Infections are common and inextricably linked to nutrition in low-income countries. Our work is focused on two axes of research. The first line involves iron deficiency, infection and inflammation. Concerns that iron interventions can increase the burden of infectious diseases, notably malaria, have been a barrier to scaling up iron interventions.
Conversely, infections cause iron deficiency through blood loss and inflammation, and complicate the diagnosis of iron deficiency. Evidence is growing that infection-induced inflammation, even at low-grade levels, impairs the efficacy of iron interventions in Africa. The second line concerns gut pathogens, inflammation and child growth.
Recent studies indicate that nutritional interventions (including vitamin A and zinc supplementation, balanced energy protein supplementation, complementary feeding, breastfeeding promotion, and prenatal micronutrient supplementation) have limited efficacy in reducing the prevalence of stunting in young children in developing countries. This poor growth response to nutritional interventions may be due to ‘environmental enteropathy’, i.e., a condition of chronic inflammation of the gastrointestinal tract, induced by gut infections that is associated with structural changes in the small bowel, increased intestinal permeability, impaired gut immune function, and malabsorption of nutrients.
Iron deficiency anaemia in sub-Saharan Africa : a review of current evidence and primary care recommendations for high-risk groupsThe Lancet Haematology 8 (2021)10. - p. e732 - e743.
Safety and benefits of antenatal oral iron supplementation in low-income countries : A reviewBritish Journal of Haematology 177 (2017)6. - ISSN 0007-1048 - p. 884 - 895.
Effect of daily antenatal iron supplementation on plasmodium infection in Kenyan women. A randomized clinical trialJAMA: The Journal of the American Medical Association 314 (2015)10. - ISSN 0098-7484 - p. 1009 - 1020.
Effect of preventive supplementation with zinc and other micronutrients on non-malarial morbidity in Tanzanian pre-school children: a randomized trialPLoS ONE 7 (2012)8. - ISSN 1932-6203