School of Public Health - International Health
Democratic Republic of the Congo
Democratic Republic of the Congo-Evaluation of a Baby WASH Intervention to Reduce Environmental Enteropathy and Impaired Growth in Young Children in Democratic Republic of the Congo
The Democratic Republic of the Congo (DRC) is the second largest country in Africa. In South Kivu Province 54% of children under five years are stunted. Undernutrition is estimated to be an underlying cause of death of over half of young children globally. This decline in nutritional status is thought to be greatest during the first 2 years of life. There is a growing evidence base demonstrating an association between stunting and environmental enteropathy (EE).This disorder is defined by abnormal intestinal morphology, including villous atrophy and crypt hyperplasia, which leads to reduced intestinal barrier function and increased inflammation. EE is thought to arise from unsanitary environmental conditions that lead to repeated exposure to enteric pathogens causing chronic infections. In our recent prospective cohort study in Bangladesh, we found childhood mouthing behavior, close contact with animals, and caregiver hygiene to be important risk factors for EE and impaired growth in young children. Building on this previous work in partnership with Food for the Hungry, the objective of this project is to develop and evaluate interventions to reduce pediatric exposures to fecal pathogens and thereby reduce environmental enteropathy and impaired growth among this highly susceptible population. Johns Hopkins University will lead the formative research and prospective cohort study that will inform intervention development, and direct a randomized controlled trial of the developed intervention approaches in South Kivu, DRC.
PI Mentor: Christine Marie George