Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development

Summary

Malnutrition is considered one of the most prevalent risk factors for morbidity and mortality in children under five. An estimated 20% of children in the developing world are malnourished \[1\] and poor nutrition is linked to more than half of all child deaths worldwide \[2\]. Malnutrition in early childhood may lead to cognitive and physical deficits and may cause similar deficits in future generations as malnourished mothers give birth to low birth weight children \[3\]. In addition, malnutrition increases susceptibility and incidence of infections and is associated with diminished response to vaccines.

The MAL-ED Project is designed to determine the impact of enteric infections/diarrhea that alter gut function and impair children's nutrition, growth and development to help develop new intervention strategies that can break the vicious enteric infection-malnutrition cycle and reduce its global burden.

The overall objective of the MAL-ED Project is to quantify the associations of specific enteric pathogens, measures of physical and mental development, micronutrient malnutrition, gut function biomarkers, the gut microbiome, and immune responses in very young children in resource-limited settings across eight sites that vary by culture, economics, geography, and climate.

The central hypothesis of the MAL-ED Project is that infection (and co-infection) with specific enteropathogens leads to impaired growth and development and to diminished immune response to orally administered vaccines by causing intestinal inflammation and/or by altering intestinal barrier and absorptive function. Data analyses will test for associations between enteropathogen infections and growth/development to help illuminate:

* which micro-organisms or mixed infections are most frequently associated with growth faltering and poor development; and
* at what age specific infections cause the most disruption to growth and development and impair immune response.

Conditions

• Diarrhea
• Malnutrition
• Stunting
• Wasting
• Immune Response
• Cognitive Development

Sponsors & Collaborators

• University of Virginia

  collaborator OTHER

• Johns Hopkins University

  collaborator OTHER

• Aga Khan University

  collaborator OTHER

• Christian Medical College, Vellore, India

  collaborator OTHER

• Henry M. Jackson Foundation for the Advancement of Military Medicine

  collaborator OTHER

• Fogarty International Center of the National Institute of Health

  collaborator NIH

• Penn State University

  collaborator OTHER

• Foundation for the National Institutes of Health

  lead OTHER

Principal Investigators

• Michael Gottlieb, Ph.D. · Fountation for the National Institutes of Health

• Roger Glass, M.D. · Fogarty International Center of the National Institute of Health

Eligibility

Min Age

1 Minute

Max Age

17 Days

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2008-11-30

Primary Completion

2017-02-28

Completion

2017-04-30

Countries

• Bangladesh
• Brazil
• India
• Nepal
• Pakistan
• Peru
• South Africa
• Tanzania

Study Locations