Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh.
Lin, Audrie;
Arnold, Benjamin F;
Afreen, Sadia;
Goto, Rie;
Huda, Tarique Mohammad Nurul;
Haque, Rashidul;
Raqib, Rubhana;
Unicomb, Leanne;
Ahmed, Tahmeed;
Colford, John M;
+1 more...Luby, Stephen P;
(2013)
Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh.
The American journal of tropical medicine and hygiene, 89 (1).
pp. 130-137.
ISSN 0002-9637
DOI: https://doi.org/10.4269/ajtmh.12-0629
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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.
