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Study: Infection May Play Role in Stunting Impoverished Children's Growth

An infant lies in bed in a malnutrition intensive care unit in Dharbhanga, India, April 16, 2015. Researchers thought stunting was mostly caused by malnutrition, but a study indicates a parasite may be a factor.

Stunting, or failure to grow at a normal rate, is a leading cause of death among children living in impoverished areas. Until now, researchers thought the problem was due mostly to malnutrition resulting from a lack of food, but they have found an intestinal parasite may play a major role in stunting.

Public health officials say that worldwide, 178 million children under age 5 suffer from stunted growth. More than 20 percent of them will die as a direct result of that. The experts say smaller-than-normal children suffer from irreversible brain damage and, if they live, continue to lead lives of poverty because of cognitive problems.

Poonum Korpe, an infectious-diseases physician at Johns Hopkins University’s Bloomberg School of Public Health in Baltimore, Maryland, said prior studies of the problem had indicated that even when steps to improve nutrition for children had been taken, "we had only reduced stunting by one-third in the world. There is still a large knowledge gap in what causes growth failure in younger kids.”

She and her colleagues suspected stunting might also be caused by some sort of infection. They followed nearly 400 impoverished children for the first two years of life in a slum outside Dhaka, Bangladesh, and they found that three out of four had experienced at least one infection with the waterborne pathogen Cryptosporidium, which is spread by contaminated drinking water and poor toilet facilities.

A quarter of those infected youngsters suffered severe bouts of diarrhea, but almost three-quarters of them had no symptoms at all.

More than half of all the children in the study experienced stunted growth by 2 years of age.

Korpe speculated that the pathogen "is getting inside the intestines and causing irreversible damage to the lining of the gut, which probably leads to long-term malabsorption. So the body is not able to absorb essential nutrients that are needed for growth.”

Overall, young children infected with Cryptosporidium are nearly three times as likely to suffer from moderate to severe stunting as those who aren't infected.

Korpe said there is only one drug approved to treat the infection, but it is not available in the developing world. She concluded that adequate nutrition, along with health education, could be key to preventing infection with Cryptosporidium and the subsequent stunting of vulnerable children.

The findings by Korpe and her colleagues were published in the journal PLoS Neglected Tropical Diseases.