Enteric parasitic infections: From environmental enteric dysfunction to gut microbiota and childhood malnutrition

Document Type : Review Article

Authors

1 Medical Parasitology Departments, Faculty of Medicine, Ain-Shams University

2 Gastroenterology Department, Police Authority Hospital, Giza2, Egypt

Abstract

Malnutrition accounts for high morbidity and mortality in children. Specifically, linear growth failure (stunting)
has long-term consequences. It affects approximately 25% of children under the age of five worldwide and
has been linked to increased mortality, cognitive dysfunction, and productivity loss. Understanding that a
significant proportion of stunting is not caused solely by lack of nutrition, diarrhea, and repeated exposure to
intestinal infections implies that other factors must be analyzed to clarify continued growth faltering. Enteric
parasitic infections are prevalent in many tropical environments and are linked to poor nutritional status
and growth stunting. Environmental enteric dysfunction (EED) is an undefined syndrome characterized
by inflammation, decreased absorptive capacity, and impaired barrier function in the small intestine. The
dysfunction has been allied to malnutrition, as well as oral vaccine failure causing delayed development
in children from poor resource settings. This syndrome might be triggered by unhygienic environmental
conditions that cause frequent exposure to fecal pathogens and decreased nutrient absorption. Additionally,
childhood malnutrition was strongly linked to changes in the gut microbiome. Motivation for the present
review was the relatively obscure cumulative effect of repeated enteric parasitosis on nutritional status
of children in developing countries from various perspectives. Accordingly, intestinal parasites infections,
EED, and microbiota alteration are all likely issues that must be concurrently addressed. Addressing all
these conditions would resolve the grave public health issues of malnutrition and infection susceptibility,
and consequently, lead to application of behavioral and therapeutic policies among vulnerable pediatric
populations.

Keywords

Parasitologists United Journal
Volume 15, Issue 3
December 2022
Pages 216-223

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