title: Interactions between intestinal pathogens, enteropathy and malnutrition in developing countries.
abstract: This review focuses on recent data highlighting the interactions between intestinal pathogens, enteropathy and malnutrition in developing countries, which drive morbidity and mortality and hinder the long-term developmental potential of children.
  
  
  
  Diarrhoea remains the second commonest cause of death in children below 5 years, and malnutrition underlies 45% of all child deaths. Even in the absence of diarrhoea, subclinical pathogen carriage and enteropathy are almost universal in developing countries. Here, we review recent studies addressing the causes and consequences of diarrhoea; emerging data on environmental influences that govern postnatal development of the gut and microbiota; current concepts of environmental enteric dysfunction; and recent intervention trials in the field. We highlight the interactions between these processes, whereby intestinal pathogens drive a cycle of gut damage, malabsorption, chronic inflammation and failed mucosal regeneration, leading to malnutrition and susceptibility to further enteric infections.
  
  
  
  Efforts to improve child survival and long-term developmental potential need to address the overlapping and interacting effects of diarrhoea, enteropathy and malnutrition. Recent insights from human and animal studies suggest potential targets for intervention.
authors.affiliation: aBlizard Institute, Queen Mary University of London, London, UK bZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe cDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA dUniversity Teaching Hospital, Lusaka, Zambia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Prendergast
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
mesh_terms: D001419:Bacteria / Q000472:pathogenicity; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D003967:Diarrhea / Q000382:microbiology / Q000503:physiopathology; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000382:microbiology / Q000503:physiopathology; D044342:Malnutrition / Q000382:microbiology / Q000503:physiopathology