ArticlePLoS neglected tropical diseases2022
High prevalence of small intestine bacteria overgrowth and asymptomatic carriage of enteric pathogens in stunted children in Antananarivo, Madagascar.
Article in PLoS neglected tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Enteric infections and childhood stunting: a systematic review and meta-analysis across four pathogen domains.Pediatric research · 2026Pooled it
- Effects of lipid-based nutrient supplements on gut markers in stunted children: Secondary analysis of a randomised trial.Journal of pediatric gastroenterology and nutrition · 2025Trial
- Longitudinal Analysis of the Intestinal Microbiota among a Cohort of Children in Rural and Urban Areas of Pakistan.Nutrients · 2023Trial
- Salivary Microbiome Differences in Stunted and Healthy Children: A Metagenomic Analysis.European journal of dentistry · 2026Article
- Chronic exposure to intestinal parasites and bacterial enteropathogens among children in rural Madagascar: Implications for asymptomatic carriage and co-infections.PLoS neglected tropical diseases · 2026Article
- Article
- Socioeconomic and nutritional determinants outweigh gut microbiota influence on neurodevelopment in young children from Antananarivo, Madagascar.Scientific reports · 2026Article
- Delving the depths of 'terra incognita' in the human intestine - the small intestinal microbiota.Nature reviews. Gastroenterology & hepatology · 2025Review
- Small Intestinal Bacterial Overgrowth and Childhood Malnutrition: A Comprehensive Review of Available Evidence.Nutrients · 2024Review
- Postnatal supplementation with alarmins S100a8/a9 ameliorates malnutrition-induced neonate enteropathy in mice.Nature communications · 2024Article
- Cellular and molecular basis of proximal small intestine disorders.Nature reviews. Gastroenterology & hepatology · 2024Review
- Enteric pathogens relationship with small bowel histologic features of environmental enteric dysfunction in a multicountry cohort study.The American journal of clinical nutrition · 2024Article
- Microbial imbalance in Chinese children with diarrhea or constipation.Scientific reports · 2024Article
- Risk factors for food contamination among children discharged from community management of acute malnutrition programmes in South Sudan: A cross-sectional study and hazard analysis critical control point approach.Maternal & child nutrition · 2024Article
- Ectopic colonization by oral bacteria as an emerging theme in health and disease.FEMS microbiology reviews · 2024Review
- Epithelial Cell Infection Analyses with Shigella.Journal of visualized experiments : JoVE · 2024Article
- The relationship between small intestinal bacterial overgrowth and constipation in children - a comprehensive review.Frontiers in cellular and infection microbiology · 2024Review
- A foundational approach to culture and analyze malnourished organoids.Gut microbes · 2023Article
- Shigella Serotypes Associated With Carriage in Humans Establish Persistent Infection in Zebrafish.The Journal of infectious diseases · 2023Article
- Shigella and childhood stunting: Evidence, gaps, and future research directions.PLoS neglected tropical diseases · 2023Review
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Environmental Enteric Dysfunction (EED) refers to an incompletely defined syndrome of inflammation, reduced absorptive capacity, and reduced barrier function in the small intestine. It is widespread among children and adults in low- and middle-income countries and is also associated with poor sanitation and certain gut infections possibly resulting in an abnormal gut microbiota, small intestinal bacterial overgrowth (SIBO) and stunting. We investigated bacterial pathogen exposure in stunted and non-stunted children in Antananarivo, Madagascar by collecting fecal samples from 464 children (96 severely stunted, 104 moderately stunted and 264 non-stunted) and the prevalence of SIBO in 109 duodenal aspirates from stunted children (61 from severely stunted and 48 from moderately stunted children). SIBO assessed by both aerobic and anaerobic plating techniques was very high: 85.3% when selecting a threshold of ≥105 CFU/ml of bacteria in the upper intestinal aspirates. Moreover, 58.7% of the children showed more than 106 bacteria/ml in these aspirates. The most prevalent cultivated genera recovered were Streptococcus, Neisseria, Staphylococcus, Rothia, Haemophilus, Pantoea and Branhamella. Feces screening by qPCR showed a high prevalence of bacterial enteropathogens, especially those categorized as being enteroinvasive or causing mucosal disruption, such as Shigella spp., enterotoxigenic Escherichia coli, enteropathogenic E. coli and enteroaggregative E. coli. These pathogens were detected at a similar rate in stunted children and controls, all showing no sign of severe diarrhea the day of inclusion but both living in a highly contaminated environment (slum-dwelling). Interestingly Shigella spp. was the most prevalent enteropathogen found in this study (83.3%) without overrepresentation in stunted children.
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Registered trials
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