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Clinical Trial
. 2023 Jan 19;17(1):e0010472.
doi: 10.1371/journal.pntd.0010472. eCollection 2023 Jan.

Environmental enteric dysfunction and small intestinal histomorphology of stunted children in Bangladesh

Md Shabab Hossain  1 , S M Khodeza Nahar Begum  2 , M Masudur Rahman  3 , Mashud Parvez  2 , Ramendra Nath Mazumder  1 , Shafiqul Alam Sarker  1 , Md Mehedi Hasan  1 , Shah Mohammad Fahim  1 , Md Amran Gazi  1 , Subhasish Das  1 , Mustafa Mahfuz  1 , Tahmeed Ahmed  1   4   5
Affiliations
Clinical Trial

Environmental enteric dysfunction and small intestinal histomorphology of stunted children in Bangladesh

Md Shabab Hossain et al. PLoS Negl Trop Dis. .

Abstract

There is lack of information on the histological characteristics of the intestinal mucosa in Bangladeshi children. Collection of intestinal biopsy samples and assessment of the histomorphological features is considered to be the traditional gold standard for diagnosis of environmental enteric dysfunction (EED). The purpose of the study was to evaluate the intestinal histological characteristics of stunted children aged between 12-18 months with possible EED. 110 children with chronic malnutrition (52 stunted with length-for-age Z score, LAZ<-2 and 58 at risk of stunting with LAZ <-1 to -2) from the Bangladesh Environmental Enteric Dysfunction (BEED) study protocol who underwent upper gastrointestinal (GI) endoscopy were selected for this study. To explore the association of EED with childhood stunting, upper GI endoscopy was done and the biopsy specimens were studied for histopathology. Villous height and crypt depth were measured and the presence and intensity of inflammatory infiltrates in the lamina propria was investigated. Bivariate analysis was performed to examine the relationship between stunting and histologic morphology. More than 90% children irrespective of nutritional status were diagnosed to have chronic non-specific duodenitis on histopathology. Half of the children from both groups had villous atrophy as well as crypt hyperplasia and lymphocytic infiltration was present in more than 90% children, irrespective of groups. However, no statistically significant difference was observed when compared between the groups. The prevalence of chronic non-specific duodenitis in Bangladeshi children, irrespective of nutritional status, was high. A significant number of these children had abnormal findings in intestinal histomorphology. Trial registration number: ClinicalTrials.gov ID: NCT02812615 Date of first registration: 24/06/2016. https://clinicaltrials.gov/ct2/results?cond=NCT02812615&term=&cntry=&state=&city=&dist.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Representative histological images of villous height obtained using hematoxylin and eosin (H&E) stain.
Fig 2
Fig 2. Histomorphological features of upper GI mucosa in children with stunting.
See this image and copyright information in PMC

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