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The collaborative study by the University of Oxford and the international CHAIN Network was carried out across nine sites in six countries in sub-Saharan Africa and South Asia. The research was supported by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC) and the KEMRI-Wellcome Trust.
Childhood mortality remains unacceptably high in many low- and middle-income countries, where chronic gut inflammation and environmental enteric dysfunction (EED) are widespread.
The research team examined plasma lipopolysaccharide (LPS) —a molecule derived from groups of bacteria that colonise the human intestine.
They analysed blood samples from 638 acutely ill hospitalised children and compared them with 251 healthy peers from their communities. Their results revealed a striking pattern: higher plasma LPS levels were strongly associated with an increased risk of death within 90 days, even in those children who were not severely undernourished.
Children who did not survive and exhibited high LPS levels also showed signs of defective intestinal barrier function including increased harmful gut bacteria, and higher faecal and systemic markers of inflammation.
The findings were published in two papers in the journal Nature Communications.
Dr James Njunge of the KEMRI-Wellcome Trust Research Programme and a post-doctoral researcher with the CHAIN Network is one of the lead authors. He said: “In many low-resource settings, children have hidden damage to the gut lining – a kind of ‘leaky gut’ that routine clinic checks don’t detect. This allows bacteria and their toxins to seep into the bloodstream, driving chronic inflammation, poor growth and weaker responses to oral vaccines.
Read the full story on the NIHR Oxford Biomedical Research Centre website.