.
  • To determine if persistent intestinal abnormalities affect catch-up growth after diarrhea.
  • To quantify the contribution of long-term intestinal lesions to growth faltering.

Main Methods:

  • A longitudinal study involving 2-15 month old Gambian infants.
  • Regularly administered lactulose:mannitol permeability tests to assess intestinal integrity.
  • Continuous monitoring of infant growth rates over a mean period of 7.5 months.

Main Results:

  • Persistent abnormalities in the small bowel mucosa were identified in the study population.
  • A significant negative correlation was observed between intestinal mucosal abnormalities and infant growth.
  • Long-term intestinal lesions were found to explain up to 43% of observed growth faltering.

Conclusions:

  • Persistent small bowel mucosal lesions are prevalent in young Gambian children.
  • Intestinal integrity is a critical determinant of growth performance in this population.
  • Targeting intestinal health may be essential for improving child growth in developing countries.

Keywords:
AfricaAfrica South Of The SaharaAnthropometry--changesBiologyBody Weight--changesBreast FeedingChild DevelopmentChild NutritionDemographic FactorsDeveloping CountriesDiarrheaDiarrhea, InfantileDiseasesEnglish Speaking AfricaExaminations And DiagnosesGambiaGastrointestinal EffectsGrowthHealthInfant NutritionLaboratory Examinations And DiagnosesLongitudinal StudiesMalnutritionMeasurementNutritionNutrition DisordersPhysiologyPopulationPopulation CharacteristicsPrevalenceProspective StudiesResearch MethodologyRural PopulationStudiesWestern Africa

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