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Effect of a Homestead Food Production and food hygiene intervention on biomarkers of environmental enteric dysfunction in children under 24 months in rural Bangladesh: A cluster-randomized controlled trial

Authors
/persons/resource/anna.mueller

Müller-Hauser,  Anna
Potsdam Institute for Climate Impact Research;

Huda,  Tarique Md. Nurul
External Organizations;

/persons/resource/shafinaz

Sobhan,  Shafinaz
Potsdam Institute for Climate Impact Research;

/persons/resource/Nathalie.Lambrecht

Lambrecht,  Nathalie
Potsdam Institute for Climate Impact Research;

/persons/resource/waid

Waid,  Jillian Lee
Potsdam Institute for Climate Impact Research;

/persons/resource/Amanda.Wendt

Wendt,  Amanda
Potsdam Institute for Climate Impact Research;

Ali,  Shahjahan
External Organizations;

Rahman,  Mahbubur
External Organizations;

/persons/resource/gabrysch

Gabrysch,  Sabine
Potsdam Institute for Climate Impact Research;

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Citation

Müller-Hauser, A., Huda, T. M. N., Sobhan, S., Lambrecht, N., Waid, J. L., Wendt, A., Ali, S., Rahman, M., Gabrysch, S. (2023): Effect of a Homestead Food Production and food hygiene intervention on biomarkers of environmental enteric dysfunction in children under 24 months in rural Bangladesh: A cluster-randomized controlled trial. - American Journal of Tropical Medicine and Hygiene, 109, 5, 1166-1176.
https://doi.org/10.4269/ajtmh.23-0153


Cite as: https://publications.pik-potsdam.de/pubman/item/item_29279
Abstract
Poor sanitation and hygiene practices and inadequate diets can contribute to environmental enteric dysfunction (EED). We evaluated the impact of a combined homestead food production and food hygiene intervention on EED biomarkers in young children in rural Bangladesh. The analysis was conducted within the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial in Sylhet, Bangladesh. The FAARM trial enrolled 2,705 married women and their children younger than 3 years of age in 96 settlements (geographic clusters): 48 intervention and 48 control. The 3-year intervention (2015–2018) included training on gardening, poultry rearing, and improved nutrition practices and was supplemented by an 8-month food hygiene behavior change component, implemented from mid-2017. We analyzed data on 574 children age 0 to 24 months with multilevel linear regression. We assessed fecal myeloperoxidase (MPO), neopterin (NEO), and alpha-1-antitrypsin (AAT) as biomarkers of EED, and serum C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) as biomarkers of systemic inflammation, using ELISA. There was no intervention effect on NEO, AAT, CRP, and AGP concentrations, but, surprisingly, MPO levels were increased in children of the intervention group (0.11 log ng/mL; 95% CI, 0.001–0.22). This increase was greater with increasing child age and among intervention households with poultry that were not kept in a shed. A combined homestead food production and food hygiene intervention did not decrease EED in children in our study setting. Small-scale poultry rearing promoted by the intervention might be a risk factor for EED.