Abstract
.Children in poor environmental conditions are exposed early and often to enteric pathogens, but within developing countries, heterogeneity in enteropathogen exposure in different settings and communities is rarely addressed. We tested fecal samples from healthy infants and children from two different environments in the same Indian town for gut enteropathogens and biomarkers of gut inflammation. A significantly higher proportion of infants and children from a poor semi-urban neighborhood (93%) had one or more enteropathogens than those from a medical college campus (71.7%). Infants and children from the poor neighborhood had an average of 3.3 (95% confidence interval [CI]: 2.9–3.7) enteropathogens compared with an average of 1.4 (95% CI: 1.0–1.7) enteropathogens in campus infants/children. Viral and bacterial infections, including enteroviruses, adenoviruses, Campylobacter spp., and diarrhegenic Escherichia coli were more common and fecal biomarkers of inflammation were higher in the poor neighborhood. The findings demonstrate significant difference in the asymptomatic carriage of gut enteropathogens and gut inflammatory biomarkers in infants and children from two different environments within the same town in south India.
Highlights
Environmental enteropathy (EE) or environmental enteric dysfunction (EED) is a poorly defined condition of the small intestine usually associated with gut inflammation and increased gut permeability
We compared the prevalence of asymptomatic enteropathogens and biomarkers of gut inflammation as a component of EE/EED,[4] among infants and children living in different environmental conditions in southern India
Children from Chinnallapuram had an average of 3.3 pathogens detected (95% confidence interval [CI]: 2.9–3.7, median 5, range 0–9), whereas campus infants/children had an average of 1.4 pathogens detected using Taqman array card (TAC) assays (Mann–Whitney U test, P < 0.001)
Summary
Environmental enteropathy (EE) or environmental enteric dysfunction (EED) is a poorly defined condition of the small intestine usually associated with gut inflammation and increased gut permeability This condition is common in less developed settings and has been hypothesized to be linked to the high enteropathogen load in infants in developing countries, which leads to chronic enteric T-cell–mediated inflammation.[1] This, in turn, has been linked with linear growth failure, impaired cognition, and suboptimal response to oral vaccines.[2]. We compared the prevalence of asymptomatic enteropathogens and biomarkers of gut inflammation as a component of EE/EED,[4] among infants and children living in different environmental conditions in southern India
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