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Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth

Christine Marie George1, Vanessa Burrowes1, Jamie Perin1

  • 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Tropical Medicine & International Health : TM & IH
|November 10, 2017
PubMed

Insights

Childhood enteric infections from contaminated play spaces are linked to environmental enteropathy and impaired growth in rural Bangladesh. This highlights the critical need for improved sanitation to prevent infections and promote healthy child development.

Area of Science:

  • Environmental health
  • Pediatric infectious diseases
  • Global child health

Background:

  • Childhood enteric infections are a significant global health concern, particularly in low-resource settings.
  • Environmental enteropathy (EE) and impaired growth are serious consequences of repeated enteric infections in young children.
  • Faecal contamination of child play spaces is a potential, yet understudied, transmission route for enteric pathogens.

Purpose of the Study:

  • To investigate the association between faecal contamination in child play spaces, enteric infections, environmental enteropathy (EE), and impaired growth in young children.
  • To identify specific enteric pathogens linked to intestinal inflammation and growth deficits.
  • To explore the role of contaminated soil in child play areas as a source of infection.

Main Methods:

  • A prospective cohort study involving 203 children aged 6-30 months in rural Bangladesh.
  • Stool sample analysis using quantitative PCR for common enteric pathogens (Shigella, ETEC, Campylobacter jejuni, Giardia intestinalis, Cryptosporidium).
  • Measurement of fecal markers for intestinal inflammation and child growth, alongside E. coli quantification in play space soil.

Main Results:

  • High prevalence of enteric pathogens, with 47% of children having three or more pathogens.
  • Significant associations found between specific infections and outcomes: ETEC with higher calprotectin, Shigella with stunting, and Giardia with higher E. coli in play soil.
  • Enterotoxigenic Escherichia coli (ETEC) and Shigella infections were linked to intestinal inflammation and impaired growth, respectively.

Conclusions:

  • Enteric infections are significantly associated with environmental enteropathy and impaired growth in young children in rural Bangladesh.
  • Findings support the hypothesis that contaminated soil in child play spaces contributes to enteric infections.
  • Subclinical enteric infections resulting from environmental exposure can lead to long-term health consequences, including EE and impaired growth.
Abstract

Keywords:
croissance altéréeenteric infectionsentéropathie environnementaleenvironmental enteropathyimpaired growthinfections entériques

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