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Risk Factors for Environmental Enteropathy and Impaired Growth in Children in Rural Bangladesh

Mirzapur, Bangladesh


Recent estimates by the World Health Organization (WHO) report that a quarter of children under five years of age are stunted globally. There is a growing body of literature indicating an association between stunting and environmental enteropathy (EE), a disorder defined by abnormal intestinal morphology, reduced intestinal barrier function, and increased inflammation. Although its etiology is not fully defined, EE is thought to be caused by unsanitary environmental conditions leading to repeated exposures to enteric pathogens. In the scientific literature most studies focus on the fecal oral pathways for enteric infections described in the F Diagram (fluids, fingers, fields, flies, food). However, recent studies suggest that geophagy, defined as the consumption of soil, dirt, or mud, is frequent among young children and a potential risk factor for enteric infections. Therefore in an effort to investigate the relationship between exposure to enteric pathogens through geophagy, consumption of soil, environmental enteropathy, and stunting, we are conducting a prospective cohort study of children under five years of age in rural Bangladesh.

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