Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Zhifei Liu; Yue Mei Fan; Per Ashorn; Chilungamo Chingwanda; Kenneth Maleta; Lotta Hallamaa; Heikki Hyöty; David Chaima; Ulla Ashorn

doi:10.3390/ijerph191710891

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Zhifei Liu^*
, Yue Mei Fan
, Per Ashorn
, Chilungamo Chingwanda
, Kenneth Maleta
, Lotta Hallamaa
, Heikki Hyöty
, David Chaima
, Ulla Ashorn

^*Corresponding author for this work

Department of Clinical Microbiology

Research output: Contribution to journal › Article › Scientific › peer-review

3 Citations (Scopus)

35 Downloads (Pure)

Abstract

Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children’s EED markers in rural Malawi.

Original language	English
Article number	10891
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	17
DOIs	https://doi.org/10.3390/ijerph191710891
Publication status	Published - 1 Sept 2022
Publication type	A1 Journal article-refereed

Funding

This research was funded by the Finnish Funding Agency for Technology and Innovation, the Foundation for Paediatric Research in Finland, and the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital [9M004]. The original trial was funded by a grant to the University of California, Davis from the Bill & Melinda Gates Foundation [OPP49817] and the funding from the Office of Health, Infectious Diseases, and Nutrition, Bureau for Global Health, U.S. Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger
SDG 3 Good Health and Well-being

Keywords

alpha-1-antitrypsin
calprotectin
environmental exposure
Malawi
REG1B

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Pollution
Public Health, Environmental and Occupational Health
Health, Toxicology and Mutagenesis

Access to Document

10.3390/ijerph191710891Licence: CC BY

ijerph-19-10891Final published version, 900 KBLicence: CC BY

https://urn.fi/URN:NBN:fi:tuni-202210277955Licence: CC BY

Cite this

Liu, Z., Fan, Y. M., Ashorn, P., Chingwanda, C., Maleta, K., Hallamaa, L., Hyöty, H., Chaima, D., & Ashorn, U. (2022). Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi. International Journal of Environmental Research and Public Health, 19(17), Article 10891. https://doi.org/10.3390/ijerph191710891

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title = "Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi",

abstract = "Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children{\textquoteright}s EED markers in rural Malawi.",

keywords = "alpha-1-antitrypsin, calprotectin, environmental exposure, Malawi, REG1B",

author = "Zhifei Liu and Fan, \{Yue Mei\} and Per Ashorn and Chilungamo Chingwanda and Kenneth Maleta and Lotta Hallamaa and Heikki Hy{\"o}ty and David Chaima and Ulla Ashorn",

note = "Funding Information: This research was funded by the Finnish Funding Agency for Technology and Innovation, the Foundation for Paediatric Research in Finland, and the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital [9M004]. The original trial was funded by a grant to the University of California, Davis from the Bill \& Melinda Gates Foundation [OPP49817] and the funding from the Office of Health, Infectious Diseases, and Nutrition, Bureau for Global Health, U.S. Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360. Publisher Copyright: {\textcopyright} 2022 by the authors.",

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volume = "19",

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Liu, Z, Fan, YM , Ashorn, P, Chingwanda, C, Maleta, K, Hallamaa, L, Hyöty, H, Chaima, D & Ashorn, U 2022, 'Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi', International Journal of Environmental Research and Public Health, vol. 19, no. 17, 10891. https://doi.org/10.3390/ijerph191710891

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi. / Liu, Zhifei; Fan, Yue Mei ; Ashorn, Per et al.
In: International Journal of Environmental Research and Public Health, Vol. 19, No. 17, 10891, 01.09.2022.

Research output: Contribution to journal › Article › Scientific › peer-review

TY - JOUR

T1 - Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

AU - Liu, Zhifei

AU - Fan, Yue Mei

AU - Ashorn, Per

AU - Chingwanda, Chilungamo

AU - Maleta, Kenneth

AU - Hallamaa, Lotta

AU - Hyöty, Heikki

AU - Chaima, David

AU - Ashorn, Ulla

N1 - Funding Information: This research was funded by the Finnish Funding Agency for Technology and Innovation, the Foundation for Paediatric Research in Finland, and the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital [9M004]. The original trial was funded by a grant to the University of California, Davis from the Bill & Melinda Gates Foundation [OPP49817] and the funding from the Office of Health, Infectious Diseases, and Nutrition, Bureau for Global Health, U.S. Agency for International Development (USAID) under terms of Cooperative Agreement No. AID-OAA-A-12-00005, through the Food and Nutrition Technical Assistance III Project (FANTA), managed by FHI 360. Publisher Copyright: © 2022 by the authors.

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children’s EED markers in rural Malawi.

AB - Environmental enteric dysfunction (EED) is common and contributes to linear growth faltering (stunting) and mortality among children in low-resource settings. A few studies on the environmental causes of EED have been conducted but the exact exposures that cause or predispose children to EED are context-specific and not clear. This study aimed to assess associations between selected environmental exposures and EED markers among 620 18-month-old children. This was a secondary analysis of data from Malawian children who participated in a randomized controlled trial (iLiNS-DYAD, registered at clinicaltrials.gov as NCT01239693) from birth to 18 months of age. Data on environmental exposures, including drinking water source, sanitation, exposure to animals, housing materials, season, residential area, and food insecurity were collected at enrolment. Biomarkers of EED included concentrations of calprotectin, regenerating 1B protein (REG1B), and alpha-1-antitrypsin from stool samples to assess intestinal inflammation, repair, and permeability, respectively. We performed bivariate and multivariable analyses to assess associations between environmental exposures and EED biomarkers. Adjusting for possible confounders, we did not find associations between the selected environmental exposures and the three biomarkers. These results do not provide support for our hypothesis that the studied adverse environmental exposures are associated with increased concentrations of children’s EED markers in rural Malawi.

KW - alpha-1-antitrypsin

KW - calprotectin

KW - environmental exposure

KW - Malawi

KW - REG1B

U2 - 10.3390/ijerph191710891

DO - 10.3390/ijerph191710891

M3 - Article

C2 - 36078607

AN - SCOPUS:85137578191

SN - 1661-7827

VL - 19

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 17

M1 - 10891

ER -

Lack of Associations between Environmental Exposures and Environmental Enteric Dysfunction among 18-Month-Old Children in Rural Malawi

Abstract

Funding

UN SDGs

Keywords

Publication forum classification

ASJC Scopus subject areas

Access to Document

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