Clinical Infectious Diseases Publishes MAL-ED Goals, Methods and Site-specific Characteristics

Inadequate nutrition has been associated with half of deaths worldwide in children under age five. In addition, write investigators from the MAL-ED Network in a special section of the November 1 edition of Clinical Infectious Diseases, the long-term effects of “undernutrition” in young children “have been associated with cognitive and physical growth deficits across multiple generations and have been thought to suppress immunity to further infections and to reduce the efficacy of childhood vaccines.”

MAL-ED, a project supported by the Bill & Melinda Gates Foundation and led by the Foundation for the National Institutes of Health and the NIH Fogarty International Center, has sites in eight countries with historically high incidence of undernutrition and diarrheal disease. Researchers are studying factors such as enteric infections and other illness indicators, diet and micronutrient levels, socioeconomic status, gut function, and the environment to determine the interrelationships among these factors and their impact on outcomes such as physical growth, cognitive development and vaccine response in the first two years of life, in unprecedented detail. Central to the study is the hypothesis that enteropathogen infection causes intestinal inflammation leading to inadequate functioning of the gut for nutrient absorption, and producing a child that is undernourished and that may suffer from the consequences of undernutrition.

The 19 articles in the special section (freely available at http://cid.oxfordjournals.org/content/59/suppl_4.toc) look at the characteristics of each study site in resource-poor environments in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and Tanzania along with methods utilized for the project.