Fecal biomarkers of environmental enteric dysfunction and associated factors among children aged 24-59 months in east Dembiya district, northwest Ethiopia.
Fecal biomarkers of environmental enteric dysfunction and associated factors among children aged 24-59 months in east Dembiya district, northwest Ethiopia.
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DOI：
10.1186/s12876-022-02255-4
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发表时间：
2022-04-08
影响因子：
2.4
通讯作者：
Bisesi M
中科院分区：
文献类型：
--
作者：
Gizaw Z;Yalew AW;Bitew BD;Lee J;Bisesi M
环境性肠功能障碍是一种亚临床肠道疾病，其特征是肠道炎症伴随形态学变化，如绒毛钝化和隐窝增生。这是低收入和中等收入国家的常见疾病。然而，埃塞俄比亚的环境肠道功能障碍证据有限。因此，本研究旨在测量埃塞俄比亚西北部农村24-59个月儿童的环境肠道功能障碍的粪便生物标志物及其相关因素。在东Dembiya区的农村环境中随机选择的235名儿童中进行了一项基于社区的横断面研究。在无固定剂的情况下采集粪便样本，并使用商业酶联免疫吸附测定试剂盒分析环境肠道功能障碍的粪便生物标志物（α-1-抗胰蛋白酶、新蝶呤和髓过氧化物酶），并使用湿封片和Kato-Katz技术分析肠道寄生虫。采用问卷调查法和结构观察法收集儿童肠道病原体暴露相关行为、生活环境状况和社会人口学信息。我们拟合了多变量线性回归模型，以评估环境因素与粪便中环境肠道功能障碍的粪便生物标志物浓度之间的关联。基于校正的β值，相应的95%置信区间和p值< 0.05，宣布统计学显著相关。环境肠道功能障碍的粪便标志物的中位浓度为α-1-抗胰蛋白酶350 μg/ml，髓过氧化物酶3320.2 ng/ml，新蝶呤1562 nmol/l。在非热带环境中，161例（68.5%）粪便样本中α-1-抗胰蛋白酶的中位浓度、168例（71.5%）粪便样本中髓过氧化物酶的中位浓度和188例（80%）粪便样本中新蝶呤的中位浓度均高于正常值。此外，100名（42.6%）儿童的EED疾病活动评分较高（高于中位数）。肠道炎症粪便生物标志物浓度升高和EED疾病活动性评分高与露天排便习惯、口含土壤污染物、大肠杆菌（E.大肠杆菌（E.大肠杆菌污染的食品，E.大肠杆菌污染的土壤和肠道寄生虫。总体而言，与高收入国家的人口相比，研究地区儿童的α-1-抗胰蛋白酶，髓过氧化物酶和新蝶呤水平高度升高。此外，EED疾病活动性评分在显着比例的儿童是高的，这表明广泛的肠道炎症和肠道通透性增加。广泛的E.生活环境（饮用水、即食食品和庭院土壤）的大肠杆菌污染、卫生和卫生行为（例如露天排便和口含土壤污染物）以及肠道寄生虫的高负荷被确定为与环境肠道功能障碍的粪便生物标志物浓度升高相关的因素。父母对儿童的照顾，以避免口含土壤污染的材料和其他危险的行为，增加接触肠道感染，并保护生活环境（水，食物和土壤）免受粪便污染是很重要的。
Environmental enteric dysfunction is a subclinical intestinal disorder characterized by gut inflammation accompanied by morphological changes, such as blunted villi and crypt hyperplasia. This is a common illness in low and middle-income countries. However, environmental enteric dysfunction evidence is limited in Ethiopia. Accordingly, this study was conducted to measure fecal biomarkers of environmental enteric dysfunction and associated factors among children aged 24–59 months in rural northwest Ethiopia. A community-based cross-sectional study was employed among 235 randomly selected children in a rural setting of the east Dembiya district. Stool samples were collected without fixative and analyzed for fecal biomarkers of environmental enteric dysfunction (Alpha-1-antitrypsin, neopterin, and myeloperoxidase) using commercial enzyme-linked immunosorbent assay kits and analyzed for intestinal parasites using wet mount and Kato-Katz techniques. Child behaviors related with exposure to enteropathogens, condition of the living environment and socio-demographic information were collected using interviewer-administered questionnaire and structure observation. We fitted multivariable linear regression model to assess the association between environmental factors and concentration of fecal biomarkers of environmental enteric dysfunction in the stool. Statistically significant associations were declared based on adjusted betas with the corresponding 95% confidence interval and p-value < 0.05. The median concentration of fecal markers of environmental enteric dysfunction was 350 μg/ml for Alpha-1-antitrypsin, 3320.2 ng/ml for myeloperoxidase, and 1562 nmol/l for neopterin. The median concentration of Alpha-1-antitrypsin among 161 (68.5%), myeloperoxidase among 168 (71.5%), and neopterin among 188 (80%) of the stool samples were above the normal values in non-tropical settings. Moreover, 100 (42.6%) of the children had high EED disease activity score (above the median score). The elevated concentrations of fecal biomarkers of gut inflammation and the high EED disease activity score were significantly associated with open defecation practice, mouthing of soil contaminated materials, Escherichia coli (E. coli) contamination of drinking water, E. coli contamination of foods, E. coli contamination of soil, and intestinal parasites. Overall, Alpha-1-antitrypsin, myeloperoxidase, and neopterin levels among the children in the studied region were highly elevated in comparison to populations in high-income countries. Moreover, the EED disease activity score in significant proportion of children was high, suggesting widespread intestinal inflammation and increased intestinal permeability. Extensive E. coli contamination of the living environment (drinking water, ready-to-eat foods, and courtyard soil), hygiene and sanitation behaviors (such as open defecation and mouthing of soil contaminated materials), and a high burden of intestinal parasites were identified as factors associated with the elevated concentration of fecal biomarkers of environmental enteric dysfunction. Parental care to children to avoid mouthing of soil contaminated materials and other risky behaviors that increase exposure enteric infections, and protecting the living environment (water, food and soil) from fecal contamination are important.
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影响因子：
3.6
作者：
Goto, R;Panter-Brick, C;Tuladhar, NR
通讯作者：
Tuladhar, NR
影响因子：
11.4
作者：
Fuhrmeister, Erica R.;Ercumen, Ayse;Nelson, Kara L.
通讯作者：
Nelson, Kara L.
影响因子：
30.5
作者：
通讯作者：
--
DOI：
10.4103/ijcm.ijcm_461_19
发表时间：
2020-10
期刊：
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
影响因子：
--
作者：
Banerjee S;Ray S;Shrivastava P;Das DK
通讯作者：
Das DK
影响因子：
16.6
作者：
Brown EM;Wlodarska M;Willing BP;Vonaesch P;Han J;Reynolds LA;Arrieta MC;Uhrig M;Scholz R;Partida O;Borchers CH;Sansonetti PJ;Finlay BB
通讯作者：
Finlay BB