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Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework.

ABSTRACT: Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early childhood, vaccine failure, and loss of human potential. This article addresses the underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study to define and quantify the burden of disease caused by EE within a multisite cohort. Additionally, we will discuss efforts to improve, standardize, and harmonize laboratory practices within the MAL-ED Network. These efforts will address current limitations in the understanding of EE and its burden on children in the developing world.

SUBMITTER: Kosek M 

PROVIDER: S-EPMC4204611 | biostudies-other | 2014 Nov

REPOSITORIES: biostudies-other

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Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework.

Kosek Margaret M   Guerrant Richard L RL   Kang Gagandeep G   Bhutta Zulfiqar Z   Yori Pablo Peñataro PP   Gratz Jean J   Gottlieb Michael M   Lang Dennis D   Lee Gwenyth G   Haque Rashidul R   Mason Carl J CJ   Ahmed Tahmeed T   Lima Aldo A   Petri William A WA   Houpt Eric E   Olortegui Maribel Paredes MP   Seidman Jessica C JC   Mduma Estomih E   Samie Amidou A   Babji Sudhir S  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20141101

Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early chil  ...[more]