Malnutrition and gastroenteritis in The Gambia

There is a strong association between failure to thrive and diarrhoeal disease in young Gambian children. The high prevalence of diarrhoeal disease seen is not due to frequent attacks of "acute infantile diarrhoea" of viral orgin. The picture of protracted diarrhoea is almost certainly due to colonization of the upper bowel and the high prevalence demonstrated to be at least partly due to the environment to which the children are exposed, particularly in terms of food and water hygiene. Until this cycle of upper bowel colonization and protracted diarrhoea is broken, a diet-based nutrition programme cannot be expected to function effectively.