Abstract
Stunting is the most prevalent and pervasive form of under nutrition worldwide. In 2019, an estimate of 144 million (21.3%) of children under the age of 5 years are stunted globally. In sub-Saharan Africa, 34% of children fewer than 5 years are stunted and the burden of stunting is most prevalent in the Eastern Africa region with 37% (FAO, 2017). In Kenya, out of a total of 7 million under 5 years, 1.82 million (26%) children are suffering from stunting; out of which 11.4% are severely stunted. Stunting is associated with greater risk of death from infectious diseases in childhood, poorer cognition, poorer educational outcomes and lower adult earnings. The study population was a total of 314 children aged 0-59 months. Data was collected using survey CTO questionnaire. Use of pesticides, hygiene practices and sanitation (human waste disposal), hand washing practices, water sources and means of water treatment were examined and adequately described in relation to EED and stunting. Survey CTO programme was installed in tablets and or smart phones, in which a questionnaire with closed ended questions was programmed and used to collect a no-paper work data. The Survey CTO programmed questionnaire only allowed the researcher to key in a response for one question before moving to the next question. Data was analyzed using SPSS version 22 software. Descriptive analysis was done using SPSS while regression was done using STATA. There was no significant difference in dietary intakes between children in Kaptembwo and Milimani, and that the dietary intakes in both Milimani and Kaptembwo were adequate and balanced. Out of 202 children sampled in Kaptembwo, 40.59% had experienced diarrhea in the last four weeks to data collection while out of 112 children sampled in Milimani, only 17% had experienced diarrhea in the last four weeks. In spite of the same dietary intakes in Kaptembwo and Milimani, stunting is high in Kaptembwo than in Milimani. Out of a total of 314 children sampled, 25% were stunted in Kaptembwo, while only 3.33% were stunted in Milimani. Diarrhea increases loss of dietary nutrients thereby making the nutrients required for growth inadequate. High level of stunting in Kaptembwo is associated with poor environmental conditions (poor sanitation and hygiene) which contribute to diarrhea. Diarrhea could be key contributor to Environmental Enteric Dysfunction (EED), which is too a contributor to stunting. It is recommended that residents of Kaptembwo and Milimani are educated on the importance of good sanitation and hygiene in order to curb diarrhea, which is a contributor to the development of EED. In the same spirit, understand the importance of proper use of pesticides. Experimental research was done in the same area involving the use of biological markers for EED.
 
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Highlights
Stunting is the most prevalent and pervasive form of under-nutrition worldwide (Prendergast & Humphrey, 2014)
The causes of stunting are postulated to be multi-factorial and include at least; inadequate prenatal nutrition and inadequate dietary intake early in life; chronic and repeated acute infections leading to a catabolic inflammatory state; and the chronic intestinal inflammatory condition known as Environmental Enteric dysfunction (EED)
Enteric Dysfunction (EED) is established during infancy and is associated with poor sanitation, certain gut infections, micronutrient deficiencies, all of which may lead to chronic malnutrition, wasting and reduced vaccine efficacy among children living in low-resource settings (Crane et al, 2015)
Summary
Stunting is the most prevalent and pervasive form of under-nutrition worldwide (Prendergast & Humphrey, 2014). Clearly identifiable infectious etiology, biopsies of intestinal tissues in these individuals demonstrated morphological changes suggestive of chronic enteric infection (Lindenbaum et al, 1966; Keusch et al, 1972) The symptoms of these volunteers usually resolved within several months of returning to the USA, further supporting the link between these histological changes and recurrent exposure to pathogens in areas of poor sanitation and hygiene (Lindenbaum et al, 1971; Lindenbaum et al, 1973). Children taking adequate diets end up being stunted due to the effects of environmental factors These findings demonstrated that nutritionally adequate diet is necessary but not enough for ensuring optimal linear growth, and that environmental conditions (poor water, sanitation, and hygiene), associated with the development of EED could play a significant role in stunting (Mbuya & Humphrey, 2016)
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