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1. Factors Associated with Carriage of Enteropathogenic and Non-Enteropathogenic Viruses: A Reanalysis of Matched Case-Control Data from the AFRIBIOTA Site in Antananarivo, Madagascar

Author

Iony Manitra Razanajatovo, Lova Andrianomiadana, Azimdine Habib, Mirella Malala Randrianarisoa, Helisoa Razafimanjato, Maheninasy Rakotondrainipiana, Prisca Andriantsalama, Ravaka Randriamparany, Soa Fy Andriamandimby, Pascale Vonaesch, Philippe Jean Sansonetti, Vincent Lacoste, Rindra Vatosoa Randremanana, Jean-Marc Collard, Jean-Michel Heraud, and on behalf of the Afribiota Investigators

Subjects
enteric viruses, stunting, Madagascar, Africa, Medicine
Abstract

Environmental Enteric Dysfunction (EED) is an associate driver of stunting in poor settings, and intestinal infections indirectly contribute to the pathophysiology underlying EED. Our work aimed at assessing whether enteric viral carriage is determinant to stunting. A total of 464 healthy and asymptomatic children, aged 2 to 5 years, were recruited, and classified as non-stunted, moderately stunted, or severely stunted. Among the recruited children, 329 stool samples were obtained and screened for enteric and non-enteric viruses by real-time polymerase chain reaction. We statistically tested for the associations between enteric viral and potential risk factors. Approximately 51.7% of the stool samples were positive for at least one virus and 40.7% were positive for non-enteric adenoviruses. No statistical difference was observed between virus prevalence and the growth status of the children. We did not find any statistically significant association between viral infection and most of the socio-demographic risk factors studied, except for having an inadequate food quality score or an over-nourished mother. In addition, being positive for Ascaris lumbricoides was identified as a protective factor against viral infection. In conclusion, we did not find evidence of a direct link between stunting and enteropathogenic viral carriage in our population.

Published
2023
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2. Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic

Author

Pascale, Vonaesch, Serge Ghislain, Djorie, Kaleb Jephté Estimé, Kandou, Maheninasy, Rakotondrainipiana, Laura, Schaeffer, Prisca Vega, Andriatsalama, Ravaka, Randriamparany, Bolmbaye Privat, Gondje, Synthia, Nigatoloum, Sonia Sandrine, Vondo, Aurélie, Etienne, Annick, Robinson, Francis Allen, Hunald, Lisette, Raharimalala, Tamara, Giles-Vernick, Laura, Tondeur, Frédérique, Randrianirina, Alexandra, Bastaraud, Jean-Chrysostome, Gody, Philippe Jean, Sansonetti, Rindra Vatosoa, Randremanana, Inès, Vigan-Womas, Pathogénie microbienne moléculaire, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur de Bangui, Réseau International des Instituts Pasteur (RIIP), Unité d'Epidémiologie [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Centre pédiatrique de Bangui, Centre Hospitalier Universitaire Mère-Enfant de Tsaralalàna (CHUMET), Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA), Anthropologie et écologie de l’émergence des maladies - Anthropology and Ecology of Disease Emergence, Institut Pasteur [Paris], Centre de Biologie Clinique [Antananarivo] (IPM), Laboratoire d'hygiène des aliments et de l'environnement [Antananarivo, Madagascar] (IPM), Unité d’Épidémiologie et de Recherche clinique [Antananarivo, Madagascar], The epidemiological part of AFRIBIOTA was funded by the Total Foundation and the Fondation Petram. PV was supported by an Early Postdoctoral Fellowship (Grant No. P2EZP3_152159), an Advanced Postdoctoral Fellowship (Grant No. P300PA_177876) as well as a Return Grant (Grant No. P3P3PA_17877) from the Swiss National Science Foundation, a Roux-Cantarini Fellowship (2016) and a L’Oréal-UNESCO for Women in Science France Fellowship (2017). PJS is a HHMI Senior Foreign Scholar. The funders had no role in study design or collection, analysis, and interpretation of data and in writing this manuscript., AFRIBIOTA Investigators: Laurence Barbot-Trystram, Hôpital Pitié-Salpêtrière, Paris, France, Robert Barouki, Hôpital Necker-Enfants maladies, Paris, France, Alexandra Bastaraud, Institut Pasteur de Madagascar, Antananarivo, Madagascar, Jean-Marc Collard, Institut Pasteur de Madagascar, Antananarivo, Madagascar, Maria Doria, Institut Pasteur, Paris, France, Aurélie Etienne, Institut Pasteur, Paris, France/Institut Pasteur de Madagascar, Madagascar, Serge Ghislain Djorie, Institut Pasteur de Bangui, Bangui, Central African Republic, Tamara Giles-Vernick, Institut Pasteur, Paris, France, Bolmbaye Privat Gondje, Complexe Pédiatrique de Bangui, Bangui, Central African Republic, Jean-Chrysostome Gody, Complexe Pédiatrique de Bangui, Bangui, Central African Republic, Francis Allen Hunald, Service de Chirurgie pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU-JRA), Antananarivo, Madagascar, Nathalie Kapel, Hôpital Pitié-Salpêtrière, Paris, France, Jean-Pierre Lombart, Institut Pasteur de Bangui, Bangui, Central African Republic, Alexandre Manirakiza, Institut Pasteur de Bangui, Bangui, Central African Republic, Synthia Nazita Nigatoloum, Complexe Pédiatrique de Bangui, Bangui, Central African Republic, Lisette Raharimalala, Centre de Santé Materno-Infantile, Tsaralalana, Antananarivo, Madagascar, Maheninasy Rakotondrainipiana, Institut Pasteur de Madagascar, Antananarivo, Madagascar, Rindra Randremanana, Institut Pasteur de Madagascar, Antananarivo, Madagascar, Harifetra Mamy Richard Randriamizao, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU-JRA), Antananarivo, Madagascar, Frédérique Randrianirina, Institut Pasteur de Madagascar, Antananarivo, Madagascar, Annick Robinson, Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, Antananarivo, Madagascar, Pierre-Alain Rubbo, Institut Pasteur de Bangui, Bangui, République Centrafricaine, Philippe Sansonetti, Institut Pasteur, Paris, France, Laura Schaeffer, Institut Pasteur, Paris, France, Ionela Gouandjika-Vassilache, Institut Pasteur de Bangui, Bangui, République Centrafricaine, Pascale Vonaesch, Institut Pasteur, Paris, France, Sonia Sandrine Vondo, Complexe Pédiatrique de Bangui, Bangui, Central African Republic, Inès Vigan-Womas, Institut Pasteur de Madagascar, Antananarivo, Madagascar. We wish to thank further all families and fieldworkers who contributed to this study, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), and Vigan-Womas, Inès

Subjects
[SDV.IMM] Life Sciences [q-bio]/Immunology, Stunted growth, Nutritional Status, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Article, MESH: Madagascar, MESH: Pregnancy, Pregnancy, MESH: Risk Factors, MESH: Child, Prevalence, Madagascar, Humans, Child, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Children, Growth Disorders, MESH: Prevalence, MESH: Humans, digestive, oral, and skin physiology, MESH: Child, Preschool, Infant, Undernutrition, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, MESH: Growth Disorders, MESH: Nutritional Status, MESH: Case-Control Studies, MESH: Infant, Central African Republic, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Risk factors, MESH: Central African Republic, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Child, Preschool, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Abstract

Objectives With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-021-03201-8.

Published
2021

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