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MAL-ED: Management, Analysis and Publication of 0-24 and 25-60 Month Data (Anthropometry and Cognitive Development)

Laura Murray-KolbPI: Laura Murray-Kolb

Fogarty International Center
Administered in: College of Health and Human Development

Abstract:

Globally, malnutrition and enteric diseases are among the most prevalent risk factors for morbidity and mortality in children under the age of five. The MAL-ED Network study, conducted across eight geographically, socioeconomically, and culturally diverse populations, seeks to determine the effects of exposures to enteric infections, malnutrition and associated gut dysfunction in early childhood on subsequent physical growth, cognitive development, and immune responses to childhood vaccines.  Using a common protocol at each MAL-ED Network field site, children are followed from birth and assessed for a variety of exposures and outcomes in an effort to identify and characterize associations with growth and development shortfalls that are prevalent in less well developed regions.

MAL-ED aims to better qualify and quantify the gut/microbe interactions in the individual host and populations in resource poor environments. One of the underlying hypotheses for the project is that the effects of malnutrition and enteric infections are mechanistically associated with changes in gut function, including malabsorption and inflammation, resulting in a condition known as environmental enteric dysfunction (EED). The project was designed to identify associations among growth faltering and exposures related to specific enteric infections, non-specific fever and respiratory illness, nutritional practices and physiological conditions that occur in early childhood and to assess the validity of currently used and novel biomarkers of EED and to identify potential interventions at critical time points in early life. The MAL-ED study complements, yet is distinct from, other Bill & Melinda Gates Foundation (BMGF)-supported studies on disease burden by virtue of its longitudinal design with high temporal resolution and by its emphasis on infancy and early childhood community-acquired infection, clinical illness, dietary intake and gut dysfunction, and on their associations with growth, morbidity, cognitive development and immune responses to vaccines in resource poor communities.

We anticipate that the findings of the MAL-ED study will help elucidate age-specific times during infancy and/or early childhood for targeting interventions that could mitigate the consequences of environmental factors (e.g., exposure to enteric pathogens, extent of antibiotic use, SES, infant feeding patterns, diet adequacy and diversity, home environment, availability of health care, etc.) that impact health and well-being. Although we anticipate that certain factors may be common across all sites and may help to identify universally appropriate targets for intervention, we also expect to identify site specific exposures that may provide opportunities for targeted interventions. These findings will inform public health decision making and future biomedical research including the design of intervention studies.

Research Staff

Graduate Student