783. Contribution of Maternal Malnutrition, Enteric Infection, and Altered Intestinal Barrier Function to Infant Malnutrition in Bangladesh
Session: Oral Abstract Session: Travel/Tropical Medicine and Parasitology
Friday, October 21, 2011: 3:45 PM
Room: 204AB
Background: In the developing world, one third of all children are malnourished by 15 months of age. We have previously reported that malnourished preschool children are at increased risk for infectious diarrhea; however, the mechanism by which recurrent infectious diarrhea predisposes to stunted growth is not fully understood. We aim to identify factors in the first years of life that predispose children to malnutrition.

Methods: IRB approval was obtained for a prospective cohort study of low income children from birth to age one in Dhaka, Bangladesh. Informed consent was obtained from parents. A study questionnaire was used to collect information about socioeconomics and medical history. Non-diarrheal monthly stool specimens and diarrheal specimens were collected and transported to the ICDDR,B Parasitology Laboratory.  Stool specimens were analyzed by culture, ELISA, and PCR for common enteric pathogens. Anthropomorphic measurements of each subject were taken at birth and at three-month intervals. Data was analyzed using Chi-square analysis, Fisher’s exact test, and logistic regression.

Results: One hundred forty-seven children were enrolled in the first week of life, starting in January 2008. The majority of families had a median household expenditure of less than $100 per month. Nineteen percent of mothers had a BMI of less than 18.5. At birth, 16.3% of infants had HAZ scores < -2; at 12 months, this number increased to 42%. Independent predictors for stunting at 12 months of age were diarrhea lasting greater than 14 days (odds ratio 3.07), intestinal barrier dysfunction as measured by increased levels of serum endocab antibodies against bacterial endotoxin (odds ratio 1.02), family expenditure (odds ratio 3.7), and maternal nutrition (odds ratio 2.54).

Conclusion: Intestinal infections, gut barrier dysfunction, maternal malnutrition, and socioeconomic status all contribute to the nutritional decline seen in the first year of life. We are continuing to study the relationship between malnutrition and markers of gut barrier function, specifically zonulin, reg-1, and fecal myeloperoxidase. Evaluation of these markers may help further elucidate the complex relationship between disrupted intestinal barrier and predisposition to stunted growth.


Subject Category: T. Travel/tropical medicine and parasitology

Poonum Korpe, MD1, Dinesh Mondal, MD2, Juliana Minak, MD3, Yue Liu, BS3, Jing Dai, BS3, Lei Liu, PhD3, Rashidul Haque, MD2 and William Petri, MD, PhD3, (1)Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, (2)ICDDR,B, Dhaka, Bangladesh, (3)University of Virginia, Charlottesville, VA

Disclosures:

P. Korpe, None

D. Mondal, None

J. Minak, None

Y. Liu, None

J. Dai, None

L. Liu, None

R. Haque, None

W. Petri, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.