环境肠道功能紊乱与儿童发育迟缓。

Environmental enteric dysfunction and child stunting.

机构信息

Cranfield Water Science Institute, Cranfield University, Bedfordshire, United Kingdom.

People in Need, Prague, Czech Republic.

出版信息

Nutr Rev. 2019 Apr 1;77(4):240-253. doi: 10.1093/nutrit/nuy068.

Abstract

In 2017, an estimated 1 in every 4 (23%) children aged < 5 years were stunted worldwide. With slow progress in stunting reduction in many regions and the realization that a large proportion of stunting is not due to insufficient diet or diarrhea alone, it remains that other factors must explain continued growth faltering. Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammation, can occur in infants across the developing world and is proposed as an immediate causal factor connecting poor sanitation and stunting. A result of chronic pathogen exposure, EED presents multiple causal pathways, and as such the scope and sensitivity of traditional water, sanitation, and hygiene (WASH) interventions have possibly been unsubstantial. Although the definite pathogenesis of EED and the mechanism by which stunting occurs are yet to be defined, this paper reviews the existing literature surrounding the proposed pathology and transmission of EED in infants and considerations for nutrition and WASH interventions to improve linear growth worldwide.

摘要

2017 年,全球每 4 名(23%)5 岁以下儿童中就有 1 名发育迟缓。在许多地区,发育迟缓的减少进展缓慢,并且意识到发育迟缓的很大一部分不是由于饮食不足或单纯腹泻引起的,这表明必须有其他因素来解释持续的生长发育迟缓。肠道炎症的一种亚临床状态——环境肠道功能障碍(EED),可能发生在发展中国家的婴儿中,并被认为是将卫生条件差与发育迟缓联系起来的直接因果因素。由于慢性病原体暴露,EED 存在多种因果途径,因此传统的水、环境卫生和个人卫生(WASH)干预措施的范围和敏感性可能不大。尽管 EED 的明确发病机制和导致发育迟缓的机制尚未确定,但本文综述了围绕婴儿 EED 的拟议病理学和传播以及改善全球营养和 WASH 干预措施以促进线性生长的现有文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1df1/6394759/c2fbdcf178cd/nuy068f1.jpg

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