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Contribution of Enteric Infection, Altered Intestinal Barrier Function, and Maternal Malnutrition to Infant Malnutrition in Bangladesh
- Publication Year :
- 2011
- Publisher :
- Oxford University Press, 2011.
-
Abstract
- Background. Malnourished children are at increased risk for death due to diarrhea. Our goal was to determine the contribution of specific enteric infections to malnutrition-associated diarrhea and to determine the role of enteric infections in the development of malnutrition. Methods. Children from an urban slum in Bangladesh were followed for the first year of life by every-other-day home visits. Enteropathogens were identified in diarrheal and monthly surveillance stools; intestinal barrier function was measured by serum endocab antibodies; and nutritional status was measured by anthropometry. Results. Diarrhea occurred 4.69 ± 0.19 times per child per year, with the most common infections caused by enteric protozoa (amebiasis, cryptosporidiosis, and giardiasis), rotavirus, astrovirus, and enterotoxigenic Escherichia coli (ETEC). Malnutrition was present in 16.3% of children at birth and 42.4% at 12 months of age. Children malnourished at birth had increased Entamoeba histolytica, Cryptosporidium, and ETEC infections and more severe diarrhea. Children who became malnourished by 12 months of age were more likely to have prolonged diarrhea, intestinal barrier dysfunction, a mother without education, and low family expenditure. Conclusions. Prospective observation of infants in an urban slum demonstrated that diarrheal diseases were associated with the development of malnutrition that was in turn linked to intestinal barrier disruption and that diarrhea was more severe in already malnourished children. The enteric protozoa were unexpectedly important causes of diarrhea in this setting. This study demonstrates the complex interrelationship of malnutrition and diarrhea in infants in low-income settings and points to the potential for infectious disease interventions in the prevention and treatment of malnutrition.
- Subjects :
- Microbiology (medical)
Diarrhea
Male
Pediatrics
medicine.medical_specialty
Population
Nutritional Status
medicine.disease_cause
Infant nutrition disorder
Feces
Enterotoxigenic Escherichia coli
Poverty Areas
parasitic diseases
medicine
Humans
Prospective Studies
education
Articles and Commentaries
education.field_of_study
Bangladesh
Environmental enteropathy
Chi-Square Distribution
biology
business.industry
Malnutrition
Infant, Newborn
Infant
Infant Malnutrition
Cryptosporidium
medicine.disease
biology.organism_classification
digestive system diseases
Infant Nutrition Disorders
Infectious Diseases
Logistic Models
Socioeconomic Factors
Female
medicine.symptom
Morbidity
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....d9cfb0863f4bc0fb16090a9554ac9a20