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Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

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  • Zhifei Liu

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland)

  • Yue-Mei Fan

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland)

  • Per Ashorn

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
    Department of Paediatrics, Tampere University Hospital, 33521 Tampere, Finland)

  • Chilungamo Chingwanda

    (School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi)

  • Kenneth Maleta

    (School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi)

  • Lotta Hallamaa

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland)

  • Heikki Hyöty

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
    Fimlab Laboratories, Pirkanmaa Hospital District, 33521 Tampere, Finland)

  • David Chaima

    (School of Public Health & Family Medicine, Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi)

  • Ulla Ashorn

    (Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland)

Abstract

Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children’s EED markers in rural Malawi.

Suggested Citation

  • Zhifei Liu & Yue-Mei Fan & Per Ashorn & Chilungamo Chingwanda & Kenneth Maleta & Lotta Hallamaa & Heikki Hyöty & David Chaima & Ulla Ashorn, 2022. "Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi," IJERPH, MDPI, vol. 19(17), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:10891-:d:903625
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    References listed on IDEAS

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    1. Marion W. Jenkins & Oliver Cumming & Sandy Cairncross, 2015. "Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania," IJERPH, MDPI, vol. 12(3), pages 1-24, February.
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