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Markers of Environmental Enteric Dysfunction are Associated with Poor Growth and Developmental Outcomes among Young
Jacqueline M Lauer1, Juha Pyykkö2, Mpela Chembe3
1Department of Health Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA.
Insights
Biomarkers for environmental enteric dysfunction (EED) in Zambian children were linked to poorer growth and development. Addressing EED is crucial for improving child health outcomes globally.
Area of Science:
- Pediatric Health
- Gastroenterology
- Nutritional Science
Background:
- Environmental enteric dysfunction (EED) is an acquired subclinical condition affecting the small intestine.
- EED is prevalent in low-income settings and impacts child development.
- Understanding EED's impact on growth and development is critical for public health.
Purpose of the Study:
- To investigate the relationship between EED biomarkers and child anthropometric and developmental outcomes in Lusaka, Zambia.
- To assess the cross-sectional associations between specific EED markers and child development indicators.
Main Methods:
- Serum samples from 240 children (27-35 months) in Lusaka, Zambia were analyzed.
- The 11-plex Micronutrient and EED Assessment Tool measured biomarkers: intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14).
- Linear regression models analyzed associations between EED biomarkers and anthropometric (HAZ, WHZ, WAZ) and developmental (GSED, SRT) outcomes.
Main Results:
- Higher concentrations of sCD14 and I-FABP were significantly associated with lower height-for-age z-scores (HAZ).
- Elevated I-FABP levels correlated with reduced development-for-age z-scores and slower saccadic reaction times (SRT).
- Alpha-1-acid glycoprotein also showed associations with lower HAZ and slower SRT.
Conclusions:
- Biomarkers of EED are significantly associated with impaired anthropometric and developmental outcomes in young children in Lusaka.
- These findings highlight the importance of interventions targeting EED to improve child health.
- Addressing EED is essential for global child health improvement strategies.
Objective:
To examine cross-sectional relationships between biomarkers of environmental enteric dysfunction (EED), an acquired subclinical condition of the small intestine, and anthropometric and developmental outcomes among children in Lusaka, Zambia.
Study Design:
Serum samples were collected from 240 children aged 27 to 35 months enrolled in a cluster-randomized trial assessing the effects of growth charts and small-quantity lipid-based nutrient supplements on linear growth. Samples were analyzed using the 11-plex Micronutrient and EED Assessment Tool, which incorporates 2 biomarkers of EED, namely intestinal fatty acid-binding protein (I-FABP), a marker of epithelial damage, and soluble CD14 (sCD14), a marker of microbial translocation. Associations between log2-transformed biomarker concentrations and anthropometric (height-for-age z-score [HAZ], weight-for-height z-score, and weight-for-age z-score) and developmental (Global Scales of Early Development development for age z-score and saccadic reaction time [SRT]) outcomes were assessed using linear regression analyses adjusted for background characteristics.
Results:
Mean ± SD HAZ was -1.94 ± 1.10. Higher sCD14 and I-FABP concentrations were significantly associated with lower HAZ (β: -0.21, 95% CI: -0.41, -0.01 and β: -0.20, 95% CI: -0.32, -0.08, respectively). Higher I-FABP concentrations were significantly associated with lower development-for-age z-score (β: -0.22, 95% CI: -0.40, -0.03) and slower SRT (β: 7.37 ms, 95% CI: 2.02, 12.72) as were higher alpha-1-acid glycoprotein concentrations (HAZ β: -0.38, 95% CI: -0.72, -0.03; SRT β: 11.14 ms, 95% CI: 0.94, 21.72).
Conclusions:
In children in Lusaka, biomarkers of EED were associated with poor anthropometric and developmental outcomes, underscoring the need for interventions to address EED to improve child health globally.
Clinical Trial Registry:
ClinicalTrials.gov identifier for parent trial: NCT05120427. https://clinicaltrials.gov/ct2/show/NCT05120427.
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