Environmental enteropathy is a subclinical condition among children in the developing world, characterized by T-cell infiltration of the small-bowel mucosa and diffuse villous atrophy.
Environmental enteropathy leads to macronutrient and micronutrient malabsorption and stunting, with a resultant increased risk for infection and reduced cognitive development.
Dr Mark Manary and colleagues from Missouri, USA tested the hypothesis that zinc and albendazole treatments would reduce the severity of environmental enteropathy in rural African children.
In a randomized, double-blind, placebo-controlled trial in rural southern Malawi, asymptomatic children, 1 to 3 years old and at high risk for environmental enteropathy, received either a single dose of albendazole, a 14-day course of 20 mg zinc sulfate, or a placebo.
|The mean baseline lactulose:mannitol was 0.32 among all children|
|Clinical Gastroenterology & Hepatology|
Subjects were given the dual-sugar absorption test, and the ratio of lactulose to mannitol (L:M) in urine was used to determine the severity of environmental enteropathy at baseline, and 34 days after completion of the assigned regimen.
The primary outcome was the change in the L:M.
A complete set of urine samples was obtained from 222 of 234 children enrolled and analyzed.
The team found that the mean baseline L:M was 0.32 among all children, and did not differ among groups.
The researchers observed that at the end of the study, the L:M ratio had increased more in the placebo group than in the zinc group or the albendazole group.
Dr Manary's team comment,s "Treatment with zinc or albendazole protects against a significant increase in the L:M ratio, a biomarker for environmental enteropathy, in asymptomatic rural Malawian children."
"These findings could provide insight into the etiology and pathogenesis of environmental enteropathy."