Small Intestine Bacterial Overgrowth and Environmental Enteropathy in Bangladeshi Children. mBio, Jan 2016
Authors: Jeffrey R. Donowitz, Rashidul Haque, et al.
Recent studies suggest small intestine bacterial overgrowth (SIBO) is common among developing world children. SIBO’s pathogenesis and effect in the developing world are unclear. Our objective was to determine the prevalence of SIBO in Bangladeshi children and its association with malnutrition. Secondary objectives included determination of SIBO’s association with sanitation, diarrheal disease, and environmental enteropathy.
The strongest predictors of SIBO were decreased length-for-age Z score since birth (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.03 to 0.60) and an open sewer outside the home (OR, 4.78; 95% CI, 1.06 to 21.62). Recent or frequent diarrheal disease did not predict SIBO. The markers of intestinal inflammation fecal Reg 1β (116.8 versus 65.6 µg/ml; P = 0.02) and fecal calprotectin (1,834.6 versus 766.7 µg/g; P = 0.004) were elevated in SIBO-positive children. Measures of intestinal permeability and systemic inflammation did not differ between the groups.
These findings suggest linear growth faltering and poor sanitation are associated with SIBO independently of recent or frequent diarrheal disease. SIBO is associated with intestinal inflammation but not increased permeability or systemic inflammation.
Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth? 2015.
Authors: Iffat Mahmud and Nkosinathi Mbuya. World Bank.
This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition.
We also examine the potential impact of improved water, sanitation, and hygiene (WASH) on undernutrition. This is the first report that undertakes a thorough review and discussion of WASH and nutrition in Bangladesh.
The report is meant to serve two purposes. First, it synthesizes the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition and water and sanitation sectors to stimulate technical discussions and effective collaboration among stakeholders.
Second, this report serves as an advocacy tool, primarily for policy makers, to assist them in formulating a multisectoral approach to tackling the undernutrition problem.
BRAC staff member on a household visit
In Bangladesh, the largest NGO in the world BRAC is working its way up to help the country to get proper sanitation. It has reached more than half of the population since the start 9 years ago. It is one of the world’s largest sanitation implementation programmes. IRC works with BRAC to make it happen. In this interview, IRC sanitation expert Ingeborg Krukkert tells her story about her work in Bangladesh. ”
Bangladesh is well on track to meet the Sustainable Development Goals in 2030,” says Ingeborg Krukkert in IRC’s headquarters in The Hague. “This is undeniably due to BRAC because it’s serving half of the country. Bangladesh is a good example for others on how to achieve so much in such a short time. It is proof that change is possible.”
IRC’s Sanitation and hygiene specialist for Asia, Ingeborg Krukkert, travels to Bangladesh every two months to work with BRAC. Working on hygiene promotion and behavior change, she complements BRAC’s groundbreaking programme with IRC’s monitoring system to measure and enhance the true impact in sanitation and hygiene. Continue reading