Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh

Am J Trop Med Hyg. 2013 Jul;89(1):130-137. doi: 10.4269/ajtmh.12-0629. Epub 2013 Apr 29.

Abstract

We assessed the relationship of fecal environmental contamination and environmental enteropathy. We compared markers of environmental enteropathy, parasite burden, and growth in 119 Bangladeshi children (≤ 48 months of age) across rural Bangladesh living in different levels of household environmental cleanliness defined by objective indicators of water quality and sanitary and hand-washing infrastructure. Adjusted for potential confounding characteristics, children from clean households had 0.54 SDs (95% confidence interval [CI] = 0.06, 1.01) higher height-for-age z scores (HAZs), 0.32 SDs (95% CI = -0.72, 0.08) lower lactulose:mannitol (L:M) ratios in urine, and 0.24 SDs (95% CI = -0.63, 0.16) lower immunoglobulin G endotoxin core antibody (IgG EndoCAb) titers than children from contaminated households. After adjusting for age and sex, a 1-unit increase in the ln L:M was associated with a 0.33 SDs decrease in HAZ (95% CI = -0.62, -0.05). These results are consistent with the hypothesis that environmental contamination causes growth faltering mediated through environmental enteropathy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Bangladesh / epidemiology
  • Body Height
  • Body Weight
  • Child, Preschool
  • Developing Countries / statistics & numerical data
  • Diarrhea / complications
  • Diarrhea / epidemiology
  • Diarrhea / etiology*
  • Diarrhea / parasitology
  • Family Characteristics
  • Feces / parasitology
  • Female
  • Growth Disorders / complications
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology*
  • Humans
  • Hygiene
  • Infant
  • Infant, Newborn
  • Intestinal Diseases, Parasitic / complications
  • Intestinal Diseases, Parasitic / epidemiology
  • Intestinal Diseases, Parasitic / etiology
  • Male
  • Risk Factors
  • Rural Population
  • Sanitation
  • Water Quality