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Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh
Author(s) -
Fahim Shah Mohammad,
Das Subhasish,
Gazi Md. Amran,
Mahfuz Mustafa,
Ahmed Tahmeed
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13141
Subject(s) - slum , environmental health , biology , medicine , population
Objective Environmental Enteric Dysfunction ( EED ) can be assessed by faecal biomarkers such as Myeloperoxidase ( MPO ), Neopterin ( NEO ) and Alpha‐1 anti‐trypsin ( AAT ). We aimed to test the association of intestinal pathogens with faecal markers of EED among slum‐dwelling children in first 2 years of life. Methods The MAL ‐ ED birth cohort data of Bangladesh site were used to conduct this analysis. Multivariable analyses using Generalized Estimating Equations (GEE) were performed to test the association between intestinal pathogens and faecal markers of EED . Results Giardiasis, ascariasis and trichuriasis were the most frequent parasitic infections and Campylobacter spp., Enteroaggregative Escherichia coli ( EAEC ) and Enterotoxigenic Escherichia coli ( ETEC ) were the common bacterial pathogens observed in stool samples of the children. Overall, 71%, 97% and 58% of stool samples were above values considered normal in non‐tropical settings for MPO , NEO and AAT respectively. Giardiasis was found to be significantly associated with MPO (Coefficient = 0.55; 95% CI = 0.15, 0.95; P ‐value = 0.008) and AAT concentrations (Coefficient = 0.34; 95% CI = 0.04, 0.63; P ‐value = 0.03). A significant association was found between trichuriasis and NEO (Coefficient = 0.90; 95% CI = 0.19, 1.61; P ‐value = 0.01). Trichuriasis (Coefficient = 1.71; 95% CI = 0.32, 3.11; P ‐value = 0.02) and giardiasis (Coefficient = 1.51; 95% CI = 0.79, 2.23; P ‐value <0.001) were significantly associated with EED score. Children with EAEC had significantly higher MPO concentrations (Coefficient = 0.33; 95% CI = 0.06, 0.61; P ‐value = 0.02). Conclusion The study results imply the importance of intestinal pathogens in contributing to intestinal inflammation and increased intestinal permeability in young children.