ReviewNature reviews. Gastroenterology & hepatology2013
The impoverished gut--a triple burden of diarrhoea, stunting and chronic disease.
Review in Nature reviews. Gastroenterology & hepatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07195006 (Early Life Diarrhoea Episode), which is not on this map. Cited by 338 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Life Diarrhoea Episode(s), Malnutrition, Environmental Enteric Dysfunction and Microbiome Trajectories From Birth Until 3 Years of Life ; The University of Zimbabwe Birth Cohort Study-2 (UZBCS-2)
Who cites it
338 citing papers in PubMed, 7 syntheses or guidelines pooled it, 602 citations in OpenAlex.
- Adherence to oral zinc supplementation in the management of acute diarrhoeal disease among under-5 children: A systematic review and meta-analysis.Epidemiology and infection · 2025Pooled it
- Systematic review of associations between gut microbiome composition and stunting in under-five children.NPJ biofilms and microbiomes · 2024Pooled it
- Roles of the gut microbiome in weight management.Nature reviews. Microbiology · 2023Pooled it
- Consequences of Shigella infection in young children: a systematic review.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Pooled it
- Interventions to improve sanitation for preventing diarrhoea.The Cochrane database of systematic reviews · 2023Pooled it
- A systematic review and meta-analysis of Penner serotype prevalence of Campylobacter jejuni in low- and middle-income countries.PloS one · 2021Pooled it
- Open defecation-free slippage and its associated factors in Ethiopia: a systematic review.Systematic reviews · 2020Pooled it
- A Pilot Study of Enterade (VS001), an Oral Amino Acid Formulation, in Malnourished Bangladeshi Children with Environmental Enteric Dysfunction.The American journal of tropical medicine and hygiene · 2025Trial
- Trial
- Trial
- Cognitive Outcomes at 18 Months: Findings from the Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT) Trial.The American journal of tropical medicine and hygiene · 2021Trial
- Effect of scheduled antimicrobial and nicotinamide treatment on linear growth in children in rural Tanzania: A factorial randomized, double-blind, placebo-controlled trial.PLoS medicine · 2021Trial
- Socio-cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes - a qualitative study.International journal for equity in health · 2021Trial
- Benefits and Costs of a Community-Led Total Sanitation Intervention in Rural Ethiopia-A Trial-Based ex post Economic Evaluation.International journal of environmental research and public health · 2020Trial
- Amino Acid Digestibility of Extruded Chickpea and Yellow Pea Protein is High and Comparable in Moderately Stunted South Indian Children with Use of a Dual Stable Isotope Tracer Method.The Journal of nutrition · 2020Trial
- Impact of Water Quality, Sanitation, Handwashing, and Nutritional Interventions on Enteric Infections in Rural Zimbabwe: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial.The Journal of infectious diseases · 2020Trial
- Multi-omics insights into growth impairment mechanisms in children with persistent diarrhea.Microbiology spectrum · 2026Article
- Regulation and Characterization of the Cex system of enteric pathogens: a pathway for the lipidation and secretion of noncanoncial bacterial lipoproteins.bioRxiv : the preprint server for biology · 2026Article
- Waterborne diseases and climate change.Nature reviews. Microbiology · 2026Review
- Prevalence of Malnutrition and Associated Factors Among School Children in Hawella Tula Rural District, Hawassa, Sidama Regional State, Ethiopia: A Cross-Sectional Study.Health science reports · 2026Article
278 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
More than one-fifth of the world's population live in extreme poverty, where a lack of safe water and adequate sanitation enables high rates of enteric infections and diarrhoea to continue unabated. Although oral rehydration therapy has greatly reduced diarrhoea-associated mortality, enteric infections still persist, disrupting intestinal absorptive and barrier functions and resulting in up to 43% of stunted growth, affecting one-fifth of children worldwide and one-third of children in developing countries. Diarrhoea in children from impoverished areas during their first 2 years might cause, on average, an 8 cm growth shortfall and 10 IQ point decrement by the time they are 7-9 years old. A child's height at their second birthday is therefore the best predictor of cognitive development or 'human capital'. To this 'double burden' of diarrhoea and malnutrition, data now suggest that children with stunted growth and repeated gut infections are also at increased risk of developing obesity and its associated comorbidities, resulting in a 'triple burden' of the impoverished gut. Here, we Review the growing evidence for this triple burden and potential mechanisms and interventions that must be understood and applied to prevent the loss of human potential and unaffordable societal costs caused by these vicious cycles of poverty.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.