Child undernutrition, tropical enteropathy, toilets, and handwashing

  title={Child undernutrition, tropical enteropathy, toilets, and handwashing},
  author={Jean H. Humphrey},
  journal={The Lancet},
  • J. Humphrey
  • Published 19 September 2009
  • Medicine
  • The Lancet
2Child underweight state or stunting mainly develops during the fi rst 2 years of life, when mean weight-for-age and length-for-age Z scores of children in Africa and Asia drop to about –2·0, with little or no recovery thereafter. 3 
  • 2015
Undernutrition is the underlying cause of 45 percent of child deaths each year.1 The term undernutrition covers three primary anthropometric measures: stunting, which is low height for age; wasting,
Disease externalities and net nutrition: Evidence from changes in sanitation and child height in Cambodia, 2005–2010
Better sanitation accounts for Cambodia’s increase in child height from 2005 to 2010, and community open defecation matters more for child height than household opendefecation.
Presence of Giardia lamblia in stools of six‐ to 18‐month old asymptomatic Malawians is associated with children's growth failure
Despite high pathogen burden and malnutrition in low‐income settings, knowledge on relationship between asymptomatic viral or parasitic infections, nutrition and growth is insufficient, and a cohort of six‐month‐old Malawian infants is studied.
Enteric Infections in Young Children are Associated with Environmental Enteropathy and Impaired Growth
To investigate the relationship between faecal contamination in child play spaces, enteric infections, environmental enteropathy (EE) and impaired growth among young children, a study of faeces in play spaces and indoor environments is conducted.
Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses
The results indicate that V:C ratios are reduced in EE but are less severe than in celiac disease, and the increases in lamina propria B and T lymphocytes suggest that non-cytolytic lymphocytic activation may be a more prominent feature of EE relative to Celiac disease.
Malnutrition in developing countries
The effective management of severe acute malnutrition (SAM) is a huge challenge in low resource healthcare settings and more effective prevention and treatment of malnutrition is needed urgently.
Hand‐washing, subclinical infections, and growth: A longitudinal evaluation of an intervention in Nepali slums
This is the first study to evaluate the impact of hand‐washing on markers of subclinical, asymptomatic infections associated with childhood growth faltering and biomarkers of child health in Nepali slums.
Growth Status, Inflammation, and Enteropathy in Young Children in Northern Tanzania.
Child HAZ was significantly and inversely associated with AGP, and child stunting was significantly positively associated with low dietary diversity, severe household hunger, and absence of soap in the household, and the lack of retrospective data in this study may explain the null findings related to fecal EE biomarkers and child growth.
Determinants of stunting in East Africa
The thesis examines nutritional and environmental determinants of childhood stunting in East Africa. I will examine stunting by using epidemiologic analysis of secondary data (i.e. DHS data) and the
Fecal Markers of Environmental Enteropathy are Associated with Animal Exposure and Caregiver Hygiene in Bangladesh.
It is suggested that close contact with animals and caregiver hygiene may be important risk factors for EE in young children, consistent with the hypothesis that unsanitary environmental conditions can lead to EE in susceptible pediatric populations.


Intestinal permeability, mucosal injury, and growth faltering in Gambian infants
A non-invasive test of intestinal integrity, the lactulose:mannitol permeability test, was done regularly on children aged 2-15 months, whose growth was monitored over a mean of 7.5 months and revealed persistent abnormalities in the small bowel mucosa of Gambian infants.
Tropical sprue and subclinical enteropathy: a vision for the nineties.
  • P. Haghighi, P. Wolf
  • Biology, Medicine
    Critical reviews in clinical laboratory sciences
  • 1997
There is a group of gastrointestinal disorders mainly affecting the small intestine of individuals predominantly living in and less often visiting or returning from the Third World, usually the tropics, and ranging from asymptomatic structural and/or functional abnormalities of the gastrointestinal mucosa to a fully symptomatic condition highlighted by malabsorption of nutrients.
Asymptomatic environmental enteropathy among slum-dwelling infants.
Data show that alterations in the microecology, function and morphology of the small intestine can occur even in the absence of diarrhea, and therefore, the presence of symptoms does not necessarily imply a healthy well-being among children living in a slum.
Maternal and child undernutrition 3: what works? Interventions for maternal and child undernutrition and survival
Maternal and child undernutrition 3: what works? Interventions for maternal and child undernutrition and survival . Bhutta Z.A., Ahmed T., Black R.E., Cousens S., Dewey K., Giugliani E., Haider
The underprivileged, developing country child: environmental contamination and growth failure revisited.
It is suggested that a situation similar to the phenomenon of impaired growth of poultry and livestock reared under unsanitary conditions occurs in children from underprivileged countries.
What works? Interventions for maternal and child undernutrition and survival
To eliminate stunting in the longer term, existing interventions that were designed to improve nutrition and prevent related disease could reduce stunting at 36 months by 36%; mortality between birth and 36 monthsBy about 25%; and disability-adjusted life-years associated with stunting, severe wasting, intrauterine growth restriction, and micronutrient deficiencies by about 25%.
Maternal and child undernutrition: global and regional exposures and health consequences
The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions to reduce their occurrence or ameliorate their consequences.
Growth faltering in rural Gambian infants is associated with impaired small intestinal barrier function, leading to endotoxemia and systemic inflammation.
Data from this study are consistent with the hypothesis of translocation of immunogenic lumenal macromolecules across a compromised gut mucosa, leading to stimulation of systemic immune/inflammatory processes and subsequent growth impairment.
Tropical enteropathy: a T-cell-mediated crypt hyperplastic enteropathy
Tropical enteropathy is associated with mucosal T-cell activation and crypt hyperplasia, and appears to occur in the absence of malnutrition, diarrhoea or systemic illness.
Maternal and child undernutrition: consequences for adult health and human capital
It is concluded that damage suffered in early life leads to permanent impairment, and might also affect future generations, as undernutrition is associated with lower human capital and its prevention will probably bring about important health, educational, and economic benefits.