Public health: Long-term exposure to microbial pathogens results in childhood stunting

Constant exposure to microbial pathogens in children leads to damage to the lining of the gut, which affects food absorption and can result in stunted growth, according to research published in Nature Microbiology. The findings are based on a study of more than 300 children in Zambia.

There are 140 million children with stunting and 40 million children with wasting from malnourishment worldwide. Gut damage due to environmental factors is a major contributor to stunting in millions of children in Africa and South Asia. Previous research has shown that providing food and sanitary measures to undernourished children does not reliably restore growth, and that a proportion of children remain stunted.

Paul Kelly, Beatrice Amadi and colleagues carried out a community-based longitudinal, observational study of stunting in Lusaka, Zambia, from 2016 to 2019. Unlike interventional studies to address wasting and stunting, the authors assessed the intestinal pathology associated with stunting by using a combination of endoscopy and microscopy. They found that young children with stunting that doesn’t respond to intervention have continuous, intense exposure to gut microbial pathogens and severe ongoing inflammation of the intestine, among other gut issues. The authors conclude that treatment should focus on healing the gut and minimizing the child’s exposure to pathogens as they catch up in growth.