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Childhood undernutrition and growth impairment remain substantial burdens in Sub-Saharan Africa. Environmental enteric dysfunction (EED), a subclinical condition associated with inflammation and malabsorpition in the small intestine, is associated with growth failure. As several studies have demonstrated that individuals with low weight in early childhood are at risk for cardiometabolic disease later in life, NORCH Associate Director Dr. Christopher P. Duggan, NORCH member Dr. Wafaie Fawzi, and others recently investigated whether EED in infancy is associated with cardiovascular risk measures in mid-childhood. Anti-flagellin IgA is a marker for EED and is significantly higher in Tanzanian infants compared to infants in Boston. Drs. Duggan, Fawzie, et al. demonstrated that flagellin IgA at 6 weeks of age is associated with both systolic and diastolic blood pressure in mid-childhood (see Figure).


  • Locks LM, Mwiru RS, Mtisi E, Manji KP, McDonald CM, Liu E, Kupka R, Kisenge R, Aboud S, Gosselin K, Gillman M, Gewirtz AT, Fawzi WW, Duggan CP. Infant nutritional status and markers of environmental enteric dysfunction are associated with midchildhood anthropometry and blood pressure in Tanzania. J Pediatr. 2017 Aug;187:225-233.e1.

Research Details:

  • Research Center: Harvard Medical School
  • Featured NORC Member: Christopher P. Duggan, MD, MPH, Professor of Pediatrics, Harvard Medical School, and Professor in the Department of Nutrition, Harvard School of Public Health, and Wafaie W. Fawzi, MD, PhD, Professor of Nutrition, Epidemiology, and Global Health, Harvard School of Public Health.
  • Center contributions: Dr. Duggan is the Associate Director of the NORCH.

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