Sociodemographic factors of Environmental Enteropathy among Egyptian infants and children; A Retrospective Case–Control Study
May Fouad Nassar (1), Ehab Khairy Emam (1),
Mohamed Farouk Allam (2), Ahmed Mohamed Hamdy (3), Bassma A Abdelhaleem (1),
Nehal Ahmed Radwan (4), Abeer Mohamed Emam (1), Haya Essam Ibrahim (1)
1. Department of Pediatrics, Pediatric
Clinical Nutrition Unit, Faculty of Medicine, Ain Shams University, Egypt.
2. Department of Family Medicine,
Faculty of Medicine, Ain Shams University, Egypt.
3. Department of Pediatrics, Pediatric
Gastroenterology Unit, Faculty of Medicine, Ain Shams University, Egypt.
4. Department of Pathology, Faculty of
Medicine, Ain Shams University, Egypt.
Clin Ter 2026; 177 (3):525-531. doi:
10.7417/CT.2026.2037
Abstract
Background. There is substantial evidence that nutritional
rehabilitation does not effectively resolve growth faltering in low- and
middleincome countries, suggesting that environmental enteropathy (EE) may be a
key underlying factor. EE is a chronic, subclinical condition associated with
poor environmental conditions and limited resources in these regions. It is
marked by pathological changes in the small intestine that impair the
absorption of both macronutrients and micronutrients, ultimately contributing
to growth faltering.
Objective. to assess the sociodemographic factors underlying
the EE among infants and children with faltering growth (FG) in our community.
Patients and methods. This retrospective case control study enrolled 200 cases of primary
faltering growth infants and children aged from 6 months to 5 years old after
exclusion of secondary cases. Enrolled patients were divided into refractory
cases and responsive cases to nutritional rehabilitation programs and
sociodemographic factors were assessed among the 2 groups. No routine endoscopy
was done nor existing histopathology findings were available.
Results. The results of this study revealed that out of the 200 enrolled patients
170 responded to the tailored nutritional program (responsive controls), while
30 patients were considered as refractory cases. On comparing the two groups,
there were significantly higher frequencies of housewife mothers, non-skilled
manual worker fathers, rural and slum residency, and low socioeconomic status
among the refractory cases with p-values of 0.024, 0.002, 0.022, and 0.045
respectively.
Conclusion. Malnutrition is a complex condition with multifactorial causes, including
socioeconomic factors besides the deficiencies in protein, energy, and
essential micronutrients. In developing countries, EE is recognized as a
significant contributor to the burden of malnutrition percolating their
response to the nutritional rehabilitation program. Non-responders to
nutritional rehabilitation program should be referred for endoscopy to confirm
the diagnosis of EE.
Keywords: Pediatric Malnutrition, Growth Faltering, Sociodemographic factors.
https://www.clinicaterapeutica.it/ojs/index.php/1/article/view/1555/1041
