Gut Integrity Biomarkers and Parasitic Infections in Indonesian Children: A Cross-Sectional Analysis

Gastrointestinal integrity in young population warrants special attention. Infectious pathogens may induce changes in intestinal microbiota, facilitating gut permeability. This study aimed to investigate the gut integrity and inflammatory markers in children with parasitic and non-parasitic infection in Kupang and North Kodi, Indonesia.

A cross-sectional study assessed the anthropometric measurement, socio-demographic factors and personal hygiene practices. Stool samples for helminthic and protozoan infections were analysed using standard microscopy, while blood samples for gut integrity (intestinal fatty acid-binding protein [I-FABP] and fatty acid-binding protein 6 [FABP6]) and inflammatory markers (soluble cluster of differentiation 14 [sCD14] and soluble cluster of differentiation 163 [sCD163]) were assessed using enzyme-linked immunosorbent assay kit.

As many as 80 stool samples taken from the children with age of 36-45 months to examine gut parasites in East Nusa Tenggara. Thirty-three from 80 children have intestinal parasites infection and 5 of them infected with 2 types of parasites. A total of 38 intestinal parasites were found with 47.37% protozoa and 52.63% helminths. The most predominant parasites found are Giardia lamblia (21.1%) for protozoans and Trichuris trichiura (26.3%) for helminths. Furthermore, significantly, the median levels of gut integrity biomarkers concentration were higher in non-parasitic group compared to parasitic group, as follows I-FABP 99.50 ng/mL (33.81-393.39); FABP6 56.13 ng/mL (2.43-234.69); sCD14 4.87 ng/mL (1.98-15.06) and sCD163 17.338 ng/mL (1.98-60.92) and significant in FABP6 and sCD14 (p=0.014; 0.001 respectively).

In Kupang and North Kodi, intestinal parasitic infections remain a significant concern. The elevated markers of gut integrity and inflammation biomarkers in children with non-parasitic infection are quite concerning and need additional research to justify the causality.