The Intestinal Pathobiome: Its Reality and Consequences Among Infants and Young Children in Resource-Limited Settings. Journal of Infectious Diseases Advance Access, October 9, 2013
E Ryan.
It seems that for infants in resource-limited areas, the norm is a chronic state of intestinal inflammation with villous blunting and intestinal leakage and malabsorption, a condition that plays into a cycle of malnutrition, micronutrient deficiencies, and growth impairment and results in cognitive delay, poor take of intestinal vaccines, and poor absorption of nutrients and critical medications. As death rates from diarrhea continue to fall globally, we must more fully recognize the repercussions and longitudinal morbidity associated with the polypathogen mix in the intestines of surviving infants and children, especially its relationship with environmental enteropathy.
The ultimate and optimal solution to all of these issues is safe water and adequate sanitation for all; however, with 0.8 billion individuals currently lacking safe water, and >2 billion currently lacking adequate sanitation, it will unfortunately take decades to reach such elusive goals of global equity. In the meantime, we as a global health community will have to ascertain more fully and then deal with the negative consequences of allowing a pathobiome to become the “normobiome” for so many infants and young children around the world.
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